Oregon Public Health Division (OPHD), in collaboration with The Johns Hopkins University Applied Physics Laboratory, implemented Oregon ESSENCE in 2011. ESSENCE is an automated, electronic syndromic surveillance system that captures emergency department data from hospitals across Oregon. While each hospital system sends HL7 2.5.1-formatted messages, each uses a uniquely configured interface to capture, extract, and send data. Consequently, ESSENCE receives messages that vary greatly in content and structure. Emergency department data are ingested using the Rhapsody Integration Engine 6.2.1 (Orion Health, Auckland, NZ), which standardizes messages before entering ESSENCE. Mechanisms in the ingestion route (error-handling filters) identify messages that do not completely match accepted standards for submission. A sub-set of these previously-identified messages with errors are corrected within the route as they emerge. Existence of errors does not preclude a message’s insertion into ESSENCE. However, the quality and quantity of errors determine the quality of the data that ESSENCE uses. Unchecked, error accumulation also can cause strain to the integration engine. Despite ad-hoc processes to address errors, backlogs accrue. With no meta-data to assess the importance and source of backlogged errors, the ESSENCE team had no guide with which to mitigate errors. The ESSENCE team needed a way to determine which errors could be fixed by updating the Rhapsody Integration Engine and which required consultation with partner health systems and their data vendors. To formally address these issues, the ESSENCE team developed an error-capture module within Rhapsody to identify and quantify all errors identified in syndromic messages and to use as a guide to prioritize fixing new errors.

Objective:

To streamline emergency department data processing in Oregon ESSENCE (Oregon’s statewide syndromic surveillance) by systematically and efficiently addressing data quality issues among submitting hospital systems.