Syndromic Surveillance: Real-time Data for Public Health Action
On this page:
Who Can Participate
Meaningful Use Rules for Syndromic Surveillance
Start Today - Instructions for Participating
Technical Guidance
Delve Deeper
Syndromic surveillance in Oregon (a project called Oregon ESSENCE) provides real-time data for public health and hospitals to monitor what is happening in emergency departments across the state before, during and after a public health emergency.
With Oregon ESSENCE, hospital users and public health personnel will have a window into the health consequences of emergencies and planned events. Participating facilities are encouraged to leverage Electronic Health Record systems to automate reporting of health records (often in coordination with Federal Meaningful Use preparations. Oregon ESSENCE (Electronic Surveillance System for the Early Notification of Community-Based Epidemics) is a collaboration between the Oregon Health Authority (OHA) and
The Johns Hopkins University Applied Physics Laboratory.
Who can participate?
Currently OHA is actively seeking data submission from certain healthcare facilities and is offering exemptions for others through the Meaningful Use (MU) program. MU is a federal incentive program intended to improve how health information is collected, stored, and utilized in the United States. Read the following information carefully to learn whether data from your facility or practice is currently being accepted for syndromic surveillance.
Eligible Providers
OHA is not accepting syndromic surveillance data from outpatient providers or other Eligible Professionals (EPs) at this time.
- Because OHA is not capable of receiving syndromic surveillance data from EPs, they may claim an exclusion from sending syndromic surveillance data in Oregon.
- Exclusion information for Stage 1 MU may be found on page 44568 of the CMS Final Rules (pdf) 42 Code of Federal Regulations (CFR) 495.6(e)(10)(iii). Exclusion guidance for Stage 2 MU is on page 54154 of CMS Final Rules (pdf) 42 Code of Federal Regulations (CFR) 495.6(k)(3)(iii).
Eligible Hospitals and Critical Access Hospitals
OHA is currently accepting syndromic surveillance data from Eligible Hospitals (EHs) with emergency departments (EDs) or Critical Access Hospitals (CAHs) with EDs.
- EHs and CAHs without EDs and Urgent Care centers not affiliated with an ED may claim an exemption from submitting data.
- Exclusion information for Stage 1 MU may be found on page 44570 of the CMS Final Rules (pdf) 42 Code of Federal Regulations (CFR) 495.6(g)(10)(iii). Exclusion guidance for Stage 2 MU is on page 54156 of CMS Final Rules (pdf) Code of Federal Regulations (CFR) 495.6(l)(14)(iii).
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Meaningful Use and syndromic surveillance
Final rules for stages 1 and 2 of MU have been released and may guide successful participation in syndromic surveillance. While it is possible to participate in syndromic surveillance without meeting criteria for MU, participation in MU is encouraged. Syndromic surveillance is one of several Public Health MU measures in Oregon (for links to other measures, see OHA's Meaningful Use web site).
Successful participation by EHs or CAHs in the syndromic surveillance MU measure is defined as the following:
Stage 1
Test submission of an HL7 v2.3.1 or v2.5.1 message (generated with a certified EHR).
- See instructions below for message specifications and formatting.
- Upon completion of this stage of MU, Oregon ESSENCE will provide an attestation letter.
- Upon successful test submission, the EH/CAH should institute ongoing message submission.
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Stage 2
Ongoing submission of HL7 v2.5.1 messages for the EHR reporting period.
- Stage 2 MU does not begin until 2014.
- An EHR reporting period is defined as 90 days of reporting for the first year of participation.
- See CMS Reporting FAQs for more details about the EHR Reporting period.
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Stage 3
MU rules for Stage 3 are not finalized.
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Learn more
For an overview of syndromic surveillance and MU, see the Centers for Disease Control and Prevention's (CDC's) Public Health Information Network Syndromic Surveillance Fact Sheet (pdf). For specific questions about MU rules and syndromic surveillance, please refer to CMS Final Rules, Stage 1 (pdf) and Stage 2 (pdf).
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Start today - Instructions for participating
There are a few concrete steps in the onboarding process for Oregon ESSENCE. Please take a moment to review the following flowchart detailing these steps. See below also for the data elements requested for syndromic surveillance.
Steps for Participating Flowchart (pdf)

Requested Data Elements (pdf)

Do now
Before any data can be accepted, the Oregon ESSENCE Data Use Agreement (DUA) (pdf) will need to be signed and returned.
Get in touch
After reviewing the participation process, contact Oregon ESSENCE epidemiologists to notify us of your intent to send syndromic surveillance data.
Email: Oregon.ESSENCE@state.or.us
Phone: 971-673-1111
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Technical Guidance
Message creation
Format messages using the syndromic surveillance PHINMS guide (created by CDC and the International Society for Disease Surveillance [ISDS]). Several versions of this guide have been released and are located on the CDC's PHIN Guide web site.
Message testing
Refer to the Oregon ESSENCE Testing Suite (pdf) for guidance on message testing. Contact Oregon ESSENCE epidemiologists to notify us of your intent to test messages.
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Accessing Oregon ESSENCE
Update
Currently, Oregon ESSENCE is in production, but has not released a go-live date for external users to access the application.
Training
Under development.
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Delve Deeper
Syndromic surveillance
To learn more about syndromic surveillance, see:
ESSENCE in action
To learn more about ESSENCE and for examples of how other jurisdictions have used the system see:
MU Recommendations for syndromic surveillance
To learn more about meaningful use recommendations for syndromic surveillance, see ISDS Meaningful Use Recommendation.
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Get Started With Oregon ESSENCE