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Background

With the broad adoption of electronic health records (EHRs), public health has the opportunity to take advantage of the availability of electronic health data to improve surveillance. Today, many clinical care providers use manual mechanisms (e.g., fax, web form, email or mailed paper forms) to report cases of reportable and nationally notifiable diseases and conditions to public health authorities. Manual reporting creates a burden on both the clinical provider and public health and increases opportunities for data errors. Much of the data needed for the case report exists in the patient’s EHR. Automating building and sending of case reports with EHR technologies promises to reduce the burden of reporting while improving data accuracy, timeliness and completeness.

Sexually transmitted infections

Sexually transmitted infections (STIs) account for the majority of the reportable condition case reports received by state and local public health agencies. In 2018, more than 2.3 million cases of Chlamydia trachomatis and Neisseria gonorrhoeae infections were reported to the Centers for Disease Control and Prevention (CDC). STI cases account for approximately 85% of notifiable infectious condition reports each year; the disease with the next greatest number of reported cases is campylobacteriosis at 70,200 in 2018. Clearly, automating STI reporting warrants particular attention.

Electronic case reporting can help!

Leveraging EHR data for case reporting of chlamydia and gonorrhea alone can dramatically lessen the burden of notifiable disease surveillance for clinicians and public health agencies alike. In recent years, timeliness of reporting has improved because public health departments began receiving electronic reports of laboratory test results for reportable conditions from various laboratories. However, this electronic laboratory reporting (ELRs) often lacks treatment information and case demographic data that are crucial for tracking disease trends and developing public health responses. Case reports sent automatically from EHRs can further improve data quality through more complete reports and by fulfilling reporting requirements when ELRs and paper-based reports are not provided to public health.

While sending a case report by fax or web form involves electronic communications, the term electronic case reporting (eCR) refers specifically to the approach whereby an EHR or intermediary system (e.g., a health information exchange) automatically detects reportable conditions and sends a digital case report to a public health surveillance system. eCR depends on clear communications between public health and clinical care about what to include in a case report and what values or codes in a patient’s clinical record should trigger report sending. In an effort to facilitate public health agencies’ communication of these requirements for eCR of chlamydia and gonorrhea, CDC’s Division of Sexually Transmitted Disease Prevention (DSTDP) collaborated with the Public Health Informatics Institute (PHII) to develop this toolkit.