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Electronic Case Reporting (eCR)

​​​​​​​​​​​​​​​Electronic Case Reporting (eCR) is the automated generation and transmission of public health case reports directly from an electronic health record system (EHR) to a disease surveillance system of a public health agency for review and action.

The Maryland Department of Health (MDH) currently accepts electronic case reports (eCRs) from hospitals, critical access hospitals, and clinicians for the following reportable diseases and conditions:

  1. Acanthamoeba Infection
  2. Amebiasis
  3. Anthrax
  4. Balamuthia mandrillaris Disease
  5. Blastomycosis
  6. Botulism
  7. Botulism, Infant
  8. Chikungunya Virus Diseases
  9. Congenital cytomegalovirus (cCMV) Infection and D​isease
  10. Coccidioidomycosis (Valley Fever)
  11. COVID-19​
  12. Creutzfeldt-Jakob Disease (CJD) and Variant Creutzfeldt-Jakob Disease (vCJD)
  13. Diphtheria
  14. Encephalitis
  15. Giardiasis
  16. Glanders
  17. Hansen's Disease
  18. ​Hantavirus (Pulmonary Syndrome, Infection)
  19. Hepatitis B, Acute and Chronic Infections
  20. Hepatitis C​, Acute and Chronic Infection​
  21. Hepatitis C, Perinatal Virus Infection
  22. Hepatitis D Virus Infection
  23. Hepatitis E Virus Infection​​​​​
  24. Hepatitis G Virus Infection
  25. Histoplasmosis
  26. Influenza-associated Pediatric Mortality
  27. Invasive Cronobacter Infection Among Infants​​
  28. Invasive Haemophilus Influenzae Disease
  29. Invasive Pneumococcal Disease
  30. Kawasaki Disease
  31. Latent Tuberculosis Infection (LTBI)
  32. Legionellosis
  33. Listeriosis
  34. Malaria
  35. Measles​
  36. Meningitis
  37. Meningococcal Disease
  38. Middle East Respiratory Syndrome (MERS)
  39. Mpox (formerly Monkeypox)​​​
  40. Mycobacterial Infection (non-TB/non-Hansen's Disease)
  41. Naegleria fowleri Primary Amebic Meningoencephalitis
  42. ​​Novel Influenza A Virus Infection
  43. Oropouche Virus Disease​​
  44. Orthopoxvirus Disease
  45. Plague (Yersinia pestis​)
  46. Poliomyelitis, paralytic
  47. Poliovirus Infection, nonparalytic
  48. ​Q Fever
  49. ​Rabies (Human)
  50. Ricin Toxin Poisoning
  51. Rubella, Congenital Syndrome
  52. Severe Acute Respiratory Syndrome (SARS)​
  53. ​Smallpox
  54. Streptococcal Disease, Invasive, Group A (Group A Strep)
  55. Streptococcal Disease, Invasive, Group B (Group B Strep)
  56. Streptococcal Toxic Shock Syndrome​
  57. Strongyloidiasis
  58. Tetanus
  59. Toxoplasmosis
  60. Tularemia
  61. Varicella (Chickenpox) - Fatal cases only
  62. Viral Hemorrhagic Fevers (VHF): including, but not limited to: Ebola hemorrhagic fever, Guanarito hemorrhagic fever, Junin hemo​rrhagic fever, Lassa fever, Lujo virus, Machupo hemorrhagic fever, Marburg Virus Disease​, and Sabia-associated hemorrhagic fever
  63. West Nile Virus Infection
  64. ​Yellow Fever

Please note that this list is a subset of the diseases and ​conditions that are reportable in the State of Maryland. 

 The MDH eCR team is continuing to expand the number of conditions for which hospitals and healthcare providers will be able to submit electronic case reports. Please check this page for regular updates.

Sending eCRs to MDH

Requirements for Electronic Case Reporting to Maryland Departmen​t of Health​

​​
  1. Maryland Department of Health (MDH) uses Health Level 7 (HL7) standards for Initial Electronic Case Reports (eICRs) and Reportability Respon​ses (RRs) for electronic case reporting (eCR). ​To engage in eCR with MDH, healthcare organizations must use an electronic health record (EHR) system that is capable of supporting these HL7 Clinical Document Architecture (CDA) implementation guides:
  2. ​​Any EHR that uses the eCR Now FHIR App must implement version 3.1.13 or higher; see the latest eCR Now ​version. If your organization uses the eCR Now FHIR App and is unable to update it, please open a support ticket with your EHR vendor and request that your vendor promptly update the app.​
  3. All healthcare organizations (HCO) that are onboarding for eCR for the first time or that are changing their EHR must trigger for All Conditions. All HCOs currently triggering for only emergent conditions should transition to ​triggering for All Conditions as soon as possible.
  4. ​​​​​All HCOs must use Electronic Reporting and Surveillance Distribution (eRSD) version 3 or higher. 
    • ​Note: eRSD versions 1 and 2 were sunsetted on January 31, 2026 and will no longer be maintained or updated. HCOs that are using versions 1 or 2 risk not reporting all required cases. ​
    • Ensure that your organization's ​electronic health records (EHR) system is triggering eCRs from the most recent version of the eRSD. If your organization's eRSD is not on the most recent version, please install the latest eRSD release.​​​ You must have the current eRSD​ installed no later than the ​Effective Start Date of the release; see the release documentation for that date.​
  5. Check your Reportability Responses (RRs) regularly for messages from the AIMS platform that indicate that your eRSD is out-of-date or malformed, and take the appropriate action to correct it. This will ensure that your organization is triggering on the latest version of the code sets for reportable conditions.​​
  6. ​Pay prompt attention to email messages that you may receive from the CDC, AIMS, or MDH eCR onboarding ​​​teams. The MDH eCR team will review the frequency and volume of the eCRs received from your healthcare organization to ensure a steady flow of data.
  7. Ensure that your eCRs comply with the CSTE eCR Consensus Criteria: Completeness Thresholds for Priority Data Elements​  and the ​items on the MDH eCR data validation page​.

Additional questions about electronic case reporting to the Maryland Department of Health​? Please contact the MDH eCR Team at: [email protected]​​​​

Page last updated on February 27, 2026