HL7's new AMS is live!   We are working with Fonteva to resolve log in issues. My Account

Section 1c: FHIR®
Section 3: Implementation Guides

HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR), Release 2.1 - US Realm


The FHIR Implementation Guide (IG) specifies a US Realm FHIR electronic Case Reporting (eCR) implementation guide. It profiles FHIR for electronic initial case report (eICR), Reportability Response and trigger code / business logic distribution with FHIR resources.

With the advent of FHIR standards, there is a need for FHIR implementation guidance to specify appropriate resources and transactions needed for the eCR process. FHIR offers opportunities to further enable automated triggering and reporting of cases from EHRs, to ease implementation and integration, to support the acquisition of investigation supplemental data, and to connect public health information (e.g., guidelines) and clinical workflow. Over time, FHIR may also support the distribution of reporting rules to clinical care to better align data authorities and make broader clinical data available to public health decision support services inside the clinical care environment.



Version  Name Download link

STU 2.1

HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR), Release 2.1 - US Realm http://hl7.org/fhir/us/ecr/STU2.1





Submit Feedback on all STU versions using:

  • Project = “FHIR Specification Feedback (FHIR))”
  • Specification = “Electronic Case Reporting (FHIR)”
  • Raised in Version = "2.1.0"


Related Specifications

Name Product Brief
HL7 CDA® R2 Implementation Guide: Public Health Case Report Release 2: the Electronic Initial Case Report (eICR) Release 1, STU Release 1.1 - US Realm View Brief
HL7 CDA® R2 Implementation Guide: Reportability Response, Release 1, STU Release 1.1 - US Realm View Brief








HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR), Release 2.1 - US Realm may also go by the following names or acronyms:

"FHIR IG: eCR, R1-US Realm", Electronic Case Report, eCR, Reportability Response, RR, eICR, Electronic Initial Case Report


  • Supports public health surveillance as well as the delivery of relevant public health information to clinical care with the adoption and maturing of Electronic Health Records (EHRs).
  • Provides more complete and timely case data, support disease / condition monitoring, and assist in outbreak management and control.
  • Improves bidirectional communications through the delivery of public health information in the context of a patient's condition and local disease trends and by facilitating ad hoc communications.
  • Reduces healthcare provider burden by automating the completion of legal reporting requirements.



  • Association of Public Health Laboratories
  • Association of State and Territorial Health Officials
  • Centers for Disease Control and Prevention Centers/Institutes/Offices
  • CGI Federal
  • Council of State and Territorial Epidemiologists
  • Electronic Health Record Developers
  • Healthcare Providers
  • Public Health Informatics Institute
  • State, Territory, Local and Tribal Public Health Agencies



Suggested data needed by public health for inclusion in the electronic initial case report was identified by the Council of State and Territorial Epidemiologist Initial Case Report Task Force.


To Submit Feedback on all versions of this STU: (must obtain a Jira account)

  • Click on "Submit feedback on STU" link
  • Click on "Create" button in Jira
  • From the "Specification" dropdown select "Electronic Case Reporting (FHIR)”
  • From the "Raised in Version" dropdown select = “2.1.0”






  • Public Health


  • STU




Public Health


  • Implementation Guide


  • EHR, PHR Vendors
  • Health Care IT Vendors
  • Lab Vendors
  • Local and State Departments of Health
  • Regulatory Agency
  • Standards Development Organizations (SDOs)


  • FHIR


  • Active


  • US Realm