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PHIN Messaging Guide for Syndromic Surveillance: Emergency Department, Urgent Care and Inpatient Settings, Release 1.9 (April 2013)


This document represents the collaborative effort of the International Society for Disease Surveillance (ISDS), the Centers for Disease Control and Prevention (CDC), and National Institute of Standards and Technology (NIST) to specify a national electronic messaging standard that enables disparate healthcare applications to submit or transmit administrative and clinical data for public health surveillance and response. Recommendations made by expert committees convened by ISDS and CDC serve as the basis for this guide.

This Guide provides:

  1. An HL7 messaging and content reference standard fornational,syndromic surveillance electronic health record technology certification

  2. A basis for local and state syndromic surveillance messaging implementation guides

  3. A resource for planning for the increasing use of electronic health record technology and for providing details on health data elements that may become a part of future public health syndromic surveillance messaging requirements

This Guide provides elements of interest and business rules for laboratory results processing for syndromic surveillance but does not include the segment profiles. It is expected that a version 2.0 will be published that will reference conformance profile for electronic laboratory reporting for syndromic surveillance based on the S&I Framework Laboratory Results Interface (LRI) Implementation Guide.

Developed through a collaborative effort between ISDS and the Division of Informatics Solutions and Operations, PHISIPO, OSELS of the Centers for Disease Control and Prevention (CDC), the new Guide provides messaging specifications for communicating syndromic surveillance data from hospitals and urgent care settings to public health authorities (PHAs).

What is the PHIN Messaging Guide for Syndromic Surveillance?

 The PHIN Messaging Guide for Syndromic Surveillance: Emergency Department, Urgent Care And Inpatient Settings, Release 1.9 provides direction to PHAs looking to implement syndromic surveillance systems. Prior versions of the Guide have been used to create certification standards for Meaningful Use. Release 1.9 looks beyond the 2014 Meaningful Use certification and creates specifications not only for Urgent Care and Emergency Department settings, but also for hospital inpatient settings. 

Who will benefit from Release 1.9?

The updated PHIN Messaging Guide for Syndromic Surveillance provides clearer and more complete instructions for communicating syndromic surveillance data from hospitals and urgent care settings to public health departments. As a result, it will be a vital tool to both EHR vendors and public health authorities. EHR vendors will use Release 1.9 in developing EHR technologies compatible with future syndromic surveillance requirements. Prior Release 1.1set standards for 2014 Meaningful Use EHR certification; this Guide anticipates certification guidelines for beyond 2014. PHAs will use the Release 1.9 to develop local implementations of syndromic surveillance and to meet their evolving needs as Meaningful Use progresses and more PHAs incorporate inpatient data into their syndromic surveillance systems.

Specifics on Release 1.9

Release 1.9 provides HL7 versions 2.5.1 and 2.3.1 messaging specifications for hospitals (both emergency department and inpatient) and urgent care centers providing clinical data to a PHA for syndromic surveillance. It also provides specific implementation notes that can be used for guidance by jurisdictions establishing or updating their syndromic surveillance systems. Finally, Release 1.9 includes updated interaction diagrams and business rules to make it applicable for jurisdictions wishing to receive laboratory data; specifications for lab data will be incorporated into future versions of the Messaging Guide.

On the other hand, Release 1.9 does not aim to provide guidelines for sending ambulatory data for syndromic surveillance; only urgent care settings fall within the scope of the guidance, not ambulatory settings in general. Additionally, Release 1.9 is not a fully complete update. As noted above, specifications for the laboratory information will be updated in the future to meet the increasing desire of PHAs to receive and use laboratory data in syndromic surveillance.

To view Frequently Asked Questions on Release 1.9, please see the Release 1.9 FAQ file below.

To view details of the requirements and applicable settings (e.g., ED/UC only, inpatient only, or all three settings) for the Data Elements of Interest, please see the Release 1.9 Data Element Crosswalk file below.

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