CSTE National ELR Workgroup

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👋 RCKMS-eCR question

Hi sorry, This is an not an ELR question, but I wasn't sure where/who else to ask. I just saw an email from Laura Conn that now APHL AIMS will be delivering eCRs to a state if found from another state once you have your state's RCKMS rules authored. The email said "For most jurisdictions (those that don’t have active eCR implementations), this connection will only be for the very limited numbers of reports where patients who reside in your jurisdiction receive care in another jurisdiction and have a condition that is reportable to your PHA. You can think of these the same as a faxed report you might receive from another jurisdiction now."

Okay, it might just be me reacting given we are under grant stress right now, but these are NOT the same as receiving a faxed report. For states like ours, who have not committed to a eCR pilot or project yet, isn't this rushing us? So the assumption is that once a jurisdiction does eCR, all of their out of state notifications will be delivered the same way, even if the recipient state is not ready? Depending on the disease, this may not be just a few reports. But even if it is just one report, it is still asking us to meet an expectation that we are not ready to meet for an optional grant project. Did anyone else see this email and am I over-reacting?

Thanks so much!
Nancy

Comments & Events

Mark Dittman
Nancy,

I was honestly put off by this at first and read it a couple times, more slowly. Disclaimer: I’m a huge APHL skeptic/critic so keep that in mind.

I read this as a push as well and it gives me an “or else” feel. We implemented an eCR process similar to our ELR workflow so we can do something with the reports to make them accessible if necessary to our program staff. Our pilot project was suspended because the provider backed out…or more so found out that they couldn’t generate the files after swearing they could. If pressed, we could first approach this as our pilot and we discussed that this morning in one of our grant writing sessions. I am advocating that from the IT perspective we say “Ok” for inter-jurisdictional but “No” to EHR/EMR messaging from providers (I strongly believe that is not APHL’s realm).

So, no, I don’t think you are overreacting. I prefer to think Laura probably did not intend to be as a hard line as it reads…but maybe she/they did. I would also prefer to think that CDC/ELC gave their consent as well, otherwise this looks odd in the bigger picture of their collaborations. Then again those are very aggressive dates and objectives. Either way, I’m not to warm and fuzzy with the dictate nor the time lines. I would opt to put it in the grant as an “Evaluation and Assessment” activity. Nothing more.

Hope that helps,
Mark
Nancy Barrett, Epi 4/PH Informatics Specialist
Hi Mark, 
I actually think that this should have been put out on a call for discussion (CDC knows who Project C contacts are from quarterly calls) and not a surprise email as an "ultimatum". And we are already deep in grant writing so are we to take this email as part of the project C objectives for an optional project? But even for inter-jurisdictional reporting, this is still work on a tight timeline. And I know we could process this, but it would take staff time that I don't have from other higher priority projects. I'm not trying to sound whiny, but this seems heavy handed to me.
Mark Dittman
Yep. Agreed. Really a late and somewhat low-blow. That’s why I would tack it on as “Assess” ish and not commit to anything more than that. It will obviously carry-over into the next grant cycle for most states. Well… cover your ears…. But this kind of comes off as “fees for service” and “there’s money to be grabbed so throw together some project we can force on the states so that CDC pays us that left-over pile of money we couldn’t get by some other means….”… but I’m not bitter………
Annie Fine
I cannot imagine that they expect states to be able to process these reports.  Who did this email even go to?  I would also say that I doubt any states/jurisdictions in the pilot are actually relying on eCR in a real "production way".  This is one of the points I have actually raised with the Digital Bridge folks.  Reporting facilities CANNOT assume that this reporting via pilot eCR projects in any way replaces other normal reporting. So for example, if they had a reportable case in a patient who resided in another jurisdiction, I would presume that they should report that case in the normal way that they would.  If we received a case via eCR that resided in another jurisdiction, we would probably need to notify the other jurisdiction in our normal way (ie. NOT through eCR).  This needs to be worked out though to be sure that cases do not fall through the cracks.  I have not seen the Laura Conn email.  Could one of you please forward it to me?  Thank you!!
Nancy Barrett, Epi 4/PH Informatics Specialist
Annie -- I just forwarded it to you. I can share my response email as well if you like. You actually have some additional info I didn't.
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