Syndromic surveillance is a population-based early detection and monitoring system that uses data collected in near real-time from emergency departments and other clinical (e.g., nurse telephone triage) and non-clinical (e.g., over-the-counter drug sales) sources. This public health tool aids traditional surveillance by providing timely awareness of disease trends through the analysis of existing health data for unusual increases in syndromes.
The Los Angeles County Department of Public Health (LAC DPH) Syndromic Surveillance Project (SSP) has accepted Admit-Discharge-Transfer (ADT) data submissions from hospitals with emergency departments (EDs) since 2002, and now collects data on more than 2.5 million encounters every year as reported by 80% of hospitals with EDs throughout the county, or 91% of all ED encounters. The ADT messages are snippets that contain limited demographic, chief complaint, diagnosis, admission, and discharge disposition information that are triggered as the patient progresses through certain points or actions initiated during their encounter. Once received, LAC DPH performs key word searches on the chief complaint and diagnosis information. The ADT messages do not contain the breadth and accuracy of information contained in a complete patient medical chart. However, the timely assessment of these pre-diagnostic and diagnostic data have provided a vital component to LAC DPH's emerging event detection capabilities, as well as situational awareness of various public health conditions.
In Los Angeles County, common uses of data include:
Syndromic surveillance data are not meant to represent the true number of cases of a disease in a population, but can be used to look at disease trends by the percentage of visits over time. Additional considerations include:
LAC DPH is able to accept syndromic surveillance data reporting from eligible hospitals (EHs) and critical access hospitals (CAHs) to contribute to the Center for Medicare and Medicaid Services (CMS) regulatory requirements of the Public Health and Clinical Data Exchange objective for the Promoting Interoperability (PI) Program and the Merit-based Incentive Payment System (MIPS) (PDF) Eligible hospitals for PI are defined as acute care hospitals (including CAHs and cancer hospitals) with at least a 10 percent Medicaid patient volume, and children’s hospitals (no Medicaid patient volume requirements).
LAC DPH is the public health agency for required Promoting Interoperability reporting in Los Angeles County. To meet the federal PI public health syndromic surveillance requirements, all ED-receiving EHs and CAHs in Los Angeles County must report and electronically submit the appropriate data for syndromic surveillance directly to LAC DPH.
LAC DPH's SSP is currently onboarding new hospital connections. Eligible hospitals and critical access hospitals must be ED-receiving and operating in Los Angeles County; connections with private providers or medical groups cannot be accommodated at this time.
LAC DPH's Syndromic Surveillance Project (SSP) is in the process of onboarding with the National Syndromic Surveillance Program (NSSP) to contribute LAC DPH syndromic data to the NSSP BioSense Platform, a secure integrated electronic health information system. NSSP is a collaboration among the CDC, public health agencies, and partners with the aim of advancing the timely exchange and use of syndromic data. The BioSense platform enables aggregation and analysis of syndromic data which can be used to provide local, regional, and national awareness of various public health conditions.
For concerns about your facility's data being shared with the NSSP, please contact the SSP at lacphsynd@ph.lacounty.gov within 30 days of registration.