This resource defines the expected capabilities for both client and server participating in eCR exchange

This section describes the expected capabilities of a client consuming eRSD resources including the Reportable Conditions Trigger Codes (RCTC).

Conformance requirements for an eRSD Client

The eRSD Client SHALL:

• Support fetching the eRSD Bundle using the supported RESTful interactions.
• Support processing PlanDefinition and ValueSet resources that are included in the Bundle.

The eRSD Client MAY:

• Support fetching and reading a Person resource.
• Support fetching and reading Subscription resources associated with a Person.

Packages the contents referenced by an asset-collection library such as a quality program release or version manifest.

This Composition profile represents an electronic initial case report (eICR). It is based on and further constrains the US Public Health Composition.

This Composition profile represents the Reportability Response that is created in response to an electronic Initial Case Report Composition.

This Bundle profile represents an RR Document Bundle. It contains an RR Composition.

This profile represents external resources such as a text guidance, link to access forms for additional reporting needs, additional testing and/or laboratory testing needs, treatment and/or prevention resources, Public Health Agency contact information and general additional resources.

This profile represents a relevant reportable condition.

This profile represents reportability information based on the PHA in which is located the patient's home, the provider facility, or both locations.

This profile contains a detailed textual description of the reportable condition(s), including actions the provider needs to take, any supplemental information that may be required, and where the initial case report was sent.

This Organization profile represents the Responsible Agency which is a PHA to which reporting is legally required.

This Organization profile represents the Routing Entity which is a PHA or other organization identified by the PHA (such as an HIE) to which the eICR and/or the Reportability Response will be provided immediately following the creation of the Reportability Response.

This Organization profile represents the Rules Authoring Agency which is the originator of the rules that are being executed in decision support to determine reportability.

This MessageHeader profile represents metadata to support the eCR messaging paradigm.

This Observation profile represents the patient's country of usual residence.

This Bundle profile represents an eCR Document Bundle. It contains an eICR Composition.

This Encounter profile represents the encounter related to the event. It is based on the US Public Health Encounter profile.

This Procedure profile defines constraints on the US Core Procedure profile for the eICR use case.

This Observation profile represents the eICR processing status.

This Observation profile represents, if the incoming eICR was not successfully processed for a determination of reportability, the reason it was not processed.

This ServiceRequest profile represents eICR laboratory orders and other diagnostics for the eICR event.

This PlanDefinition profile defines the logic and rules around determining: whether or not a condition is reportable to public health, which jurisdiction(s) is/are responsible, which jurisdiction(s) need to be notified, and if the condition is reportable, gives timing information, next steps and condition information to the clinician. The rules for determining reportability described by an eRSD specification involve the use of triggering codes to determine potentially reportable events, and optionally locally evaluated rules for determining suspected reportable events. The final determination of reportability is made by the Public Health Agency or Agencies appropriate for the event, and may be performed by a combination of decisions occurring at various points during the processing of an eICR, as explained in the Reportability Response profile.

Defines the asset-collection library containing the eRSD supplemental assets.

This Extension profile represents an external resource (DocumentReference) pertaining to the condition such as a text guidance, link to access forms for additional reporting needs, additional testing and/or laboratory testing needs, treatment and/or prevention resources, Public Health Agency contact information and general additional resources.

This Extension profile represents the priority given to the whole composition or one or more external resources.

This Extension profile represents that the eICR, was either manually or alternately initiated by the provider.

This Extension profile represents the eICR processing status.

This Extension profile represents the date and time of eICR receipt

This Extension profile represents a flag which, if it is present, indicates that the target reference represents a triggering event and caused the eCR to be generated.

This example code system describes the possible types of jurisdictions that require public health reporting.

This example code system describes jurisdictions that require public health reporting.

Acanthamoeba Disease [Keratitis] (Disorders) (ICD10CM)

Acanthamoeba Disease [Keratitis] (Disorders) (SNOMED)

Anthrax (Tests for Bacillis anthracis Antibody)

Anthrax (Tests for Bacillis anthracis Antigen)

Anthrax Vaccine (RXNORM)

Arsenic Exposure and Toxicity (Disorders) (ICD10CM)

Arsenic Exposure and Toxicity (Disorders) (SNOMED)

Example of a US Public Health Reporting message bundle containing an electronic case report for a Zika virus infection case involving patient Eve Everywoman.

Example of an eICR Document Bundle containing a complete electronic initial case report for a Zika virus infection case involving patient Eve Everywoman.

COVID_19 (Tests for SARS_CoV_2 by Culture and Identification Method)

California Serogroup Virus Diseases (Tests for California Serogroup Virus Antibody [Quantitative])

Example of an eICR Composition representing a manually initiated electronic initial case report for patient Eve Everywoman with suspected Zika virus infection.

Example of an eICR Composition representing an initial public health case report for patient Eve Everywoman with both pertussis and Zika virus disease diagnoses.

Example of an eICR Composition representing an initial public health case report for patient Eve Everywoman with Zika virus disease.

Example of a US Public Health Condition documenting a common cold encounter diagnosis for patient Eve Everywoman.

Example of a US Public Health Condition documenting a diabetes mellitus diagnosis for patient Eve Everywoman.

Example of a US Public Health Condition documenting a pertussis diagnosis for patient Eve Everywoman.

Example of a US Public Health Condition documenting a Zika virus disease encounter diagnosis for patient Eve Everywoman.

Example of Country of Nationality Observation

Example of Country of Residence Observation

Dengue Virus Infection (Organism or Substance in Lab Results)

Example of a Device instance representing an ACME extracorporeal membrane oxygenator (ECMO) device used for patient Eve Everywoman.

Example of a Device representing the electronic health record (EHR) software system used by the YMCA Center for electronic case reporting.

Diphtheria (Disorders) (SNOMED)

Diphtheria [Suspected] (Disorders) (SNOMED)

Example of Disability Status Profile (Eve Everywoman)

Eastern Equine Encephalitis Virus Disease (Tests for Eastern Equine Encephalitis Virus Antibody [Quantitative])

Example of an eICR Encounter representing a completed inpatient encounter for patient Eve Everywoman with Zika virus disease diagnosis.

Example of an eICR Encounter representing an in-progress inpatient encounter for patient Eve Everywoman with Zika virus disease diagnosis.

Example of an eICR Encounter representing an ambulatory outpatient office visit for patient Eve Everywoman with Zika virus disease diagnosis.

Example of a US Public Health Endpoint for Salem Medical Center to receive Reportability Response messages via HL7 FHIR REST.

Example of a US Public Health Endpoint for the YMCA Center to receive Reportability Response messages via HL7 FHIR REST.

Enterococcus faecium or E. faecalis (Organism or Substance in Lab Results)

Enterococcus gallinarum or E. casseliflavus/E. flavescens (Organism or Substance in Lab Results)

This example set of values contains laboratory observations test names that represent that the patient may have the potentially reportable condition of Chlamydia regardless of the clinical presentation of the condition

This example set of values contains laboratory observations test names that represent that the patient may have the potentially reportable condition of Chlamydia regardless of the clinical presentation of the condition

Purpose: Clinical Focus - This set of values contains diagnoses or problems that represent that the patient may have a potentially reportable condition. For example, these may be diagnoses recorded in an EHR problem list and diagnosis codes used for billing for the encounter. Purpose: Data Element Scope - Diagnoses or problems documented in a clinical record. Purpose: Inclusion Criteria - See individual value sets. Purpose: Exclusion Criteria - See individual value sets. Note - Includes codes from selected value sets used in the Reportable Condition Knowledge Management System (RCKMS) reporting logic. RCKMS value sets in VSAC are for informational use only. When implementing trigger codes for electronic case reporting, use the Reportable Condition Trigger Codes (RCTC) file.

This example set of values contains diagnoses or problems that represent that the patient may have a potentially reportable condition regardless of the clinical presentation of the condition

Purpose: Clinical Focus - This set of values contains laboratory test names that may be used for placing a lab order for a test that represents that the patient may have a potentially reportable condition. These pertain to laboratory orders placed, coded in LOINC, where the lab order includes at least one test for a condition reportable upon suspicion of the condition. Purpose: Data Element Scope - Laboratory test names used in orders documented in a clinical record. Purpose: Inclusion Criteria - See individual value sets. Purpose: Exclusion Criteria - See individual value sets. Note - Includes codes from selected value sets used in the Reportable Condition Knowledge Management System (RCKMS) reporting logic. RCKMS value sets in VSAC are for informational use only. When implementing trigger codes for electronic case reporting, use the Reportable Condition Trigger Codes (RCTC) file.

Purpose: Clinical Focus - This set of values contains laboratory observation test names that may represent that the patient may have a potentially reportable condition. These pertain to resulted laboratory reports, where the lab test name, coded in LOINC, is specific to a reportable condition. Purpose: Data Element Scope - Laboratory test names used in observations documented in a clinical record. Purpose: Inclusion Criteria - See individual value sets. Purpose: Exclusion Criteria - See individual value sets. Note - Includes codes from selected value sets used in the Reportable Condition Knowledge Management System (RCKMS) reporting logic. RCKMS value sets in VSAC are for informational use only. When implementing trigger codes for electronic case reporting, use the Reportable Condition Trigger Codes (RCTC) file.

This example set of values contains laboratory observations test names that represent that the patient may have a potentially reportable condition regardless of the clinical presentation of the condition

This example set of values contains laboratory test names for orders that represent that the patient may have a potentially reportable condition regardless of the clinical presentation of the condition

Purpose: Clinical Focus - This set of values contains CVX,RXNORM,SNOMED medication codes that may represent that the patient may have a potentially reportable condition. These pertain to medications administered and medications prescribed, where the medication, coded in CVX,RXNORM,SNOMED, may be indicative of a reportable condition. Purpose: Data Element Scope - Prescription drugs names used in observations documented in a clinical record. Purpose: Inclusion Criteria - See individual value sets. Purpose: Exclusion Criteria - See individual value sets. Note - Includes codes from selected value sets used in the Reportable Condition Knowledge Management System (RCKMS) reporting logic. RCKMS value sets in VSAC are for informational use only. When implementing trigger codes for electronic case reporting, use the Reportable Condition Trigger Codes (RCTC) file.

This example set of values contains CVX, RXNORM,and SNOMED medication codes that may represent that the patient may have a potentially reportable condition. These pertain to medications administered and medications prescribed, where the medication, coded in CVX,RXNORM,SNOMED, may be indicative of a reportable condition.

Purpose: Clinical Focus - This set of values contains organism and substance names received in a laboratory results report, that may represent that the patient has a potentially reportable condition. These pertain to resulted laboratory reports, where the test method is a non-specific test (e.g., general cultures not specific to a condition) and the result value, coded in SNOMED, includes the organism or substance name. Purpose: Data Element Scope - Nominal laboratory result values documented in a clinical record. Purpose: Inclusion Criteria - See individual value sets. Purpose: Exclusion Criteria - See individual value sets. Note - Includes codes from selected value sets used in the Reportable Condition Knowledge Management System (RCKMS) reporting logic. RCKMS value sets in VSAC are for informational use only. When implementing trigger codes for electronic case reporting, use the Reportable Condition Trigger Codes (RCTC) file.

This example set of values contains organism and substance names that represent that the patient may have a potentially reportable condition regardless of the clinical presentation of the condition

This example set of values contains procedure names for orders that represent that the patient may have a received a procedure or that a procedure has been requested.

Purpose: Clinical Focus - This set of values contains suspected diagnoses or problems that represent that the patient may have a potentially reportable condition. For example, these may be diagnoses recorded in an EHR problem list and diagnosis codes used for billing for the encounter. Purpose: Data Element Scope - Suspected diagnoses or problems documented in a clinical record. Purpose: Inclusion Criteria - See individual value sets. Purpose: Exclusion Criteria - See individual value sets. Note - Includes codes from selected value sets used in the Reportable Condition Knowledge Management System (RCKMS) reporting logic. RCKMS value sets in VSAC are for informational use only. When implementing trigger codes for electronic case reporting, use the Reportable Condition Trigger Codes (RCTC) file.

This example set of values contains suspected diagnoses or problems that represent that the patient may have a potentially reportable condition. For example, these may be diagnoses recorded in an EHR problem list and diagnosis codes used for billing for the encounter.

An example library with logic for determining whether or not an event or situation is reportable.

HIV Infection (ARV Attachment Inhibitors) (RXNORM)

HIV Infection (ARV Boosters [CYP3A4 Inhibitor]) (RXNORM)

HIV Infection (ARV Integrase Strand Transfer Inhibitors [INSTIs]) (RXNORM)

HIV Infection (ARV Postattachment Inhibitors) (RXNORM)

Hepatitis B Virus Infection (Organism or Substance in Lab Results)

Hepatitis C Virus Infection (Organism or Substance in Lab Results)

Example of a US Core Immunization documenting the administration of pneumococcal polysaccharide PPV23 vaccine to patient Eve Everywoman.

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Example of a US Public Health Triggering ValueSet Library containing Reportable Condition Trigger Codes (RCTC) for initiating decision support for electronic case reports. This release includes code updates for existing conditions, adds codes for Parkinson's disease and 13 enteric conditions, and includes medication codes.

Example of a US Public Health Specification Library containing PlanDefinition and ValueSet Library for public health reporting specifications.

Example of a US Public Health Supplemental Library containing executable rule filters and supplemental ValueSet Library for public health reporting.

Example of a US Public Health Supplemental ValueSet Library containing supplemental ValueSets for public health reporting.

Example of a US Public Health ValueSet Library containing a collection of ValueSets used for public health reporting.

Example of a US Public Health Specification Library containing eRSD PlanDefinition and RCTC ValueSet Library for electronic case reporting specification.

Example of an eRSD Supplemental Library containing executable rule filters, supplemental ValueSet Library, and jurisdictions CodeSystem for electronic case reporting.

Example of a US Core Location representing a sports stadium where potential disease exposure may have occurred.

Example of a US Public Health Location representing Clinic Building A at Salem Medical Center in Ann Arbor, Michigan.

Measles [Suspected] (Disorders) (SNOMED)

Example of a US Public Health MedicationAdministration documenting the administration of Azithromycin 500 MG oral tablets to patient Eve Everywoman.

Example of a US Public Health MedicationAdministration documenting naloxone hydrochloride injection to patient Eve Everywoman with therapeutic medication response extension indicating patient's condition improved.

Example of an eCR MessageHeader for a requested electronic initial case report indicating the source EHR software and destination public health agency.

Mumps (Test Panels for mumps virus IgM IgG Antibody)

Mumps (Test Panels for mumps virus Nucleic Acid)

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Example of ODH Employment Status profile (Eve Everywoman)

Example of a US Core Vital Signs observation documenting blood pressure measurements (systolic 109 mmHg, diastolic 44 mmHg) for patient Eve Everywoman.

Example of a US Public Health Characteristics of Home Environment observation indicating that Eve Everywoman is experiencing homelessness.

Example of a US Public Health Laboratory Result observation documenting lymphocyte count in blood for patient Eve Everywoman with high interpretation.

Example of a US Public Health Laboratory Result observation documenting Bordetella pertussis antibody levels in serum for patient Eve Everywoman with high interpretation.

Example of a Last Menstrual Period observation documenting the start date of Eve Everywoman's last menstrual period.

Example of an Occupational Data for Health (ODH) Past or Present Job observation for Eve Everywoman as a nursing aide in a nursing care facility with asbestos hazard exposure.

Example of an Occupational Data for Health (ODH) Usual Work observation documenting Eve Everywoman's occupation as a Human Resources Manager in the hospital industry.

Example of a US Public Health Pregnancy Outcome observation documenting a term birth outcome for patient Eve Everywoman.

Example of a US Public Health Pregnancy Status observation documenting pregnancy status with gestational age and estimated delivery date for patient Eve Everywoman.

Example of a Reportability Response (RR) Relevant Reportable Condition observation identifying Zika virus disease as a reportable condition for patient Eve Everywoman.

Example of a Reportability Response (RR) Reportability Information observation providing determination of reportability, timeframe to report, and external resources for a reportable condition.

Example of a Reportability Response (RR) Summary observation providing summary information about electronic case reporting submission and reportability determination for Zika virus disease.

Example of a US Public Health Travel History observation documenting travel to Fiji and Vanuatu by patient Eve Everywoman in January 2018.

Example of a US Public Health Vaccine Credential Patient Assertion observation indicating immunization status reported for patient Eve Everywoman.

Example of a US Public Health Organization representing Salem Medical Center, an outpatient facility in Ann Arbor, Michigan.

Example of a US Public Health Patient representing Eve Everywoman, the primary patient in electronic case reporting examples.

Example of an eRSD PlanDefinition demonstrating the use of the US Public Health RelatedData Extension for linking related resources.

Poliomyelitis [Suspected] (Disorders) (SNOMED)

Powassan Virus Disease (Tests for Powassan Virus Antibody [Quantitative])

Example of a US Core Practitioner representing Dr. Henry Seven, M.D., a physician at Salem Medical Center.

Example of a US Public Health PractitionerRole for Dr. Henry Seven, a family practice physician at Salem Medical Center.

Example of an eICR Procedure instance representing an extracorporeal membrane oxygenation (ECMO) procedure performed on patient Eve Everywoman.

Example RR Document Bundle: One Condition, One PHA

Example of RR DocumentReference profile: Additional reporting needs

Example of RR DocumentReference profile: Zika follow-up

Example of RR DocumentReference profile: Zika info

Example of RR Responsible Agency Organization profile (Health Authority West Responsible Agency)

Example of RR Routing Entity Organization Example profile (Health Authority West Routing Entity)

Example of RR Rules Authoring Agency profile (Health Authority West Rules Authoring Agency)

Example of RR eCIR Processing Status Observation profile

Example of RR eICR Processing Status Reason Observation profile

Rabies [Suspected] (Disorders) (SNOMED)

Example of Reportability Response Composition - One Condition/One PHA with eICR Validation Output

Example of Reportability Response Composition - One Condition/One PHA

Example of an eICR ServiceRequest for Zika virus envelope E gene testing via NAA with probe detection for patient Eve Everywoman.

Example of a Subscription resource for monitoring Diagnosis Problem trigger codes (DXTC) for public health reporting.

Example of a Subscription resource for monitoring Lab Order Test trigger codes (LOTC) for public health reporting.

Example of a Subscription resource for monitoring Organism Substance trigger codes (OSTC) for public health reporting.

Example of Travel History Observation profile (Eve Everywoman)

Example of Travel History Observation profile (Eve Everywoman - October 2016)

Example of US Public Health Encounter profile (Eve Everywoman, external encounter)

Example of US Public Health Encounter profile (Eve Everywoman: external historical)

Example of US Public Health Organization profile (Acme Labs)

Example of US Public Health Organization profile (Health Authority West)

Example of US Public Health Organization profile

Example of Emergency Outbreak Information profile (Eve Everywoman)

Example of US Public Health Exposure Contact Information (Football Game)

Example of US Public Health PlanDefinition profile

Example of US Public Health Postpartum Status profile (Eve Everywoman)

Example of US Public Health Transportation Example (Eve Everywoman)

This example set of values contains laboratory observation test names that represent Chlamydia tests.

Viral Hemorrhagic Fever [Suspected] (Disorders) (SNOMED)

An example eRSD PlanDefinition

This PlanDefinition is a simplified duplicate of the eRSD PlanDefinition Instance created for the purposes of demonstrating by example the usage of the US Public Health Named Event extension.

An example eRSD PlanDefinition

Example value set for jurisdiction types in US public health .

Example of expansion parameters for electronic case reporting (eCR) that references the US edition of SNOMED CT.

An example eRSD Specification Bundle

An example eRSD Supplemental Bundle