As the knowledge required to support case reporting evolves from unstructured to more structured and standardized formats, it becomes suitable for electronic clinical decision support (CDS). CDS for case reporting confronts two challenges: a) While EHRs are moving toward local CDS capabilities, it will take several years for EHR systems to consistently support this capability; and b) public health-related CDS knowledge, such as Zika infection detection and reporting rules, may differ from jurisdiction to jurisdiction. Therefore, there is an ongoing need to manage reporting rules in a distributed manner. Similarly, there is a need for more decentralized models of CDS execution to overcome some of the disadvantages of centralized deployment and to leverage local CDS capabilities as they become available over the next several years.
Objective: To discuss how clinical decision support (CDS) for electronic case reporting (eCR) will evolve over time to provide multiple deployment models