Electronic Case Reporting (eCR)

Declaration of Readiness

Montana Department of Health and Human Services (DPHHS) has officially declared readiness to receive electronic case reports (eCRs) to fulfill the CMS Promoting Interoperability Program (PIP) and Merit-Based Incentive Program (MIPS) requirements for eCR within the Public Health and Clinical Data Exchange Objective. 

DPHHS is actively onboarding healthcare organizations for eCR. Contact eCR@mt.gov for more information.

What is Electronic Case Reporting (eCR)?

Electronic Case Reporting

Electronic Case Reporting (eCR) is the automated generation and transmission of case reports from electronic health records (EHRs) to the appropriate public health agencies (PHAs) for disease tracking, case investigating, and contact tracing. The reports sent are referred to as electronic initial case reports (eICRs) since some are the first ‘initial’ report sent by providers with diagnoses or suspect diagnoses, and further investigation might be needed before case status is determined by the PHA.  

Reportability Response (RR)

To confirm delivery of eICRs to PHA(s) providers and PHAs will receive a reportability response (RR) with information concerning: (1) condition(s) reported, (2) PHA(s) who received eICR, and (3) optional information from the PHA (i.e., timeframe which reporting is required, whether the eICR was delivered based on the “Patient home address” or “Provider facility address”, treatment information, factsheets, etc.).

Benefits of eCR

  • Fulfills Montana’s mandated provider reporting requirementsfor reportable diseases and other conditions  
  • Improves timeliness of data transmission to public health 
  • Reduces the burden of manual care reporting on healthcare providers and public health  
  • More complete data (e.g., demographics and social history) 
  • Bidirectional data exchange between healthcare providers and public health
  • Streamlines reporting to all applicable jurisdictions automatically 

eCR Requirements

A checklist will soon be provided that details the requirements that must be completed by healthcare organizations (HCOs) and EHRs prior to engaging with CDC’s eCR Onboarding Team.

For more information about getting started with eCR please visit the CDC eCR website.

 

All CMS Promoting Interoperability Program (PIP) and Merit-Based Incentive Program (MIPS) participants are required to register their intent to implement eCR with DPHHS. Please complete the Promoting Interoperability Registration form with DPHHS or email eCR@mt.gov to inquire about registration status. 

Registration is only required once; however, re-registration is required if change in EHR vendor occurs. 

DPHHS uses Health Level 7 (HL7) eICR and RR standards for eCR. Please ensure that your Electronic Health Record (EHR) or Health IT product can support at least one of the HL7 implementation guides shown below:

 Starting January 1st, 2027, DPHHS will require all eCR senders to utilize the HL7 CDA R3.1.1 or FHIR standard.

Work with your EHR vendor, CDC eCR Onboarding Team, and APHL to implement eCR within EHR system and connect with Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS).   

To complete APHL Onboard the sender must meet the eCR Consensus Criteria that has identified completeness and threshold requirements for priority data elements.

Starting July 1st, 2026, DPHHS will require that new onboarding senders utilize the HL7 CDA R3.1.1 or FHIR standard.

Participating eCR senders are required to utilize APHL Informatics messaging Services (AIMS) platform to transmit eICRs to DPHHS. AIMS is a secure, cloud-based platform that receives, processes, and delivers eICRs to the appropriate jurisdiction(s). All 50 states along with some territories and local jurisdictions have connections with AIMS to receive eICRs. For more information on AIMS and their role in eCR please visit their website.  

AIMS uses a tool called the Reportable Conditions Knowledge Management System (RCKMS) to determine the reportability and appropriate jurisdictions to send eICRs. The trigger codes within the eICR are compared against the reporting specifications authored by PHA jurisdiction to determine reportability and jurisdiction(s) to deliver the eICR.  

Any senders utilizing the eCR Now FHIR App must update to the latest version at least annually. Release information can be found here: Releases · drajer-health/eCRNow [github.com]. 

Senders must conduct full triggering of eICRs (i.e., triggering for all conditions) by implementing Electronic Reporting and Surveillance Distribution (eRSD) version 3 or higher.

After completion of eCR onboarding and receiving approval from APHL, CDC, and DPHHS eCR Teams the HCO will move into PHA Validation phase with Montana. While production eICRs will be received by DPHHS they will not be ingested into the production environment of our surveillance system while data validations are being conducted. During this phase Montana’s eCR team will conduct data validation and provide feedback on any necessary changes before processing the eICRs into our surveillance production environment 

DPHHS will email applicable healthcare organizations/facilities that manual reporting methods can discontinue for specific conditions once: (1) eICRs are being processed into the production environment of our surveillance system, (2) eICR data has been validated, and (3) any identified issues have been addressed/fixed.  

 Please note that DPHHS will be implementing conditions into the production environment on a rolling basis.    

Latest Updates 

Montana DPHHS has established a connection with AIMS to receive eICRs; however, is currently working on implementing eCR into the production environment of our National Electronic Disease Surveillance System (NEDSS) Base System (NBS). Manual reporting methods for all reportable conditions must continue at this time.  

All interested and capable healthcare organizations and providers are encouraged to implement eCR to eventually replace manual reporting methods.  

Promoting Interoperability 

The EHR reporting period for CY 2026 runs from January 1st – December 31st, 2026. The period must be 180 consecutive days. For more information about Promoting Interoperability please visit the DPHHS Promoting Interoperability webpage or the CMS Promoting Interoperability webpage. MIPS participants can view more information on electronic case reporting requirements and criteria for exclusions.  

Attestation letters can be requested here and letters will be sent out in January 2027 for CY2026 participation. Please be aware that Montana DPHHS does not provide exclusion letters for PI or MIPS participants. 

Current EHR/ Health IT products approved for general healthcare organization onboarding for eCR according to the CDC: 

To view the list of EHR systems that have been approved for general eCR onboarding, visit the CDC eCR Getting Started page. Please be aware that inclusion on the CDC list does not guarantee approval for facilities located in Montana. Montana DPHHS must independently approve each EHR system before onboarding can begin for Montana facilities. This determination is based on any known issues with the EHR system and its ability to meet the data quality requirements of the eCR Consensus Criteria. If you have questions about whether your EHR is approved to begin eCR onboarding with the APHL/CDC team, please email eCR@mt.gov"

For more information about eCR implementation capabilities and options please inquire further with your EHR vendor and visit the CDC eCR website for the most up to date EHR vendor information.

Resources

 

Contact Information

Kristen Merrell, MPH 

eCR Coordinator Epidemiologist 

Kristen.Merrell@mt.gov 

eCR@mt.gov