Leegon Jeffrey

Syndromic surveillance is commonly supported by information generated from electronic health record (EHR) systems and sent to public health via standardized messaging. Before public health can receive syndromic surveillance information from an EHR, a healthcare provider must demonstrate reliable and timely generation of messages according to national standards. This process is known as onboarding. Onboarding at the Tennessee Department of Health (TDH) focused heavily on human review of HL7 messages. However, the visual inspection of messages was time-intensive and delayed efforts to provide constructive feedback to participating healthcare providers. To ease the quantity of manual review done during the onboarding process, TDH created an application to assist in the process of reviewing syndromic surveillance messages.

Objective:

To show how the creation of a software tool and implementation of new processes improved the efficiency of syndromic surveillance onboarding at the Tennessee Department of Health.

Syndromic surveillance is the monitoring of symptom combinations (i.e., syndromes) or other indicators within a population to inform public health actions. The Tennessee Department of Health (TDH) collects emergency department (ED) data from more than 70 hospitals across Tennessee to support statewide syndromic surveillance activities. Hospitals in Tennessee typically provide data within 48 hours of a patient encounter. While syndromic surveillance often supplements disease- or condition-specific surveillance, it can also provide general situational awareness about emergency department patients during an event or response. During Hurricanes Harvey (continental US landfall on August 25, 2017) and Irma (continental US landfall on September 10, 2017), TDH supported all hazards situational awareness using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) in the BioSense Platform supported by the National Syndromic Surveillance Program (NSSP). The volume of out-of-state patients in Tennessee was monitored to assess the impact on the healthcare system and any geographic- or hospital-specific clustering of out-of-state patients within Tennessee. Results were included in daily State Health Operations Center (SHOC) situation reports and shared with agency response partners such as the Tennessee Emergency Management Agency (TEMA).

Objective:

To demonstrate the use of ESSENCE in the BioSense Platform to monitor out-of-State patients seeking emergency healthcare in Tennessee during Hurricanes Harvey and Irma.