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eCR/RCKMS Community of Practice

The purpose of the eCR/RCKMS Community of Practice Basecamp is to provide staff from state, local, territorial, and tribal public health agencies with a venue to participate in peer-to-peer discussions pertaining to using RCKMS. This Basecamp is not intended for formal communications about RCKMS or eCR and will not be moderated by CSTE staff. For technical issues or assistance with RCKMS, please visit www.rckms.org to submit a ticket. Disclaimer: The statements and responses posted on the eCR/RCKMS Community of Practice are solely the views of the authors and do not necessarily represent the official views of CDC or CSTE.
Becky Lampkins, Manager, Surveillance/Informatics Program at CSTEMeredith Lichtenstein, CSTELaura ErhartNancy Barrett, Epi 4/PH Informatics SpecialistRita Altamore, EpidemiologistDavid DiCesareWalter Kemper, ELR Coordinator, NC DHHS Div of Public HealthAmanda Payne, Senior Consultant at J Michael ConsultingJohn Satre, Informatician at Iowa Department of Public HealthShaily Krishan, Program Manager at CSTEJudie HyunKathy Turner, Deputy State Epidemiologist at IDSara Robinson, ID Epi Program Director at Maine CDCMisty Johnson, Informatician, WI DHSCrystal Snare +376 others
Posted by Annalyse Bergman ·

eCR Implementation Plans

Hi all,

Has anyone developed a successful implementation plan for eCR that they are willing to share, specifically for the automatic processing of eICR and RR? I'm looking for best practices to determine which case reports appear in the Documents Requiring Review queue for surveillance staff.

Thank you!

Annalyse Bergman
Alabama Department of Public Health

Comments & Events

Angela Herbert, Informatician at Nebraska Department of Health and Human Services Angela Herbert, Informatician
Following this conversation...
Angela Herbert
Nebraska
Notified 320 people
Ann Kayser Ann Kayser
Hey Annalyse - "documents requiring review" sounds like an NBS specific inquiry (correct me if I'm wrong though!). While not on NBS, in Minnesota we did feel overwhelmed with the amount of COVID eICRs coming in, especially during surges. We do automate eICRs into our surveillance system, but have the ability to remove the need to review eICRs if the case is deemed a case through other means (such as ELR), which has helped in reducing the number of eICRs to review. Regardless of your surveillance system, here are a few other approaches that might help in volume reduction.
1. RCKMS rule altering: One way we addressed that was to look at what we had authored in RCKMS to determine if we could modify our rules to decrease volume, while not affecting cases (essential review the RR rules hit against the case status defined by the program area). We saw a large pattern around events being marked as "not a case" when only active problem/diagnosis of COVID existed. We worked with the COVID program area to get approval to change the RCKMS rule and were able to decrease the number of eICRs by two-thirds volume.
2. Reach out to Epic sites: Some Epic sites implemented triggering on resolved problems, which would increase the likelihood of receiving more eICRs. There was an Epic release "November 2021" and later that has since resolved this issue. APHL mentioned this in their December, 2022 meeting. If AL deems triggering eICRs on resolved problems to be not necessary, it might be worth sending communication out to your healthcare organization contacts.

Any other NBS jurisdictions willing to share their experience with Documents Requiring Review and eICRs?

Ann Kayser
MN Dept of Health
Notified 320 people
Kate Goodin, Surveillance Systems and Informatics Program Director Kate Goodin, Surveillance Systems and Informatics Program Director
I was speaking with Sherri in AL about this last week at our CSTE board meeting. I think it would be good to go over the authoring rules that Ann highlighted and then go through a staged onboarding with your facilities where you can turn on and off your rules into your staging environment. For TN, we also set up some filtering rules in our SFTP to route prod eCRs into our staging environment until we approved a facility to go to production. We also implemented a couple of filters in Rhapsody for the NBS provided route which reinforces a combo of facilities and conditions that allows them to pass or fail out of Rhapsody just in case our SFTP routing doesn’t work. After that we have instituted some data clean up steps in NBS to manage the DRR using R. If you’d want to review the NBS portion of this I’m sure we could bring it up on the NBS eCR SME call and present.

-Kate
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Annalyse Bergman, Epidemiologist at Alabama Department of Public Health Annalyse Bergman, Epidemiologist
Thank you for your suggestions Ann Kayser Ann ! I am in the process of reviewing our authoring rules now. 

Kate Goodin, Surveillance Systems and Informatics Program Director Kate , that would be great! I believe the call this week is canceled. Are you able to present the NBS portion at the one next week? 

-Annalyse
Notified 323 people