Associated Facilities and When to Use Them: Guidance for Site Administrators

Designating facilities as associated facilities in NSSP allows them to be grouped with a primary facility to simplify facility administration and alert monitoring. To best understand what an associated facility is and how it can improve your ability to monitor data, first you need to understand NSSP’s definition of a primary facility: A primary facility represents itself and associated facilities as a single entity that ESSENCE can use to display data in a time-series graph.

Most free-standing facilities (emergency departments, urgent care centers) are primary facilities. Site administrators enter information from the primary facilities into the site-specific Master Facility Table (MFT). The MFT contains all necessary information for processing data, called metadata. MFT fields ensure data are mapped correctly on the journey from facility to BioSense Platform and are easily identifiable when queried.

What are Associated Facilities?

Put simply, an associated facility can function exactly like a primary facility—it may be a free-standing emergency department, urgent care center, physician’s office, etc. The ONLY difference is that it is being grouped with a primary facility for administrative reasons. For example, the site administrator—in consultation with site staff or syndromic surveillance governance group—may prefer to see multiple facilities’ data or view several departments in the same facility as a single facility in ESSENCE for ease in monitoring surveillance alerts. Adding an associated facility is the way to do this. Associated facilities are intentionally affiliated with primary facilities but are NOT considered separate facilities within ESSENCE.

What’s the goal?

We’ve established that the ultimate use for associated facilities is to view data in ESSENCE under a single time-series umbrella—and NOT as several time series graphs. While defining associated facilities makes combined analysis easy, it also allows the site administrator to consolidate facility management.

Figure 1. This primary facility uses one data feed to transmit electronic health record data for 100 physicians’ offices, each of which is considered an associated facility on the MFT.

Sometimes, however, the site administrator needs to drill down further. Site administrators may want to create associated facilities to capture information about

• additional facility types (inpatient practice setting, medical specialty, primary care),
• incoming ID values that should be converted to the primary ID (“historic crosswalk” information), and
• incoming ID values that should NOT be converted to the primary ID but should be associated with the generic C_BioSense_Facility_ID of the primary facility (e.g., multiple facilities reporting under one primary facility identifier).

Keep in mind that a primary facility can have any number of associated facilities. In Figure 1, the primary facility comprises 100 associated facilities, each of which represents a single physician’s office. When an analyst looks at the time series graph for this primary facility in ESSENCE, the data will appear as a single trendline.

Figure 2. A primary facility represents itself and associated facilities as a single entity, which ESSENCE can display in a time-series graph.

3 Scenarios in Which Adding an Associated Facility Should be Considered over Creating a Primary Facility

Here are some real-world scenarios where adding a facility as an Associated Facility may be useful:

1. A site would like to receive data from multiple departments or providers that exist within a facility or practice, typically at the same physical location. They want all the facility or practice data to be seen as a single entity within ESSENCE.
2. A site has multiple primary facilities at different locations that include the same facility identifiers; consequently, the sender is unable to distinguish among the various facilities’ data. The sender may be an electronic health record (EHR) vendor, healthcare organization, or public health jurisdiction.
3. A site needs to monitor continuity of care across multiple facilities.

Sites may have other reasons to use associated facilities under a primary instead of as separate primary facilities, but these are common scenarios.

How to Add an Associated Facility to the MFT

Site administrators can easily add associated facilities by going to the Access & Management Center and clicking the MFT tab. Any existing primary facility record can now be edited to include new facilities.

Associated facilities may have the same or different FacilityID_UUID as the primary facility. If the associated FacilityID_UUID differs from that of the primary, you can choose how your data are stored in the Archive Processed table (Figure 3).

Figure 3. View of Associated Facility Table (in MFT) highlighting the different UUIDs.

Always Remember…

• Associated facilities always have the same C_Biosense_Facility_ID as the primary facility.
• Associated facilities may have different C_Facility_ID values if you choose to convert IDs during data processing.
• Within the MFT Module, site administrators may add associated facilities but cannot edit associated facility information. (This functionality will be included in an upcoming AMC release.)

Technical Support

Please contact the NSSP Service Desk (support.syndromicsurveillance.org) if you need to modify the metadata for an associated facility, have questions about associated facilities, or are unsure how to use the MFT to support your data processing needs. The onboarding team can help you set up the MFT correctly to get meaningful results.

You may also refer to the BioSense Platform Quick Start Guide to Using the Master Facility Table (https://www.cdc.gov/nssp/biosense/docs/BioSense-Platform-Quick-Start-Guide-for-MFT.pdf) for more information on primary and associated facilities and for guidance about how to enter them in the MFT.