{"id":25847564,"date":"2025-09-16T12:23:02","date_gmt":"2025-09-16T12:23:02","guid":{"rendered":"https:\/\/chronicdisestg.wpenginepowered.com\/?page_id=25847564"},"modified":"2026-07-30T16:14:44","modified_gmt":"2026-07-30T16:14:44","slug":"implementation-stories","status":"publish","type":"page","link":"https:\/\/preparedness.cste.org\/?page_id=25847564","title":{"rendered":"Engagement"},"content":{"rendered":"

[et_pb_section fb_built=”1″ _builder_version=”4.24.2″ _module_preset=”default” positioning=”none” z_index=”2″ custom_margin=”|20px||20px|false|true” custom_margin_tablet=”|20px||20px|false|true” custom_margin_phone=”|10px||10px|false|true” custom_margin_last_edited=”on|phone” custom_padding=”||180px|||” border_radii=”on|20px|20px|20px|20px” border_radii_tablet=”on|20px|20px|20px|20px” border_radii_phone=”on|15px|15px|15px|15px” border_radii_last_edited=”on|phone” locked=”off” global_colors_info=”{}”][et_pb_row module_id=”section1″ _builder_version=”4.16″ _module_preset=”default” width_tablet=”” width_phone=”90%” width_last_edited=”on|phone” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][dipi_dual_heading first_heading=”Preparedness” second_heading=”Engagement ” heading_tag=”h1″ heading_display=”column” fh_padding=”0px|20px|20px|20px|false|true” sh_style=”background” sh_background_style=”normal” sh_padding=”0px|20px|20px|20px|false|true” sh_margin=”-30px|0px|0px|20px|false|false” fh_padding_tablet=”0px|20px|20px|20px|false|true” fh_padding_phone=”0px|20px|20px|20px|false|true” fh_padding_last_edited=”on|desktop” fh_margin_last_edited=”off|desktop” sh_padding_tablet=”0px|20px|20px|20px|false|true” sh_padding_phone=”0px|20px|20px|20px|false|true” sh_padding_last_edited=”on|desktop” sh_margin_tablet=”-30px|0px|0px|20px|false|false” sh_margin_phone=”-20px|0px|0px|0px|false|false” sh_margin_last_edited=”on|phone” _builder_version=”4.27.4″ _module_preset=”default” first_heading_font=”Poppins||||||||” first_heading_text_color=”#919eb0″ first_heading_font_size=”80px” first_heading_letter_spacing=”-9px” first_heading_line_height=”1.1em” second_heading_font=”Poppins||||||||” second_heading_text_color=”#071018″ second_heading_font_size=”80px” second_heading_letter_spacing=”-9px” second_heading_line_height=”1em” custom_margin=”0px||10px||false|false” first_heading_font_size_tablet=”100px” first_heading_font_size_phone=”60px” first_heading_font_size_last_edited=”on|tablet” first_heading_letter_spacing_tablet=”-7px” first_heading_letter_spacing_phone=”-4px” first_heading_letter_spacing_last_edited=”on|tablet” second_heading_font_size_tablet=”100px” second_heading_font_size_phone=”60px” second_heading_font_size_last_edited=”on|tablet” second_heading_letter_spacing_tablet=”-7px” second_heading_letter_spacing_phone=”-4px” second_heading_letter_spacing_last_edited=”on|tablet” locked=”off” global_colors_info=”{}” overlay_bg_color_gradient_type_tablet=”linear” overlay_bg_color_gradient_type_phone=”linear” overlay_bg_color_gradient_type__hover=”linear” image_bg_color_gradient_type__hover=”linear”][\/dipi_dual_heading][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.24.2″ _module_preset=”default” width_tablet=”” width_phone=”90%” width_last_edited=”on|phone” custom_margin=”-51px|auto|-4px|auto||” custom_padding=”0px||0px||false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_blurb image_icon_width=”40px” icon_alignment=”left” content_max_width=”100%” _builder_version=”4.27.4″ _module_preset=”default” header_text_color=”#071018″ header_font_size=”22px” header_letter_spacing=”-0.2px” header_line_height=”1.2em” body_font=”Poppins||||||||” body_text_color=”#64748B” body_font_size=”20px” body_line_height=”1.4em” text_orientation=”center” custom_margin=”3px||51px|0px|false|false” custom_padding=”|8px||8px|false|true” header_font_size_tablet=”22px” header_font_size_phone=”18px” header_font_size_last_edited=”on|phone” body_font_size_tablet=”” body_font_size_phone=”12px” body_font_size_last_edited=”on|phone” custom_css_blurb_title=”text-transform: none;” locked=”off” global_colors_info=”{}”]<\/p>\n

Effective response to public health incidents and emergencies requires close collaboration and coordination. CSTE\u00a0<\/span><\/span>maintains strong\u00a0<\/span><\/span>partnerships with federal organizations such as the Centers for Disease Control and Prevention (CDC)<\/span>\u00a0<\/span><\/span>and\u00a0<\/span><\/span>member organizations including the Association of State and Territorial Health Officials (ASTHO),\u00a0<\/span><\/span>Association of Public Health Laboratories (APHL), Big Cities Health Coalition (BCHC), and National Association of City and County Health Officials (NACCH).<\/span><\/p>\n

[\/et_pb_blurb][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}” disabled_on=”on|on|on” disabled=”on”][et_pb_column type=”4_4″ _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_code _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”]\n\n\n\n\t\n\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t
Tool Name<\/th>Tool Description<\/th>eCR Workflow Stage<\/th>Maturity Level<\/th>Developing Organization<\/th>\n<\/tr>\n<\/thead>\n
eCR Hold Queue<\/td>Identifies the last eICR by SetID and version number<\/td>Data Visualization<\/td>Broad Adoption<\/td>California<\/td>\n<\/tr>\n
EMSA<\/td>Process eCR and ELR into EpiTrax<\/td>Data Processing<\/td>Broad Adoption<\/td>Nevada<\/td>\n<\/tr>\n
ScOT-e<\/td>Inserts parsed eCR data from Rhapsody intoSQL tables<\/td>Data Processing<\/td>Implemention<\/td>Oregon<\/td>\n<\/tr>\n
eCR Ingestion<\/td>Ingests eCRs from AIMS into Maven system<\/td>Data Processing<\/td>Implementation<\/td>South Dakota<\/td>\n<\/tr>\n
EMSA: Electronic Message Standardization and Automation<\/td>Uses rules-based processing and message queuing to automatically translate, classify, and process electronic health messages into disease surveillance systems<\/td>Data Processing<\/td>Broad Adoption<\/td>Utah<\/td>\n<\/tr>\n
eCR XML Parser<\/td>Parses eCR case report data from the NBS Document table and stores surveillance-relevant variables in the NEDSS reporting database.<\/td>Data Parsing<\/td>Implementation<\/td>Alabama<\/td>\n<\/tr>\n
R Code to Parse eCR XML via XSLT<\/td>Uses R scripts and XSLT to parse incoming eCRs and update surveillance data tables with relevant information of interest.<\/td>Data Parsing<\/td>Implementation<\/td>Colorado<\/td>\n<\/tr>\n
R Code for eCR Data<\/td>Extracts data from eICR and RR pairs to generate Excel-based outputs for data evaluation and visualization.<\/td>Data Validation<\/td>Implementation<\/td>Wisconsin<\/td>\n<\/tr>\n
Catergory Pull and Check<\/td>Pulls and extracts information from eICR zip files to support validation of specific data elements in Excel.<\/td>Data Validation<\/td>Implementation<\/td>Connecticut<\/td>\n<\/tr>\n
R Markdown for eCR Validation<\/td>Uses R Markdown to evaluate eCR data quality, validate core surveillance variables, and identify missing eCR messages associated with ELR records.<\/td>Data Quality<\/td>Broad Adoption<\/td>Utah<\/td>\n<\/tr>\n
eCR Pipeline<\/td>Supports eCR data quality, refinement, and validation through an integrated internal eCR processing pipeline.<\/td>Data quality, Data Validation, Data Refinement<\/td>Implementation<\/td>Louisiana<\/td>\n<\/tr>\n
eCR Datamart<\/td>Supports reporting, dashboard creation, and eCR data quality analysis through a datamart that parses and stores key surveillance fields.<\/td>Onboarding, Data Parsing, Data Visualizations.<\/td>Implementation<\/td>Kentucky<\/td>\n<\/tr>\n
Modified HTML<\/td>Uses a modified XML stylesheet to suppress display of sensitive eICR content and selected codes within HTML-rendered reports.<\/td>Data Visualization<\/td>Implementation<\/td>California<\/td>\n<\/tr>\n
eCR DQ Dashboard<\/td>Visualizes eCR data quality schematron results to support validation and monitoring activities.<\/td>Data Visualization<\/td>Implementation<\/td>South Dakota<\/td>\n<\/tr>\n
eCR\u00a0Refiner<\/td>Generate condition-specific eICR outputs to improve public health surveillance system ingestion, streamline epidemiology case investigation workflows, and enhance data usability for public health action.<\/td>Data Refinement<\/td>Pilot\/ Testing<\/td>APHL\/ CDC DIBBs<\/td>\n<\/tr>\n
Electronic Reporting and Surveillance Distribution (eRSD)<\/td>Electronic Reporting and Surveillance Distribution (eRSD) facilitates the automated distribution of trigger codes, reporting parameters, and surveillance guidance to EHRs for electronic case reporting<\/td>Data Triggering Logic<\/td>Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
Implementation Guide Schematron<\/td>A tool designed to assess the schema of eICRs based on the HL7 CDA Implementation Guides for public health case reports. Its primary purpose is to ensure that eICRs conform to the standards set in the Implementation Guide. <\/td>Data Quality<\/td>Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
eCR Data Quality Schematron<\/td>A comprehensive tool designed to evaluate data quality metrics for eICRs. It contains all the rules outlined in the Implementation Guide Schematron and introduces new rules for a more robust data quality assessment. <\/td>Data Quality, Data Validation
\n<\/td>		Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
PHA Monitoring Dashboard<\/td>A tool designed to help public health agencies (PHAs) track and manage eCR feeds. It provides real-time monitoring of incoming eICRs, ensuring operational efficiency and enabling timely alerts for outage response<\/td>Data Visualization<\/td>Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
Data Quality Dashboard<\/td>Centralized, national analytics tool providing shared, real-time visibility into eCR data quality across onboarding and production.<\/td>Data Quality<\/td>Development<\/td>APHL<\/td>\n<\/tr>\n
Terminology Exchange Service (TES)<\/td>Designed to streamline terminology management for\u00a0eCR\u00a0among PHAs. It provides centralized, condition-associated codes through a searchable user interface and an application programming interface (API), helping PHAs efficiently manage reportable\u00a0conditions<\/td>Vocabulary Management<\/td>Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
eCR Mapper<\/td>Creates a Simplified XML file, composed of data elements from both the RR and the eICR. The structure and content of both the RR and eICR source files are standardized Clinical Document Architecture (CDA) XML documents. The eCR Simplified XML Output is a flattened, less cumbersome, XML schema where many of the CDA templates and organizers are removed. <\/td>Data Parsing, Data Transformation<\/td>Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
XSL Style Sheets<\/td>A tool that can be utilized to transform XML files into human-readable HTML files. This allows the files to be easily opened and viewed in a web browser, facilitating a more straightforward user experience. <\/td>Data Visualization, Data Formatting<\/td>Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
FHIR Transforms<\/td>Enables\u00a0transfrom\u00a0of CDA\u00a0eICR\u00a0R1.1 or R3.1 to\u00a0FHIR\u00a0 2.1.1\u00a0or FHIR 2.1.1 to CDA\u00a0eICR\u00a0R3.1 to enable PHAs to opt to receive one or both payloads regardless of what HCOs send to AIMS.<\/td>Data Parsing, Data Transformation<\/td>Development<\/td>APHL<\/td>\n<\/tr>\n
Difference in Documents (Local)<\/td>A local DiD implementation that compares document versions to remove duplicate content already received by PHAs, reducing clutter while preserving key information.<\/td>Data Refinement<\/td>Implementation<\/td>APHL<\/td>\n<\/tr>\n
Difference in Documents (Central)<\/td>A central DiD implementation that evaluates updated eICRs to identify meaningful changes and suppress non-actionable updates, reducing unnecessary report volume for public health review.<\/td>Data Volume, Data Refinement<\/td>Development<\/td>APHL\/ CDC DIBBS<\/td>\n<\/tr>\n
Text to Code<\/td>A machine learning-powered shared service that converts unstructured clinical text and local codes in eICRs into standardized codes to improve reportability determination and downstream eCR processing.<\/td>Data Standards, Data Quality, Data Validation<\/td>Development<\/td>APHL\/ CDC DIBBs<\/td>\n<\/tr>\n
eCR Document Splitter and Filter<\/td>Provides grouping and filtering functionality that delivers condition-prioritized electronic Initial Case Reports (eICRs) and Reportability Responses (RRs) to the receiving surveillance system.<\/td>Data Refinement, Grouping & Filtering<\/td>Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
eCR Feed Splitter<\/td>A tool that PHAs can utilize to split the production feed from AIMS into different environments, such as a test, stage, and\/or production environment. This allows jurisdictions to manage and monitor their data flows and ensure that the right data gets to the right environment at the right time.<\/td>Data Parsing, Data Routing<\/td>Broad Adoption<\/td>APHL<\/td>\n<\/tr>\n
AIMS online Validator<\/td>A tool for checking eICR test documents against inline validation artifacts on AIMS; supports eICR R1.1, R3.1, and eCR Data Quality Schematron v2.0<\/td>Data Quality<\/td>Broad Production<\/td>APHL<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n[\/et_pb_code][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_4,1_4,1_4,1_4″ disabled_on=”on|on|on” _builder_version=”4.27.4″ _module_preset=”default” custom_margin=”|auto|-5px|auto||” disabled=”on” global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_image src=”https:\/\/chronicdm1.wpenginepowered.com\/wp-content\/uploads\/2025\/09\/CSTE-BC-St1.png” title_text=”CSTE BC- St1″ url=”https:\/\/cste.sharepoint.com\/:b:\/s\/CSTE831\/EZ7BYNC23fdJuUjk6gOLmJcBm_k11ofrFXYRJfkb4o4luw?e=S6l7bk” url_new_window=”on” _builder_version=”4.27.4″ _module_preset=”default” background_color=”rgba(100,116,139,0.27)” 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For\u00a0<\/span><\/span>more information<\/span><\/span>\u00a0<\/span><\/span>on CSTE\u2019s Preparedness and Response activities<\/span><\/span>, please contact the CSTE National Office<\/span><\/span>\u00a0at<\/span><\/span>\u00a0<\/span><\/span>preparedness@cste.org<\/span><\/span>.<\/span><\/span><\/a>\u00a0<\/span><\/p>\n

[\/et_pb_blurb][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.24.2″ _module_preset=”default” background_enable_color=”off” custom_padding=”50px|30px|50px|30px|true|true” custom_padding_tablet=”50px|30px|50px|30px|true|true” custom_padding_phone=”20px|20px|20px|20px|true|true” custom_padding_last_edited=”on|phone” link_option_url=”#” border_radii=”on|10px|10px|10px|10px” border_width_all=”1px” border_color_all=”rgba(100,116,139,0.2)” global_colors_info=”{}” border_color_all__hover=”rgba(100,116,139,0.5)” border_color_all__hover_enabled=”on|hover”][et_pb_blurb title=”World Cup 2026″ use_icon=”on” font_icon=”||fa||900″ icon_color=”#7ED3FC” image_icon_width=”30px” icon_alignment=”left” _builder_version=”4.27.4″ _module_preset=”default” header_font=”Poppins|||on|||||” header_text_color=”#FFFFFF” header_font_size=”16px” header_letter_spacing=”1px” body_font=”Poppins||||||||” body_text_color=”#64748B” body_font_size=”16px” body_line_height=”1.6em” image_icon_custom_margin=”||100px||false|false” max_width=”290px” custom_margin=”auto||||false|false” custom_padding=”||||false|false” link_option_url=”https:\/\/preparedness.cste.org\/?page_id=25847292″ locked=”off” global_colors_info=”{}”]<\/p>\n

As the World Cup draws global attention, preparedness is key\u2014not just for fans, but for public health, safety, and security professionals.<\/span><\/p>\n

[\/et_pb_blurb][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.24.2″ _module_preset=”default” background_enable_color=”off” custom_padding=”50px|30px|50px|30px|true|true” custom_padding_tablet=”50px|30px|50px|30px|true|true” custom_padding_phone=”20px|20px|20px|20px|true|true” custom_padding_last_edited=”on|phone” link_option_url=”#” border_radii=”on|10px|10px|10px|10px” border_width_all=”1px” border_color_all=”rgba(100,116,139,0.2)” global_colors_info=”{}” border_color_all__hover=”rgba(100,116,139,0.5)” border_color_all__hover_enabled=”on|hover”][et_pb_blurb title=”Response Strategies And Coordination” use_icon=”on” font_icon=”||divi||400″ icon_color=”#7ED3FC” image_icon_width=”30px” icon_alignment=”left” _builder_version=”4.27.4″ _module_preset=”default” header_font=”Poppins|||on|||||” header_text_color=”#FFFFFF” header_font_size=”16px” header_letter_spacing=”1px” body_font=”Poppins||||||||” body_text_color=”#64748B” body_font_size=”16px” body_line_height=”1.6em” image_icon_custom_margin=”||100px||false|false” max_width=”290px” custom_margin=”auto||||false|false” custom_padding=”||||false|false” link_option_url=”https:\/\/preparedness.cste.org\/?page_id=25847221″ locked=”off” global_colors_info=”{}”]<\/p>\n

The CSTE Preparedness and Response Team and other staff from the CSTE National Office engage STLT epidemiologists<\/span><\/p>\n

[\/et_pb_blurb][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.27.4″ _module_preset=”default” background_color=”#7ED3FC” custom_padding=”50px|30px|50px|30px|true|true” custom_padding_tablet=”50px|30px|50px|30px|true|true” custom_padding_phone=”20px|20px|20px|20px|true|true” custom_padding_last_edited=”on|phone” link_option_url=”#” border_radii=”on|10px|10px|10px|10px” border_width_all=”1px” border_color_all=”rgba(100,116,139,0.2)” global_colors_info=”{}” border_color_all__hover=”rgba(100,116,139,0.5)” border_color_all__hover_enabled=”on|hover”][et_pb_blurb title=”Resources” use_icon=”on” font_icon=”||divi||400″ icon_color=”#071018″ image_icon_width=”30px” icon_alignment=”left” _builder_version=”4.27.4″ _module_preset=”default” header_font=”Poppins|||on|||||” header_text_color=”#071018″ header_font_size=”16px” header_letter_spacing=”1px” body_font=”Poppins||||||||” body_text_color=”#64748B” body_font_size=”16px” body_line_height=”1.6em” image_icon_custom_margin=”||100px||false|false” max_width=”290px” custom_margin=”auto||||false|false” custom_padding=”||||false|false” link_option_url=”https:\/\/preparedness.cste.org\/?page_id=25847221″ locked=”off” global_colors_info=”{}”]<\/p>\n

Identify and cultivate partnerships with other practitioners working on chronic disease surveillance modernization.<\/p>\n

[\/et_pb_blurb][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

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\n \n \n \n Preparedness\n <\/span>\n <\/span>\n <\/span>\n \n \n \n Engagement \n <\/span>\n <\/span>\n <\/span>\n <\/h1>\n <\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>Effective response to public […]<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"dipi_cpt_category":[],"class_list":["post-25847564","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=\/wp\/v2\/pages\/25847564","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25847564"}],"version-history":[{"count":12,"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=\/wp\/v2\/pages\/25847564\/revisions"}],"predecessor-version":[{"id":25847961,"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=\/wp\/v2\/pages\/25847564\/revisions\/25847961"}],"wp:attachment":[{"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25847564"}],"wp:term":[{"taxonomy":"dipi_cpt_category","embeddable":true,"href":"https:\/\/preparedness.cste.org\/index.php?rest_route=%2Fwp%2Fv2%2Fdipi_cpt_category&post=25847564"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}