Meaningful Use

Hawaii Department of Health Meaningful Use

The American Reinvestment & Recovery Act (ARRA) was enacted on February 2009 and includes the “Health Information Technology for Economic and Clinical Health (HITEC) Act”.  This Act supports the concept of electronic health records and Meaningful Use (MU) which is an effort led by Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC).  MU is defined by the use of certified EHR technology in a meaningful manner as defined by CMS and ONC.  This includes a set of measures and metrics that are shared through a set of rules that are released in three stages.   “Promoting Interoperability” formally known as Electronic Health Records Meaningful Use began on December 2014.

Hawaii Public Health Declaration of Readiness

MeasuresStage 2 MU (2014-2017)Stage 3 MU -2018 Year
Electronic Lab ReportingYesYes
Electronic Case ReportingNAYes
Immunization Registry ReportingYesNo
Syndromic Surveillance ReportingNoNo
Cancer Registry ReportingYesNo (Effective March 1st, 2018)

Laboratory Reporting:

The Hawaii Dept. of Health (HDOH), Disease Investigation Branch is accepting HL7 (version 2.5.1) messages from certified electronic health record (EHR) systems for electronic laboratory reporting (ELR) and Meaningful Use (MU) attestation. ELR reporting is designed to be secure, automated, and unobtrusive to facility operations. Successful ongoing submission to HDOH using the ELR reporting method will assist eligible hospitals in receiving Medicare and Medicaid incentive funds.

The Hawaii Dept. of Health  encourages all laboratories, providers and EHR vendors to coordinate with the Hawaii Health Information Exchange (HHIE) to establish a connection for secure data transmission of HL7 2.5.1 for ELR data.  To register intent, a provider MUST HAVE a hospital / laboratory application which has certified laboratory messaging capabilities at the time of their registration.

Please contact the HDOH ELR coordinator for more information about the Laboratory Reporting attestation process.

There are no changes to the HL7 implementation guide used for Electronic Laboratory Reporting in Meaningful Use stage 3.  However, there may be a need to re-validate if a hospital or laboratory updates or purchases new certified software.

Last reviewed September 12, 2019

Meaningful Use Stage 3 Electronic Case Reporting (eCR)

Electronic case reporting is the electronic transmission of reports of potential cases of reportable diseases and conditions from an electronic health record (EHR) system to the public health agency’s disease surveillance system for review and action.  Public health agencies should declare readiness six months prior to being able to receive data.  As of September 25, 2017, the Hawaii Department of Health (HDOH) is ready to actively engage eligible professionals, eligible hospitals and /or critical access hospitals participating in electronic case reporting (eCR) pilots for MU3 electronic case reporting (eCR) beginning in 2018. Note that electronic case report data is not a replacement for reporting of communicable diseases, nor is it a substitute for electronic laboratory reporting (ELR).

To register intent, a provider MUST HAVE certified eCR capabilities at the time of their registration.

Implementation Guide: eCR messages must meet the HL7 definition as described in HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 – US Realm Electronic Initial Case Report (eICR). HL7 membership may be required to access this document.

Certification Criteria: eCR must meet the 2015 edition CEHRT definition

HDOH is currently developing requirements to begin pilot testing.  To register your intent to participate in eCR engagement with the Hawaii Department of Health, please complete our eCR registration survey.  For assessment of disease reporting volume, please complete the Hawaii infectious disease reporting survey

Additional information will be posted as it becomes available, please contact  DOH.ELR.Hawaii for questions.

Last reviewed September 12, 2019

Helpful Links:

CDC Meaningful Use Website

CMS Incentive Program Criteria

The Association of State and Territorial Health Officials (ASTHO) website on Electronic Case Reporting

The Digital Bridge and its initial focus on electronic case reporting (eCR)

Meaningful Use: Immunization Information System (IIS) Reporting

To meet requirements, eligible professionals and eligible hospitals and/or critical access hospitals must be in active engagement with an immunization registry or other type of Public Health agency to submit electronic public health data in a meaningful way using Certified Electronic Health Record Technology. Active engagement can be in the form of registration of intent, testing and validation, and ongoing electronic submission of data to the registry.


The Hawaii Immunization Registry (HIR) has been unable to accommodate new requests from providers for electronic data exchange submissions since June 1, 2017.  In addition, since August 3, 2018 to the present, the HIR has not been operational and existing HIR providers have not been able to submit data electronically or access records in HIR (for updates on the status of the HIR please check

Eligible professionals, hospitals and/or critical access hospitals enrolled with HIR seeking a meaningful use attestation for active engagement in 2018 and/or 2019 may qualify for an interoperability exclusion for those years due to HIR’s inability to accept, process or engage in ongoing electronic data exchanges to its system.

The above language is being provided to use when submitting your request to Medicare/Medicaid for Exclusion under Medicaid Promoting Interoperability Program Eligible Professionals Objectives and Measures for 2019 Objective 8.

Last reviewed September 12, 2019

Syndromic Surveillance Reporting:

Effective 10/01/2014, HDOH is no longer supporting Syndromic Surveillance Reporting.

Cancer Reporting:
Effective March 1st, 2018, Hawaii Tumor Registry would like to inform all Eligible Providers (EP) and Critical Access Hospitals (CAH) that the Hawai‘i Tumor Registry will no longer participate in Meaningful Use (MU) for Cancer Reporting.

If in the future the Hawai‘i Tumor Registry decides to participate once again, we will announce such notices on this web page, the State of Hawai‘i, Department of Health Meaningful Use web page.

Last reviewed September 12, 2019