BACKGROUND
From a paper world…
A key element of public health surveillance is the reporting of infectious and certain non-infectious conditions to state, local, territorial, and tribal public health agencies (PHA). Today, most case reporting is done manually; when a clinician suspects that a reportable condition exists or may exist, a paper form is faxed to the PHA for review and, if necessary, follow-up.
The Centers for Disease Control and Prevention (CDC) in conjunction with the Council of State and Territorial Epidemiologists (CSTE) and the Association of Public Health Laboratories (APHL) is spearheading an effort to move case reporting to an electronic process as electronic health records (EHR) become more pervasive. Electronic case reporting (eCR) is the automated identification and transmission of reportable health events from the electronic health record (EHR) to state and local public health departments. As COVID-19 cases rise, faster and more reliable case reporting is a major requirement of national monitoring and response.
APPROACH
… to the digital age
To support eCR, HLN developed and supports the open source Reportable Conditions Knowledge Management System (RCKMS), which provides a web-based Authoring Tool tailored to eCR that allows jurisdictions to rapidly create and maintain rules that determine whether a patient is reportable to public health. The RCKMS software includes a Decision Support Service (DSS) which runs the deployed rules against a submitted patient record and determines if the patient is reportable, and if so, for which condition(s), and to which jurisdiction(s).
When COVID-19 emerged, RCKMS quickly added default rules for the new condition. Jurisdictions immediately began publishing the reporting specifications into the live DSS based on their own rules. At the same time, health systems and jurisdictions have been rapidly onboarding as eCR sites in order to use RCKMS to improve the speed and accuracy of reportable cases.
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