In 2010, as rules for the Centers for Medicaid and Medicare Electronic Heatlh Record (EHR) Incentive Programs (Meaningful Use)(1), were finalized, ISDS became aware of a trend towards new EHR systems capturing or sending emergency department (ED) chief complaint (CC) data as structured variables without including the free-text. This perceived shift in technology was occurring in the absence of consensus-based technical requirements for syndromic surveillance and survey data on the value of free-text CC to public health practice. On 1/31/11, ISDS, in collaboration with CDC BioSense, recommended a core set of data for public health syndromic surveillance (PHSS) to support public health's participation in Meaningful Use.
This study was conducted to better support a requirement for ED CC as free-text, by investigating the relationship between the unstructured, free-text form of CC data and its usefulness in public health practice. To better inform health IT standardization practices, specifically related to Meaningful Use, by describing how US public health agencies use unstructured, free-text EHR data to monitor, assess, investigate and manage issues of public health interest.