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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 ​human diseases and conditions:

  1. Acanthamoeba Infection
  2. Alpha-gal Syndrome
  3. Amebiasis
  4. Anthrax
  5. Arboviral Diseases (not specified elsewhere on this list) 
  6. Balamuthia mandrillaris Disease
  7. Blastomycosis
  8. Botulism
  9. Botulism, Infant
  10. California Serogroup Virus Diseases (not specified elsewhere on this list) ​
  11. Chikungunya Virus Diseases​​​
  12. Congenital Cytomegalovirus (cCMV) Infection and D​isease
  13. Coccidioidomycosis (Valley Fever)
  14. COVID-19​
  15. COVID-19-associated Pediatric Mortality
  16. Creutzfeldt-Jakob Disease (CJD) and Variant Creutzfeldt-Jakob Disease (vCJD)
  17. Dengue Virus Infection
  18. Diphtheria
  19. Eastern Equine Encephalitis Virus Disease​​
  20. Encephalitis
  21. Giardiasis
  22. Glanders
  23. Hansen's Disease
  24. ​Hantavirus (Pulmonary Syndrome, Infection)
  25. Hepatitis B, Acute and Chronic Infections
  26. Hepatitis C​, Acute and Chronic Infection​s
  27. Hepatitis C, Perinatal Virus Infection
  28. Hepatitis D Virus Infection
  29. Hepatitis E Virus Infection​​​​​
  30. Hepatitis G Virus Infection
  31. Histoplasmosis
  32. Influenza-associated Pediatric Mortality
  33. Invasive Cronobacter Infection Among Infants​​
  34. Invasive Haemophilus Influenzae Disease
  35. Invasive Pneumococcal Disease
  36. Jamestown Canyon Virus Disease
  37. Kawasaki Disease
  38. La Crosse Virus Disease
  39. Latent Tuberculosis Infection (LTBI)
  40. Legionellosis
  41. Listeriosis
  42. Malaria
  43. Measles​
  44. Meningitis
  45. Meningococcal Disease
  46. Middle East Respiratory Syndrome (MERS)
  47. Mpox (formerly Monkeypox)​​​
  48. Mumps
  49. Mycobacterial Infection (non-TB/non-Hansen's Disease; pulmonary & non-pulmonary)
  50. Naegleria fowleri Primary Amebic Meningoencephalitis
  51. ​​Novel Influenza A Virus Infection
  52. Oropouche Virus Disease​​
  53. Orthopoxvirus Disease
  54. Plague (Yersinia pestis​)
  55. Poliomyelitis, paralytic
  56. Poliovirus Infection, nonparalytic
  57. Powassan Virus Disease
  58. ​Q Fever
  59. ​Rabies
  60. Ricin Toxin Poisoning
  61. Rubella, Congenital Syndrome
  62. Severe Acute Respiratory Syndrome (SARS)​
  63. ​Smallpox
  64. Snowshoe Hare Virus Disease
  65. St. Louis Encephalitis Virus Infection
  66. Streptococcal Disease, Invasive, Group A (Group A Strep)
  67. Streptococcal Disease, Invasive, Group B (Group B Strep)
  68. Streptococcal Toxic Shock Syndrome​
  69. Strongyloidiasis
  70. Tetanus
  71. Toxoplasmosis
  72. Tularemia
  73. Varicella (Chickenpox) - Fatal cases only
  74. Viral Hemorrhagic Fevers (VHFs): 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​, Rift Valley Fever, and Sabia-associated hemorrhagic fever
  75. West Nile Virus Infection
  76. Western Equine Encephalitis Virus Disease​
  77. ​Yellow Fever
  78. Zika Virus Disease

Please see the full list of 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 October 9, 2026​