Electronic Public Health Reporting and Promoting Interoperability

The Centers for Medicare and Medicaid Services (CMS) incentivizes providers and facilities to successfully demonstrate Meaningful Use of certified electronic health record (EHR) technology (CEHRT). The Rhode Island Department of Health works with eligible professionals and hospitals to help them meet public health objectives to qualify for these incentives. CMS renamed the Electronic Health Records (EHRs) Incentive Programs as the Promoting Interoperability (PI) Programs in April 2018.

The Promoting Interoperability initiative has moved the programs beyond the existing requirements of Meaningful Use to a new phase of EHR measurement with an increased focus on interoperability and improving patient access to health information. The initiative’s goal is to improve electronic reporting to public health, and ultimately improve patient care. Benefits include: 

  • Bi-directional communication between state public health departments and clinical care providers 
  • Standardized data elements for data exchange 
  • Improved efficiency across the healthcare and public health system

For fiscal year 2022, the Medicare Promoting Interoperability Program for eligible hospitals and Critical Access Hospitals (CAHs) requires reporting “yes” on four of the existing Public Health and Clinical Data Exchange Objective measures or requesting applicable exclusion(s).

  • Syndromic Surveillance Reporting,
  • Immunization Registry Reporting,
  • Electronic Case Reporting, and
  • Electronic Reportable Laboratory Result Reporting,

The Rhode Island  Department of Health (RIDOH) is actively working with eligible professionals (EPs) and eligible hospitals (EHs) to  help them meet 2022 Medicare Promoting Interoperability Program requirements.

Syndromic Surveillance

All Rhode Island acute care hospital emergency departments (EDs) currently report syndromic surveillance data to RIDOH through the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE). EDs report admission, discharge, and transfer message data through HL7 format as they occur in compliance with the Centers for Disease Control and Prevention’s (CDC’s) HL7 implementation guides. RIDOH uses these data to detect changes in ED visits for various health conditions as part of CDC’s National Syndromic Surveillance Program (NSSP).

RIDOH currently only receives syndromic surveillance data from hospital EDs and not individual providers. RIDOH is working to receive data from additional reporters and care settings.


 RICAIR (The Rhode Island Adult and Child Immunization Registry) accepts immunization data for patients of all ages from both Eligible Professionals and Eligible Hospitals. MORE

Electronic Case Reporting (eCR)

Electronic Case Reporting (eCR) is the automated generation and transmission of case reports from electronic health records (EHRs) to public health agencies (PHAs) for review and action. eCR reduces burden to public health and improves the timeliness and completeness of case reports at the local, state, and national levels.

RIDOH uses the HL7 electronic initial case report (eICR) standards (R1.1 and R3) for electronic case reporting (eCR), and to support CMS Promoting Interoperability standards for eCR. We will require the use of the Association of Public Health Laboratories’ Informatics Messaging System (AIMS) and the Reportable Condition Knowledge Management System (RCKMS) for reporting.

We accept electronic case reporting (eCR) from Eligible Professionals (EPs), Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs).  The eCR will conform to HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 - US Realm - the Electronic Initial Case Report (eICR)

Visit RIDOH's eCR webpage to learn more about the process and details.

Electronic Laboratory Reporting (ELR)

Electronic Laboratory Reporting is a secure, automated mechanism for the reporting of laboratory and patient information by hospitals and commercial laboratories ELR allows us to avoid these time-consuming manual processes; thus, it is the required reporting mechanism for laboratory providers.

As of February 17, 2014, the Division of Preparedness, Response, Infectious Disease and Epidemiology (PRIDE) will accept electronic laboratory results (ELR) data related to reportable diseases from both Eligible Hospitals (in HL7 2.5.1 format) and clinical laboratories (in HL7 2.3.1 or 2.5.1 format). Eligible Hospitals wishing to attest to data submission need to register their intent at the beginning of their reporting period using this form if:

  • They are beginning to test sending Meaningful Use Compliant HL7 messages for Reportable Diseases to us for the first time or have not previously established ongoing submission of HL7 2.5.1 prior to the beginning of their reporting period.
  • They currently have ongoing submission of Reportable Disease related messages to us and want to switch to Meaningful Use Compliant HL7 2.5.1.
  • Please enter your intent to register for ELR

Specialized Registries

Birth Defects Registry

The Rhode Island Birth Defects Program is ready to accept data as a specialized registry (Stage III Meaningful Use, Measure 3) from hospitals and providers and use the data to improve birth defects outcomes. The Rhode Island Birth Defects Program  will:

  • Develop a standard electronic data file layout.
  • Develop a testing and validation process to move into production.
  • Receive electronic files through a secure mechanism.
  • Provide appropriate documentation to participating providers.

Cancer Registries

We currently do not have the capacity to accept cancer registry data in HL7 format from Eligible Professionals or Eligible Hospitals.

What Eligible Healthcare Providers Should Do