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Syndromic Surveillance (SS)

image representing a new item PHIN Messaging Guide For Syndromic Surveillance: Emergency Department, Urgent Care And Inpatient Settings, Release 1.9 (April 2013) is now available on the Public Health Information Network (PHIN) Message Guides Website.

Public health syndromic surveillance using inpatient and ambulatory clinical care electronic health record (EHR) data is a relatively new practice. As eligible health professionals and hospitals adopt, implement, and upgrade their EHR systems through the CMS EHR Incentive programs (Meaningful Use programs), there is an opportunity for public health agencies (PHAs) to routinely receive health data from settings other than emergency departments and urgent care centers. Given the number of factors and complex relationships that affect EHR data quality, a collaborative approach that includes public health, healthcare, and EHR technology developers is the best way to determine how EHR data can be meaningfully used for surveillance.

In November 2012 the International Society for Disease Surveillance (ISDS) released Electronic Syndromic Surveillance Using Hospital Inpatient and Ambulatory Clinical Care EHR Data: Recommendations from the ISDS Meaningful Use Workgroup (Recommendations). These Recommendations are the product of an ISDS-convened Meaningful Use (MU) Workgroup that used their various stakeholder perspectives and expertise in public health practice and medical informatics to guide the document's development. With the facilitation of ISDS staff, the Centers for Disease Control and Prevention (CDC), and HLN Consulting, the MU Workgroup used an iterative development process, soliciting stakeholder feedback at project initiation and twice while recommendations were developed. The Workgroup used both stakeholder input and their own expertise to draft Recommendations that balance current feasibility and resource concerns with community enthusiasm for surveillance innovation with these clinical data.

The finalized Recommendations provide clarity for Stage 2 Meaningful Use, when on-going syndromic surveillance reporting will be required for eligible hospitals. They also provide a basis for planning and establishing data use relationships between PHAs and eligible professionals or hospitals while building upon prior ISDS work by incorporating both lessons learned and broader stakeholder participation. Additionally, the Recommendations suggest Stage 3 of Meaningful Use rules for the syndromic surveillance objective and future EHR certification criteria.

To view the final Recommendations and learn more about the project, please visit the ISDS MU Inpatient and Ambulatory page.

The Public Health Information Network (PHIN) message guides for syndromic surveillance are available at:

PHIN Message Quality Framework (MQF) is an automated testing tool that ensures messages are adhering to standards defined in the supported messaging guides. More information is available at:

NIST Test Procedure for syndromic surveillance


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