Public Health Reporting — eCR/eICR & ELR
CDC_ECRfree12 data-quality rules for mandated public-health disease reporting from hospitals and labs to state/local health departments and CDC. Covers the HL7 electronic Initial Case Report (eICR) and Electronic Laboratory Reporting (ELR, HL7 v2.5.1): required data elements, value-set conformance (LOINC, SNOMED CT, ICD-10-CM, and the Reportable Conditions Trigger Codes RCTC), reportability, timeliness, condition/result consistency, and duplicate case suppression. Use it to certify a submission is conformant and complete BEFORE it is sent.
Checks included (20)
Required Patient Demographics Present
Every case report must carry the patient demographics required by the eICR: a patient identifier, birth date, administrative sex, and a jurisdiction-routing address. Missing demographics block processing at the public health agency.
Reportable Condition Code Present(condition_code)
Each case report must name the condition that triggered reporting. A report with no condition code cannot be routed to the correct program.
Specimen Source & Collection Date Present
ELR results must carry a specimen source and a collection date/time; without them the result cannot be interpreted for surveillance.
Routing Jurisdiction Resolvable
Each report must carry the patient address fields (state, county/zip) needed to route it to the correct public health jurisdiction.
Patient Identifier Present(patient_id)
Every case report and lab result must carry a patient identifier for linkage and de-duplication.
Performing Lab CLIA Present (ELR)(performing_lab_clia)
Each ELR result must identify the performing laboratory by its CLIA number.
HL7 Message Control ID Present (ELR)(message_control_id)
Each ELR HL7 message must carry a unique message control id (MSH-10) for acknowledgement and tracking.
Condition Is in the RCTC Value Set
The reported condition code must exist in the Reportable Conditions Trigger Codes (RCTC) value set published in the eRSD. Codes outside the RCTC are not recognized as reportable and will be rejected.
Lab Test Code Is Valid LOINC
In ELR, the observation/test identifier (OBX-3) must be a valid LOINC code. Non-LOINC or retired test codes break public-health analytics.
Result / Organism Coded in SNOMED CT
Coded results and identified organisms must use SNOMED CT, per the ELR implementation guide. Uncoded or non-SNOMED results cannot be aggregated across jurisdictions.
Diagnosis Coded in ICD-10-CM
Diagnoses on the case report must be valid ICD-10-CM codes so the condition can be classified consistently downstream.
Reporting Provider NPI Is Valid
The ordering/reporting provider on the report must carry a valid NPI present in the NPPES registry.
Specimen Source Coded in SNOMED
The specimen source/type must be coded against the SNOMED CT specimen value set per the ELR implementation guide.
Patient State Is a Valid FIPS
The patient state used for jurisdiction routing must be a valid state FIPS code.
Observation Result Status Is Valid (HL7 0085)(result_status)
OBX-11 result status must be a value from HL7 table 0085 (e.g. F, C, P, X). Out-of-vocabulary statuses indicate a malformed ELR message.
Result Abnormal Flag Is Valid (HL7 0078)(abnormal_flag)
OBX-8 abnormal flag must be a value from HL7 table 0078 (N, A, H, L, HH, LL, AA, U, etc.).
Reported Condition Consistent With Result
The condition that triggered the report must map to the underlying lab result via the trigger-code crosswalk. A condition with no supporting result is a false or mis-coded report.
Specimen Collected Before Report
The specimen collection date cannot be after the result/report date.
Report Submitted Within Required Window(result_finalized_at)
Reportable results must be transmitted to public health within the jurisdiction's mandated window (commonly 24 hours for urgent conditions) of the result being finalized. Late reports defeat outbreak response.
No Duplicate Case Reports(case_dedup_key)
A patient + condition + specimen should produce a single case report. Duplicates inflate counts and trigger redundant investigations.