Community of Practice Updates

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*If you have questions about the NSSP CoP, its highly collaborative user groups, the NSSP CoP Slack Workspace (a collaboration platform), or syndromic surveillance, please email

Community Highlights

NSSP Community of Practice Monthly Call

Happy New Year! Let’s start the year by sharing some good news. Despite the unprecedented challenges of 2020 and 2021, we advanced syndromic surveillance in ways that will have far-reaching impact on the future of public health surveillance.

We attribute this to having a well-established Community of Practice (CoP), one that has been honing its collaborative skills for years. The essential tools, workflows, and relationships for conducting syndromic surveillance were intact at the onset of the pandemic, easing our ability to unify response efforts.

For starters, our response to COVID-19 has helped us do the following:

  • Expand emergency department (ED) coverage to all 50 states and Guam. In 2022, we want to increase facility participation to provide more coverage within public health jurisdictions.
  • Rapidly respond to questions from senators and White House staff, produce a data summary for the CDC Director, and issue weekly reports on both pediatric ED visits and trends by race and ethnicity.
  • Pioneer analytics that serve as leading-edge indicators of COVID-19 transmission.
  • Develop an innovative method that monitors trends in the number of counties with a statistical increase in COVID-19 ED visits.

Our real-time surveillance for COVID-19 demonstrated to those outside public health the potential of syndromic surveillance. And as the term syndromic surveillance began appearing in mainstream articles, the media helped to educate the public by describing the fundamentals of how this surveillance works to capture near real-time data. The media also brought long-overdue attention to our fractured public health system, exposing limitations in funding, staffing, and infrastructure.

What we’ve learned in our quest to understand, monitor, and combat the spread of COVID-19 has been applied to other endeavors. In 2021, the NSSP team and community collaborated to accomplish the following:

  • Expand the use of analytic tools that control for changes in facilities sending data over time, increasing confidence in longer term trend data.
  • Develop the Rnssp package and associated report templates to support partners with code and analytic tools.
  • Use ED data in novel ways for vaccine safety. We found that by using a query to capture vaccine-associated adverse events in ED visits, NSSP could produce a weekly interactive report for the CDC team overseeing vaccine safety. This report helped the team rapidly respond to questions about long-term ED trends in health conditions including myocarditis and thrombosis.
  • Complete the categorization of commercial laboratory data, enabling rapid analysis of all health conditions reportable in any state.
  • Enable public health practitioners to search ED data by Clinical Classifications Software Refined (CCSR) and ICD-10 diagnostic categories.

In 2021, the NSSP team published more articles than in all previous years of the program’s existence combined. As cases of COVID-19 surged, we published national trends on the direct and indirect effects of the COVID-19 pandemic, including pediatric visits during high transmission of the delta variant. At the same time, we published on suicide attempt, mental health, violence, overdose, influenza and other respiratory infections, and Lyme disease. We also used data from ED visits to publish on heat-related illness following the 2021 heat wave.

Overall, our near real-time data help to meet our nation’s need for timely and reliable data. And, importantly, we are making these data available to people outside public health through innovative public-facing dashboards and by providing national- and regional-level data to researchers and academia.

In 2022, the NSSP CoP aims to build on past achievements and leverage syndromic surveillance in new ways. As in previous years, we’ll do this by working together to host high-quality conferences and trainings and by focusing NSSP CoP subcommittee projects on pressing issues that will benefit from the diverse perspectives and expertise provided by community members.

We urge you to be a part of this progress: Join a subcommittee. Attend presentations. Once you’re involved, you’ll quickly benefit from the wisdom of others. You’ll discover novel approaches, new technologies, lessons learned, value gained from mutual support, and access to expert opinions. So please take advantage of the educational opportunities and social networking available. We look forward to your involvement in 2022!


  • New Date and Time for Monthly Community of Practice Call
    • Beginning January 2022, our monthly NSSP CoP calls will be held the fourth Wednesday of the month at a NEW time: 12:00–1:30 PM ET. Please join our first call of the new year on Wednesday, January 26, 2022, at 12:00 PM ET.
    • Updates have been posted on the NSSP CoP calendar.external icon
  • NSSP CoP Members Invited to Participate in Collaboration to Improve Emergency Support for People with Disabilities
    Improve Emergency Support for People with Disabilities
    • NSSP is collaborating with partners from CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) and the Association of State and Territorial Health Officials (ASTHO) to address COVID-19 response gaps. This new collaborative project will involve developing, testing, and disseminating syndrome definitions that can identify people with disabilities. The goal is to build state and local health department capacity and better monitor the health and wellbeing of people with disabilities before, during, and after public health emergencies.
    • To accomplish this, the CoP will convene a scientific panel of experts in disability, clinical medicine, syndromic surveillance, and emergency preparedness and response to collaborate on the disability definition for the project and to finalize a list of diagnosis codes for the syndrome definitions.
    • NSSP Community of Practice members are invited to contribute to the effort. Participants will meet for up to five discussions (~1 hour) between February and July. Once this foundational work is done, members will be invited to test the definitions.
    • Representatives from NCBDDD and ASTHO gave an overview of the project and answered questions during a webinar held January 18, 2022. Information will be posted in the Knowledge Repository.
    • If you’re interested in participating or pilot testing the definitions, please email Cassandra Thompson (
  • 2021 Syndromic Surveillance Symposium Final Event Packetpdf iconexternal icon Now Available
  • Mortality Project Final Webinar Recording Now Available
    • In 2021, NSSP and the Council for State and Territorial Epidemiologists (CSTE) collaborated with the National Association for Public Health Statistics and Information Systems (NAPHSIS) on a pilot project to route mortality data into ESSENCE. Recently, CSTE hosted a webinar with NSSP and NAPHSIS colleagues to give an overview of the project, including a demonstration of the application programming interface developed.
    • The webinar recording and other materials can be accessed in the Knowledge Repository.external icon
  • CSTE 2022 Annual Conferenceexternal icon Scheduled for June 19–23, 2022; Louisville, Kentucky
    • The CSTE Annual Conference connects public health epidemiologists and surveillance practitioners from across the country. The conference includes workshops, plenary sessions, oral breakout sessions, roundtable discussions, and poster presentations.
    • At this time, CSTE is planning for the possibility of some 2022 conference sessions being held in person and others being held virtually. CSTE will monitor public health circumstances and make changes based on health recommendations for group gatherings.
    • The call for abstracts closed Thursday, January 6, 2022.
    • Accepted authors will be notified in March 2022.
  • New Slack Channel Added
    • A new channel, “#hospital-admissions,” has been added.
    • This channel serves as a space for members to discuss data quality and trends in hospital admission data, which are particularly timely for Omicron.
Join the NSSP CoP Slack Workspace
Slack Channels

It’s easy to join.external icon And the community is always exchanging ideas, exploring possibilities, and discussing topics relevant to today’s surveillance challenges.

So what are your colleagues discussing?

  • #covid19
  • #data-lab
  • #data-sharing
  • #data-quality
  • #drug-overdose-use
  • #essence-user
  • #hospital-admissions (NEW)
  • #planned-analyses-and-publications
  • #national-data-requests-sop
  • #nssp-cop
  • #race-and-ethnicity
  • #random
  • #r-user
  • #severe-weather
  • #spherr
  • #syndrome-definitions
  • #training
  • #violence-surveillance

Find and Join Channels

  1. Hover cursor over “Channels” on left side of Slack space.
  2. Click the three dots icon that appears next to “Channels” titled “Section Options.”
  3. Select “Browse Channels.”
  4. Find and join any channel that looks interesting!
CMS Interoperability Graphic

A new CMS rule will benefit public health jurisdictions that participate in NSSP or use a local syndromic surveillance system by requiring facilities to submit syndromic data.

The Centers for Medicare & Medicaid Services (CMS) is promoting sustainability and readiness so that public health agencies are better prepared to respond to emerging health threats. On August 2, 2021, CMS published the final rule for changes to the Medicare Promoting Interoperability Program. The rule revised the requirements for eligible hospitals and critical access hospitals (CAHs) participating in the Medicare Promoting Interoperability Program. These hospitals are now required to have four of the measures associated with the Public Health and Clinical Data Exchange Objective: Syndromic Surveillance Reporting, Immunization Registry Reporting, Electronic Case Reporting, and Electronic Reportable Laboratory Result Reporting. Currently, these measures are optional. Under this change, an eligible hospital or CAH will receive 10 points for the Public Health and Clinical Data Exchange objective if they report a ‘‘yes’’ response for all four measures. The rule will take effect beginning with the reporting period in calendar year 2022.

The final rule requires hospitals with emergency departments (EDs) to attest that they are actively engaged with a public health agency to submit data for measures related to nationwide surveillance for early warning of emerging outbreaks and threats. Hospital submission of syndromic data supports public health agencies as they prepare to respond to both future health threats and long-term COVID-19 recovery.

Public health jurisdictions can declare readiness if they are able to receive messages in a locally administered syndromic surveillance system or if they direct submitters to send messages directly to the NSSP BioSense Platform, which makes data available to the jurisdictions’ authorized users. The NSSP onboarding team will help sites coordinate with the facilities to set up data feeds and begin transmission.

QUICK TIP: Does your website explain the new CMS ruling and how it can benefit public health? Now is a good time to make sure your website links to CMS “Promoting Interoperability Programs.”external iconexternal icon

CDC Data Modernization Implementation Support: Improving Surveillance Systems
CDC Resources: Public Health Data Interoperability
FY2022 IPPS/LTCH PPS Final Rule fact sheetexternal icon
FY2022 IPPS/LTCH PPS Final Rule on the Federal Registerexternal icon

This article includes excerpts from a press release external icondated August 2, 2021.

Data Modernization Initiative

“Modernization” of our public health data and surveillance systems is one way in which CDC invests in the future of public health.

The CDC Public Health Data Modernization Initiative lays out a path to move us toward integrated systems that provide data more efficiently for public health action. This framework guides decisions for allocating resources to create interoperable systems (federal, state, local, and healthcare), coordinate investments across CDC (and with partners), develop next-generation tools (e.g., modeling, visualization, machine learning), and strengthen predictive analytics and forecasting. One objective of DMI is for syndromic surveillance to give a faster understanding of emerging health threats through electronic reporting of emergency department visits.

“This is a moment in time when our national leaders will seek to identify or build platforms to detect and monitor future health threats,” NSSP Lead Loren Rodgers said during a 2021 NSSP Community of Practice call. “I’d like to challenge the NSSP community to consider our place in a new public health infrastructure. I don’t know of another program that is so purpose-built for this task with the ability to scale to include new data sources and analytics and to share these data with allied [public health] jurisdictions and trusted partners. Our syndromic community exemplifies innovative approaches that other surveillance systems aim to implement.”

CDC’s earlier modernization efforts laid the groundwork that supports NSSP’s current approach to surveillance and—bolstered by CDC’s Data Modernization Initiative—positions the program to better protect our country from all types of public health threats.

Page last reviewed: January 21, 2022