Meaningful Use and Electronic Case Reporting

In July 2010, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) authorized incentive payments to health care providers and hospitals that demonstrate the meaningful use (MU) of certified electronic health records (EHRs). Eligible professionals and hospitals were able to begin participating in the incentive program in January 2011.

On October 1, 2015, CMS published a final rule for MU Stage 3 (see below) and modifications to MU for 2015-2017. For more information about these changes, see the CMS Rules and Regulations (PDF) or the New York State Meaningful Use Public Health Reporting website.

Declarations of MU Readiness

Stage 1

The Electronic Case Reporting (eCR) registry did not accept data for MU Stage 1.

Stage 2

As of January 1, 2017, the eCR registry began accepting data on reportable conditions from eligible providers and hospitals located in the city according to the standards required to meet the 2014 Edition Certified Electronic Health Record Technology (CEHRT) definition (PDF).

Stage 3

The NYC Department of Health (DOHMH) is working with the Digital Bridge initiative to implement an eCR approach for nationwide interoperability and enhanced delivery of effective disease control and patient care practices. Starting January 1, 2018, the DOHMH eCR registry will begin accepting submissions of case reports using HL7 Version 3 Clinical Document Architecture (CDA), Release 2 format.

To learn more about Digital Bridge and the eCR specifications developed through the Digital Bridge partnership, see:

Establishing a Connection with the eCR Web Service

Information for EHR Vendors


  • Must be able to generate an HL7 CDA R2 electronic initial case report.
  • Must be able to connect to Digital Bridge.


  1. Review NYC’s eCR Web Service Implementation Guide (to be posted).
  2. Review the implementation checklist (PDF).
  3. Sign and email the vendor confidentiality agreement (to be posted) to
  4. Schedule a call with DOHMH staff to review requirements.
  5. Participate in regularly scheduled follow-up calls to provide status updates until production deployment.
  6. Connect to the eCR Web Service test environment.
  7. Select a pilot site from which to send real reportable condition data.
  8. Send a minimum of one month’s worth of real reportable condition data through the test environment.
  9. If issues are identified, make necessary modifications and send a new load of data to confirm issues have been resolved.
  10. Once approved for production use, discuss roll out plans with DOHMH staff.
  11. Connect providers to the eCR Web Service live environment for ongoing reporting.
  12. Ensure that providers have evidence of ongoing submission by confirming that HL7 Reportability Response documents are logged in the EHR.

Information for NYC Providers


  1. Register your intent to submit eCR data for MU by following the directions on the New York State Meaningful Use Public Health Reporting website.
  2. Ensure that you are using an EHR that is ONC-certified for MU.
  3. Contact your EHR vendor to request a connection to Digital Bridge.
  4. Email the following information to
    • Practice name
    • Primary contact name, email and phone number
    • EHR software name and version number
  5. Work with your EHR vendor to implement a connection to Digital Bridge.
  6. Once connected, maintain ongoing reporting in accordance with City and State law.
  7. Log HL7 Reportability Response documents that are sent by Digital Bridge in response to each transaction sent by your EHR. These messages will serve as evidence that ongoing data transmission was achieved.


For more information, email

Additional Resources