Syndromic Surveillance Data
Last Updated: August 2022
Syndromic surveillance provides automated, near real-time data on health indicators using data collected early in the disease presentation or surveillance tracking usually before a lab-confirmation test or final diagnosis is received. Data are frequently available for analysis within 24 hours of patient visits. Syndromic surveillance often includes hospital Emergency Department (ED) or ambulatory visit data, Emergency Medical Service (EMS), absenteeism in schools or workplaces, phone calls to 911, poison control or telemedicine services, and over-the-counter medication sales for example.
For the overdose epidemic, ED visit data has been one of the most-established public health surveillance systems for timely situational monitoring. ED visit data commonly includes chief complaints and discharge diagnoses entered by health care providers following a patient encounter (e.g., a visit at an emergency department, urgent care center, etc.). Chief complaint symptoms and diagnoses can be grouped into categories of cause-specific illness or injury. Some syndromic surveillance systems can integrate other data sources, such as inpatient healthcare, laboratory, or mortality data.
National Syndromic Surveillance Program (NSSP)
The National Syndromic Surveillance Program is a collaboration among CDC, federal partners, local and state health departments, and academic and private sector partners to collect, analyze, and share syndromic surveillance data received from emergency departments, urgent and ambulatory care centers, inpatient healthcare settings, and laboratories. A cloud-based platform, BioSense, stores the data and allows for analyses in the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE). More than 6,000 health care facilities covering 50 states and the District of Columbia contribute syndromic surveillance data to the BioSense platform daily. In spring of 2021, 71% of the nation’s emergency departments contribute data to the BioSense platform and more than 6 million electronic health messages are received every day.
Data in syndromic surveillance systems and NSSP can include unstandardized symptom text (e.g., chief complaints, clinical impression, triage notes, etc.) and standardized diagnoses such as clinical SNOMED codes or discharge diagnosis codes using the International Classification of Diseases, 10 Revision, Clinical Modification (ICD-10-CM). These data are entered by health care providers following a patient encounter and can be updated over time as more information about the visit is known. In ESSENCE, symptoms are grouped into syndromes and subsyndromes and queried using Boolean logic. Standardized queries are available in ESSENCE, and customized ones may be developed using simple or complex logic involving chief complaint, discharge diagnosis, and other data fields. For the purposes of spike alert detection, an overdose query should be used based on symptoms and diagnosis codes.
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