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NC Department of Health and Human Services
NC Division of Public Health
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Electronic Case Reporting (eCR)

Overview
North Carolina's Division of Public Health (NC DPH) is in the early stages of onboarding facilities for electronic case reporting (eCR), the automated, real-time generation and transmission of case reports between electronic health records (EHRs) and public health agencies. The eCR technology seamlessly and securely moves eCR data from EHRs in healthcare facilities to local and state public health agencies. Under 130A — 135 and 10A NCAC 41A .0101, providers are required to report certain communicable diseases and conditions to state and local public health officials. Communicable Disease Laws and Rules

eCR Benefits
Electronic case reporting enables health care providers to satisfy mandated reporting requirements for NC DPH and CMS regulatory requirements for the Public Health and Clinical Data Exchange objectives. The eCR provides complete and accurate data, enables the ability to more quicky identify emerging public health trends, improves collaboration and communication with healthcare through the bidirectional data exchange, and reduces response time with automated information.

Reportable Mandate
As of January 2022, electronic case reports are required by the Centers for Medicare and Medicaid Services (CMS) Promoting Interoperability Program (PIP) for eligible hospitals, critical access hospitals (CAH), and eligible clinicians participating in the Merit-based Incentive Payment System (MIPS).

Declaration of Readiness
The North Carolina Department of Public Health began accepting registrations of intent for eCR from eligible hospitals and critical access hospitals in January 2019 and from eligible clinicians on March 15, 2022.

eCR Technical Requirements

The NC DPH uses Health Level 7 (HL7) Electronic Initial Case Report (eICR) and Reportability Response (RR) standards for electronic case reporting (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:

Other Requirements

  • 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. 
  • 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.

Important: 

  • All existing eICR R1.1 senders should update to eICR R3.1.1 by June 1, 2026.
  • Any new EHR product eCR implementation after January 1, 2026, must use eICR R3.1.1.

Electronic Case Reporting (eCR) Registration Instructions:

Electronic Case Reporting Resources

NCDHHS