Electronic Case Reporting for Disease Surveillance

A Tribal Data Sovereignty Project

Table of Contents:

What is eCR? | Data Sovereignty and eCR | NIHB’s Role in eCR | Get Involved | Acknowledgement | Contact Us

What is eCR?

Electronic case reporting (eCR) is the automated, real-time exchange of disease case report information between electronic health records (EHRs) and public health agencies. eCR is a tool that public health authorities (PHAs) can use, according to their needs, interests, and policies to receive immediate data on reportable diseases and possible outbreaks. eCR securely transfers patient and clinical information from healthcare providers to public health for disease tracking, case management, and contact tracing. 

As a joint effort between the CDC, the American Public Health Labs (APHL) and the Council for State and Territorial Epidemiologists (CSTE), eCR is intended to strengthen disease surveillance systems.

Benefits of eCR include:

  • Real-time surveillance: Provide more timely and complete data to support outbreak management and monitor disease trends
  • Faster outbreak response: Efficiently monitor the spread of reportable diseases like COVID-19 during outbreaks and public health emergencies
  • Better communication between healthcare and public health: Improve communication and collaboration with healthcare by enabling bidirectional data exchange 

Learn more about eCR from the Centers for Disease Control and Prevention (CDC) website here.

Data Sovereignty and eCR

Tribes and other Tribal public health authorities have faced difficulties in receiving real time infectious disease case reports from outside entities. Such delays affect how quickly a Tribe can respond to outbreaks. Electronic case reporting (eCR) can provide real time data to Tribal public health authorities to ensure a swift investigation process.  

As sovereign governments, Tribal Nations have inherent public health authority which bestows upon them the legal authority to receive case reports on conditions of interest to them. Tribes and Tribal public health authorities have faced difficulties in receiving real-time infectious disease case reports. eCR can provide real-time data to Tribal public health authorities to ensure a swift investigation process.

NIHB’s Role in eCR

NIHB is supporting eCR implementation for Tribes, Tribal Consortiums, Tribal Epidemiology Centers (TECs), or other Tribal bodies with public health authority in partnership with the CDC through the following activities:

  • Providing direct funding and technical assistance to Tribes and TECs to implement eCR
  • Developing trainings on eCR for Tribal public health authorities and healthcare providers
  • Hosting listening sessions on eCR with federal partners
  • Developing an “eCR for Tribes Roadmap” (coming soon)
  • Working with Tribes to strengthen data sharing agreements with state and local partners

NIHB currently funds two Tribes as a pilot cohort connecting to eCR through the APHL AIMS Platform.

  • Salt River Pima Maricopa Indian Community
  • Turtle Mountain Band of Chippewa Indians

Read the CDC success story to learn more about the goals of these Tribal Nations in connecting to eCR here: Two Tribal Public Health Agencies to Receive eCR Data | CDC

Get Involved

Join our Learning Community:

NIHB is developing a learning community for Tribal public health and healthcare employees to learn more about eCR for Tribes. Sign up here to receive updates on trainings and resources:

Share your expertise:

As NIHB develops guidance for eCR, we look to you for expertise from Tribal leaders, public health practitioners, healthcare providers, health administrators, and Tribal policy professionals. NIHB will be conducting key informant interviews on eCR and Tribal data sovereignty for disease surveillance in early 2024. Please reach out to [email protected] if you are interested in participating. Topics will include:

  • eCR implementation strategies
  • Tribal disease surveillance systems
  • Data sharing between healthcare and public health systems
  • Legal and policy factors for disease surveillance


Our 2023-2024 funding opportunity has closed, and recipients of this funding will be announced soon. NIHB expects to announce our next opportunity for eCR in the fall of 2024, pending funding availability.


This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS), with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

Contact Us

Electronic Case Reporting (Disease Surveillance) Program
Email: [email protected]
Phone: 202-507-4078

NIHB Contacts:

Public Health Policy and Programs

National Indian Health Board
50 F St NW, Suite 600
Washington, DC 20001
Phone: 202-507-4070

National Indian Health Board
50 F St NW, Suite 600 | Washington, DC 20001 | Phone: 202-507-4070 | Email: [email protected]