Electronic Reporting

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Electronic Laboratory Reporting

Electronic Laboratory Reporting (ELR) is the process of obtaining automated, electronic feeds of laboratory reports from participating providers and facilities for monitoring notifiable conditions as part of public health surveillance and preparedness activities. The Houston Electronic Disease Surveillance System (HEDSS) receives ELRs from hospitals, clinics, and laboratories.

Receiving ELRs improves the quality (accuracy, completeness, consistency) of lab data in HEDSS and consequently improves the efficiency and effectiveness of Houston Health Department surveillance and outbreak response.

Find the full list of notifiable conditions to report in Texas.

ELR also fulfills eligible hospitals’ public health requirements for promoting interoperability. 

Electronic Case Reporting (eCR)

Electronic Case Reporting (eCR) is the automatic, real-time transmission of clinical data from health care providers to public health for the purpose of disease control. An eCR moves data quickly, seamlessly, and securely from a provider's Electronic Health Record (EHR) system to the appropriate public health agency. Chapter 81 of the Texas Health and Safety Code requires that a jurisdictional Health Authority (represented by the local public health department) is to be provided specific information regarding notifiable conditions for the purpose of disease control. Health care providers, hospitals, laboratories, schools, and others are required to report patients who are suspected of having a notifiable condition. Electronic Case Reporting enables healthcare providers to fulfill these mandatory reporting requirements efficiently and in a timely manner.

Find the full list of notifiable conditions to report in Texas.

NOTE: While eCRs save time and effort for routine reporting, there are some infectious conditions that demand prompt action from the health department. When, for example, invasive meningococcal infection, measles, rabies, or a CDC Class A/B bioweapon, etc. is confirmed or suspected, health providers must contact the HHD Bureau of Epidemiology by telephone immediately at 832-393-5080. All immediately notifiable conditions are highlighted in red under "Notifiable Conditions List: Color (PDF)".

Declaration of eCR readiness (Nov. 1, 2021)

The Houston Health Department will continue accepting eCR data for selected Texas notifiable conditions. All facilities should continue reporting notifiable conditions through their current routes and processes until notified otherwise by HHD.

Requirements for eligible providers

If you’re in Houston: Houston Health Department uses the HL7 electronic initial case report (eICR) standards (R1.1 and R3) for electronic case reporting (eCR) and to support the new CMS Promoting Interoperability regulations for eCR. It is these standards that we will use to eventually eliminate manual reporting requirements. We also require the use of APHL AIMS and the Reportable Condition Knowledge Management System (RCKMS) to ensure appropriate reporting.

Please contact HHD to confirm eligibility, schedule an onboarding phone call, or to discuss the process further. Contact HHD about eCR by email here: eCR@houstontx.gov

eCR data categories

 The specific categories of medical information* included in an eCR are:

  • Provider details and contact information
  • Visit details including location
  • Reason for visit (narrative)
  • Problem list (current and historical)
  • Laboratory results**
  • Administered medications
  • Plan of treatment
  • Procedures
  • Immunization history
  • Social history includes:
    • Employment
    • Travel history
    •  Tobacco use
    • Alcohol use
    • Pregnancy information
    • Sex assigned at birth
  • Patient financials and insurance
  • Billing details/coding
  • Diagnostic imaging
  • Advance directives
  • Room transfers

*A full description of data elements contained in an eCR can be found in the HL7 CDA® R2 eICR STU Release 1.1 or 3.1 messaging guide.

  • Originating laboratory name/CLIA
  • Specimen ID, type/source/volume, date, received date
  • Test and result codes (LOINC/SNOMED)
  • Antibiotic susceptibility
  • Ordering provider

As such, eCRs are not a substitute for Electronic Lab Reports (ELRs) for notifiable conditions. Hospitals and commercial laboratories must continue to send ELRs to public health.