Public Health Reporting using Certified Electronic Health Record Technology (CEHRT)

The Tennessee Department of Health collects health information to prevent and contain outbreaks, analyze population health trends, track immunization rates, track infectious diseases, and educate and promote healthy choices for the people of Tennessee. Public health reporting incentives provided by the Centers for Medicare & Medicaid Services’ (CM) Promoting Interoperability Programs increased partnerships between TDH and health care providers capable of reporting to public health electronically.

Public health electronic reporting requirements can be easily reported to TDH using an EHR. The process to begin reporting electronically begins when a potential trading partner registers with TDH expressing their intent to exchange data electronically using the Trading Partner Registration (TPR) system. CMS requires Eligible Clinicians (ECs) and Eligible Hospitals (EHs) to maintain proof of active engagement with public health. TPR manages active engagement statuses, generates emails and letters as proof of public health reporting for registered users. Registration assistance is provided to help potential trading partners register – click here to see available schedule. 

TDH Declaration of Readiness for Public Health Reporting 

As of January 1, 2022, TDH is declaring readiness for the following Public Health Reporting objectives and measures. Promoting Interoperabiity and MIPS/Advancing Care Information providers should check here periodically for updates to TDH’s Public Declaration of Readiness to receive data from Certified Electronic Health Record Technology (CEHRT).

Check here periodically for updates to TDH’s Public Declaration of Readiness to receive data from Certified Electronic Health Record Technology (CEHRT). For questions related to the TDH Declaration of Readiness, contact the TDH Meaningful Use Coordinator at (615) 253-8945 or MU.Health@tn.gov.

The Communicable and Environmental Disease and Emergency Preparedness Section (CEDEP) within the Tennessee Department of Health (TDH) has revised its declaration of readiness for Electronic Case Reporting regarding the submission of electronic initial case reports (eICR). Electronic Case Reporting (eCR) is the automated generation and transmission of case reports from an electronic health record (EHR) to the public health agency’s disease surveillance system for review and action. eCR will allow healthcare providers the opportunity to report suspected cases to TDH for further investigation using an electronic health record (EHR) system rather than manually reporting on paper and waiting on lab test results to confirm a suspected case.

Effective January 1st, 2022, TDH will accept registrations from eligible clinicians (ECs), eligible hospitals (EHs) and eligible professionals (EPs) that meet the following requirements:

Requirement

EHs

ECs/EPs

Use of 2015 CEHRT product capable of generating and transmitting HL7 electronic initial case report (eICR) standards (R1.1 and R3) for electronic case reporting (eCR)

X

X

Establish connectivity and use of the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) platform and the Reportable Condition Knowledge Management System (RCKMS)

X

x

Diagnose or treat ≥ 150 reportable cases in a calendar year.   x

HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 - US Realm - the Electronic Initial Case Report (eICR)

eCR will capture critical clinical and demographic patient data from Certified Electronic Health Record Technology (CEHRT) not otherwise included in laboratory reports. Utilizing eCR will reduce the burdensome paper-based and labor-intensive administrative process reporters face in reporting and responding to public health’s requests for additional information.

EHR Incentive Programs support the adoption and meaningful use of certified EHR technology to allow providers to exchange public health information electronically. TDH is currently accepting electronic reportable laboratory results from eligible hospitals (EHs) and eligible critical access hospitals (CAH) only.

Electronic Reportable Laboratory Result Reporting Measure

In order to satisfy TDH’s requirements for Public Health Reporting using electronic health record technology, all potential trading partners must first register their intent to exchange data: Trading Partner Registration (TPR).

After completing TPR registration, you will receive an automated email confirming your registration. Your registration will then be reviewed and approved or denied by Tennessee Department of Health staff. You will then receive a follow up email to inform you of the approval status of your registration. If approved, please note you will not begin onboarding immediately. Trading partners are onboarded by priority and as resources are available. ELR onboarding staff will reach out when ready to begin the onboarding process.

The MU EHR Incentive Program requires EHs and CAHs to be in active engagement with public health to send electronic reportable laboratory results from CEHRT, except where prohibited, and in accordance with applicable law and practice.

Note: The time until live data exchange varies and depends upon the quality and speed of data exchange testing.

Send inquiries to CEDS.Informatics@tn.gov.

CEHRT Edition

Implementation Guide

Measure

Incentive Program

Supported  by TDH ELR

2014

Hl7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1 (US Realm), with Errata and Clarifications

Electronic Reportable Laboratory Result Reporting

MU Modified Stage 2

X

2015

Hl7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1 (US Realm), with Errata and Clarifications

Electronic Reportable Laboratory Result Reporting

Stage 3

 

 

X

EHR Incentive Programs support the adoption and meaningful use of certified EHR technology to allow providers to exchange public health information electronically. TDH is currently accepting syndromic surveillance data from Eligible Hospitals (EHs) with an emergency department only

Effective January 1st, 2022, TDH will accept registrations from eligible clinicians (ECs) and eligible professionals (EPs) in urgent care settings. We are actively seeking urgent care facilities for our pilot site program. 

Syndromic Surveillance Measure

In order to satisfy TDH’s requirements for Public Health Reporting using electronic health record technology, all potential trading partners must first register their intent to exchange data: Trading Partner Registration (TPR)

The MU EHR Incentive Program requires EHs to be in active engagement with public health to submit syndromic surveillance data from CEHRT, except where prohibited, and in accordance with applicable law and practice.

Note: The time until live data exchange varies and depends upon the quality and speed of data exchange testing. At this time, TDH is not accepting syndromic surveillance data from any eligible professionals.

Send inquiries to CEDS.Informatics@tn.gov.

EHR Incentive Programs support the adoption and meaningful use of certified EHR technology to allow providers to exchange public health information electronically. TDH is currently accepting immunization data from EPs, EHs, and CAHs.

Immunization Registry Reporting Measure

In order to satisfy TDH’s requirements for Public Health Reporting using electronic health record technology, all potential trading partners must first register their intent to exchange data: Trading Partner Registration (TPR)

The MU EHR Incentive Program and the MIPS Advancing Care Information program require EPs, ECs, EHs, and CAHs to be in active engagement with public health to submit immunization data from CEHRT except where prohibited and in accordance with applicable law and practice.

Note: The time until live data exchange varies and depends upon the quality and speed of data exchange testing.

Send inquiries to TennIIS.MU@tn.gov. Your points of contact will be Karen L. Curtis.

Cancer Case reporting using a CEHRT does not replace state mandated hospital and laboratory reporting. 

Effective July 1st, 2018, TCR will accept only new registrations from eligible clinicians for electronic data submissions with the following physician specialties:

  1. Dermatology                            
  2. Urology
  3. Gastroenterology
  4. Hematology
  5. Medical Oncology
  6. Radiation Oncology
  7. Surgical Oncology
  8. Gynecologic Oncology

See also TCR Declaration Update for more information.

Public Health Registry Reporting Measure

In order to satisfy TDH’s requirements for Public Health Reporting using electronic health record technology, all potential trading partners must first register their intent to exchange data: Trading Partner Registration (TPR)

The MU EHR Incentive Program requires EPs to be in active engagement with public health to submit data to a specialized registry from CEHRT except where prohibited and in accordance with applicable law and practice.

Note: The time until live data exchange varies and depends upon the quality and speed of data exchange testing.

Send inquiries to TNCancer.Registry@tn.gov.

TDH Public Health Reporting Procedures

In the MU EHR Incentive Program’s for 2015 through 2017 proposed rule 80 FR20366, CMS highlighted their intention to align with the Stage 3 proposed rule and remove the term “ongoing submission” and replace it with an "active engagement" requirement. Active engagement may be demonstrated by any of the following options:

The EP, EH or CAH registered to submit data with the PHA or, where applicable, the CDR to which the information is being submitted; registration was completed within 60 days after the start of the EHR reporting period; and the EP, eligible hospital, or CAH is awaiting an invitation from the PHA or CDR to begin testing and validation.

In Tennessee, the onboarding process to exchange data with the Tennessee Department of Health (TDH) begins when a potential trading partner registers with TDH expressing their intent to exchange data electronically.

The Trading Partner Registration (TPR) system allows potential trading partners to register for Immunization Messaging (new registrations), Cancer Case Reporting, Electronic Laboratory Reporting (ELR) and Syndromic Surveillance Messaging (Eligible Hospitals w/Emergency Room) in one location. TPR provides documentation that can be utilized for Meaningful Use attestation and allows users to view their progress from end to end through the use of milestone letters documenting on-boarding progress. Click here to download the TPR Worksheet.

Also displayed within the TPR organizational profiles are requests for actions. TDH expects the responses of potential trading partners to requests for actions to be applicable with moving the trading partner to a production status. TDH reserves the right to disengage in onboarding activates with any trading partner, at any time, due to consistent problems associated with reporting requirements, and file specifications in accordance published national standards. The trading partner’s active engagement status will be provided in the TPR system under the Interface Details tab.

Click here to see a listing of training dates and times. To receive the TPR webinar details, you must complete the registration form found at https://stateoftennessee.formstack.com/forms/tpr_training. If the requested date/time is available, you will receive an email invitation with the conference phone number and webinar link. If you do not receive an email within 2 business days send an email to mu.health@tn.gov.

The EP, EH or CAH is in the process of testing and validating of the electronic submission of data. Providers must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within an EHR reporting period would result in that provider not meeting the measure.

The TDH interfaces will invite the EPs, EHs or CAHs to begin submitting test messages. TDH staff will validate the messages and provide information needed to correct errors or omissions. The testing procedures and requirements will vary between TDH interfaces and will depend upon which stage of the Meaningful Use process is being completed. The testing and validation process will continue until the onboarding team states the messages have met the requirements. The trading partner’s active engagement status will be provided in the TPR system under the Interface Details tab.

The EP, EH, or CAH has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.

Appropriate TDH program staff will indicate that testing has been successfully completed and data is being sent to the TDH production system. TDH may communicate with those reporting electronically about data quality. The trading partner’s active engagement status will be provided in the TPR system under the Interface Details tab. 

Preferred Secure Tranport Options

Below are the current preferred transport methods for each of the Public Health measure. Additional mechanisms might be available and can be discussed when appropriate.  

Interface   Secure File Transport Protocol (SFTP) Web Services Direct Messaging AIMS
Cancer Case Reporting   Yes No No No
Electronic Case Reporting   No No No Required (w/ RCKMS)
**Electronic Laboratory Reporting   Yes Preferred No Yes
*Immunization Registry   Yes Yes No No

**Syndromic Surveillance 

(EHs w/Emergency Department or urgent care facilities)

  Yes Yes No No

*Using the formally defined transport standard for transmitting immunization data via HL7 messaging - CDC Web Service Definition Language (WSDL)

Note: trading partners seeking a bi-directional interface with TennIIS should contact the TennIIS Team at TennIIS.MU@tn.gov

** Standards-based SOAP/REST web services

Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) platform and the Reportable Condition Knowledge Management System (RCKMS)

Useful Links

Use the links below to learn more about Promoting Interoperability (PI) Programs. Be sure to check here periodically for updates.

See links below for additional information: 

Contact Us

If you have any questions or comments you would like to share, click on the link below to enter your information in the Office of Informatics and Analytics (OIA) Feedback form.

For questions regarding Promoting Interoperability programs and/or public health reporting, please contact the TDH Partner Engagement Team at MU.Health@tn.gov.