Strengthening Syndromic Surveillance for a 2026 International Sporting Event

Spotlight #1: Laying the Groundwork

Helping Healthcare Facilities Prepare for an International Sporting Event

As Kansas City prepares to host six soccer matches and act as base camp for three teams during the international sporting event, public health officials anticipate welcoming more than half a million visitors to the region. Recognizing that large-scale international events can increase the risk of infectious diseases, injuries, heat-related illness, and other public health concerns, the Kansas Syndromic Surveillance Program (KSSP) began preparing well in advance. In 2024, KSSP formalized and documented a Facility Outreach Plan designed to engage physicians, clinical staff, informatics professionals, and hospital leadership to help them understand how their documentation practices directly support public health surveillance and response.

Rather than focusing only on technical system checks, Kansas centered its strategy on relationship-building. KSSP collaborated with CDC's National Syndromic Surveillance Program to draft a tailored outreach letter offering tips to healthcare facilities to optimize their documentation for large-scale event preparedness. The state communications team reviewed the letter and the State Registrar and State Epidemiologist both signed the letter to reinforce its importance.

KSSP invited facilities to structured meetings that included an overview of syndromic surveillance, discussed outreach goals, and collaboratively reviewed data quality improvements. Five of seven healthcare organizations in the geographic area responded and requested meetings—demonstrating that framing public health surveillance enhancements within the context of a high-profile global event can drive meaningful engagement.

By starting early and grounding outreach in shared preparedness goals, Kansas positioned syndromic surveillance as an integral part of preparing for the international tournament. The approach has strengthened communication channels, clarified expectations, and created opportunities for collaborative problem-solving well before the first match begins.

Key Takeaways for Jurisdictions

• Use high-visibility events to strengthen long-term facility relationships.

• Begin outreach 12–24 months in advance for new relationships. For established partnerships, timelines may be shorter, but be sure to continue to invest in connection points, clear roles, and action tied to findings.

• Secure visible leadership endorsement to reinforce shared preparedness goals.

• Pair education about syndromic surveillance with structured, solution-oriented discussions.

• Define a clear geographic "area of interest" for prioritized engagement.

Spotlight #2: Small Changes, Big Impact

Advancing Documentation and Timeliness for Syndromic Surveillance During Mass Gatherings

For syndromic surveillance to function effectively during a mass gathering, timeliness and data completeness are critical. In preparation for the 2026 international sporting event, the Kansas Syndromic Surveillance Program (KSSP) asked facilities to increase how often they submit syndromic surveillance data, with a goal of receiving batches at least once per hour leading up to and during the event. Outreach meetings uncovered specific operational barriers, including one large healthcare organization that was not sending data overnight and had an average reporting lag of eight hours. After a series of data validation meetings among KSSP, network managers, and emergency department leaders, that healthcare organization reduced downtime and improved data reporting timeliness by 70%.

Kansas also emphasized improvements in documentation practices that make queries of healthcare data more useful to public health. KSSP encouraged facilities to improve completeness of key data fields such as triage notes, procedure codes, and travel history. They also asked clinicians to include a designated event keyword in chief complaints or triage notes when relevant and reminded providers of the ICD-10 code (Y93.82) for "Activity, spectator at an event" to flag visits related to tournament activities. The program also distributed educational materials about how to perform precise public health surveillance during the tournament by promoting travel history documentation and screening questions for event attendees.

These efforts complement CDC's Project EMRge, which focuses on strengthening engagement between public health and emergency department clinicians to improve the utility of electronic health record (EHR) data. By reinforcing the value of complete, timely documentation—including free-text fields and relevant codes—Project EMRge helps healthcare and public health collaboratively improve data quality, detect trends faster, and respond more effectively during high-profile events like international sporting gatherings.

Kansas also expanded syndromic surveillance coverage by onboarding two urgent care clinics into NSSP and starting data reporting from the final emergency department in the Kansas City metro area. These enhancements strengthen situational awareness not only for the 2026 tournament but also for routine monitoring beyond the event.

Key Takeaways for Jurisdictions

• Assess baseline timeliness and completeness metrics early in planning.

• Share data quality metrics with healthcare facilities to drive improvements in reporting timeliness, completeness, and documentation practices.

• Engage directly with information technology and clinical leaders to help resolve batching issues, downtime gaps, or reporting lags.

• Encourage simple documentation adjustments (keywords, diagnosis codes, screening prompts) to enhance detection.

• Expand surveillance coverage to urgent care clinics and other settings when feasible.

• Provide clinician-facing materials that clearly connect documentation practices to public health action.

Spotlight #3: Thinking Beyond Borders

Coordinating Across Jurisdictions to Expand Syndromic Surveillance Capacity

Because public health systems and data governance are managed at the state level, effective cross-border coordination and timely data sharing are essential to protect communities during large, multi-jurisdictional events. The Kansas City metropolitan area spans both Kansas and Missouri, with event matches scheduled in Missouri, three team base camps across both states, and fan activities near the state line. Anticipating the need for healthcare services across state lines during the tournament, Kansas' and Missouri's syndromic surveillance teams began meeting in 2025 to establish a formal data-sharing agreement. The resulting Data Use Agreement (DUA) provides impacted state public health agencies with access to health record data for patients who cross state lines. The DUA includes provisions for enhanced access during public health events. By preparing the DUA and its tournament addendum in advance, both states ensured that jurisdictional boundaries would not be a barrier to situational awareness during a high-visibility, international gathering.

Kansas also used preparations for the 2026 international sporting event to broaden syndromic surveillance beyond traditional emergency department data. KSSP encouraged facilities to begin submitting inpatient and urgent care visit data to capture a wider swath of potential health threat signals.

Kansas developed DUA language to formally include inpatient and urgent care settings, and two healthcare organizations requested to sign updated DUAs reflecting this expansion. In collaboration with CDC's National Syndromic Surveillance Program, Kansas advanced testing, validation, and quality improvement processes to strengthen these additional data streams. Additionally, Kansas began to explore the potential to onboard temporary, pop-up medical tents for matches and fan festivals—highlighting the importance of getting data from non-traditional healthcare providers during mass gatherings.

Through early governance planning, expanded data sources, and interstate collaboration, the Kansas Syndromic Surveillance Program (KSSP) leveraged preparations for the international tournament to strengthen both legal and operational components of data-sharing between healthcare and public health. These enhancements support real-time event monitoring while building durable infrastructure for future emergencies.

Key Takeaways for Jurisdictions

• Establish cross-border data sharing agreements well before large-scale events.

• Ensure DUAs include provisions for enhanced data access during declared public health activities.

• Expand surveillance beyond emergency departments to include inpatient, urgent care, and temporary care sites, and incorporate these new sites in official agreements.

• Use major events to formalize and modernize data governance frameworks.

• Coordinate early with neighboring states and national partners to avoid reactive data sharing challenges.

Learn More

Learn more about the National Syndromic Surveillance Program (NSSP). Contact nssp@cdc.gov with any questions.