Impact of the NSSP’s transition to ESSENCE on chief complaint field-based syndromes

In January 2017, the NSSP transitioned their BioSense analytical tools to Electronic Surveillance System for Early Notification of Community-Based Epidemics (ESSENCE). The chief complaint field in BioSense 2.0 was a concatenation of the record's chief complaint, admission reason, triage notes, and diagnostic impression. Following the transition to ESSENCE, the chief complaint field was comprised of the first chief complaint entered or the first admission reason, if the chief complaint was blank.

January 21, 2018

Data Quality Improvements in National Syndromic Surveillance Program (NSSP) Data

The National Syndromic Surveillance Program (NSSP) is a community focused collaboration among federal, state, and local public health agencies and partners for timely exchange of syndromic data. These data, captured in nearly real time, are intended to improve the nation's situational awareness and responsiveness to hazardous events and disease outbreaks.

January 21, 2018

Monitoring Trends of Self-diagnosis in New York City Emergency Departments

The number of US adults who use the internet to access health information has increased from about 95 million in 2005 to 220 million in 2014. The public health impact of this trend is unknown; in theory, patients may be able to better help the doctor arrive at the correct diagnosis, but self-diagnosed patients may also inappropriately self-treat or delay going to the doctor.

November 22, 2017

Using Hospital ED Data to Identify Mental Illness Trends After Hurricane Sandy

EDCC data provides an opportunity for capturing the early mental health impact of disaster events at the community level, and to track their impact over time. However, while rapid mental health assessment can facilitate a better understanding of the acute post-disaster period and aid early identification of persons at long-term risk,1 determining how wide a net to effectively capture the critical range of mental health sub-categories has not yet been clearly defined.

December 20, 2017

Emergency Department Chief Complaint Versus Discharge Diagnosis for Tracking Disease Measures

ESSENCE is a web-based syndromic surveillance system utilized by DHMH to detect and track outbreaks, suspicious patterns of illness, public health emergencies, and biological threats. ESSENCE ED chief complaint data is collected daily from 47 emergency departments in Maryland (all 45 acute care hospitals and 2 freestanding emergency medical facilities). A chief complaint in ESSENCE is a free text field that lists the patient’s reason for the ED visit upon arrival at the hospital.

August 22, 2018

Effectiveness of Using a Chief Complaint and Discharge Diagnosis Query in ESSENCE-FL to Identify Possible Tuberculosis Patients and Contacts in Hillsborough County, Florida

The Electronic Surveillance System for the Early Notification of Community-based Epidemics in Florida (ESSENCE-FL) is a web-based application for use by public health professionals within the Florida Department of Health (FDOH). The main source of data for ESSENCE-FL is emergency department (ED) data. Ten hospitals in Hillsborough County, Florida send their data to the ESSENCE-FL server. ESSENCE-FL requires only a limited data set to be sent by the hospital which includes patient chief complaint (CC) and discharge diagnosis (DD).

August 22, 2018

Detecting Unanticipated Increases in Emergency Department Chief Complaint Keywords

The CC text field is a rich source of information, but its current use for syndromic surveillance is limited to a fixed set of syndromes that are routine, suspected, expected, or discovered by chance. In addition to syndromes that are routinely monitored by the NYC Department of Health and Mental Hygiene (e.g., diarrhea, respiratory), additional syndromes are occasionally monitored when requested by outside sources or when expected to increase during emergencies.

August 22, 2018

Identifying Clusters of Rare and Novel Words in Emergency Department Chief Complaints

A goal of biosurveillance is to identify incidents that require a public health response. The challenge is creating specific definitions of such incidents so they can be detected. In syndromic surveillance, this is accomplished by classifying emergency department chief complaints, nurse triage calls, and other prediagnostic data into categories, and then looking for increases in visits related to those categories. This approach can only find incidents that match those predefined categories.

April 28, 2019

Evaluating Syndromic Data for Surveillance of Non-infectious Disease

Syndromic surveillance data has predominantly been used for surveillance of infectious disease and for broad symptom types that could be associated with bioterrorism. There has been a growing interest to expand the uses of syndromic data beyond infectious disease. Because many of these conditions are specific and can be swiftly diagnosed (as opposed to infectious agents that require a lab test for confirmation) there could be added value in using the ICD9 ED discharge diagnosis field collected by SS. However, SS discharge diagnosis data is not complete or as timely as chief complaint data.

March 19, 2018

Evaluating Usefulness of Maine's Syndromic Surveillance System for Hospitals, 2012

Maine has been conducting syndromic surveillance since 2007 using the Early Aberration Reporting System (EARS). An evaluation of the syndromic surveillance system was conducted to determine if system objectives are being met, assess the system’s usefulness, and identify areas for improvement. According to CDC’s Guidelines for Evaluating Public Health Surveillance Systems, a surveillance system is useful if it contributes to the timely prevention and control of adverse health events.

March 19, 2018

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This Knowledge Repository is made possible through the activities of the Centers for Disease Control and Prevention Cooperative Agreement/Grant #1 NU500E000098-01, National Surveillance Program Community of Practice (NSSP-CoP): Strengthening Health Surveillance Capabilities Nationwide, which is in the interest of public health.

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