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Why Consider Participating
The decision to consider participating in Oregon ESSENCE may not always be straightforward. Beyond the incentives provided by the federal Meaningful Use program, facilities may to know more about how sharing this data will benefit them. The questions below have been asked by facilities around the state and are posted here to help your facility make this decision. If you don’t find an answer to your question please email directly.

Frequently Asked Questions:

What is syndromic surveillance?
What does it take to participate in Oregon ESSENCE?
Who in the hospital sends the data to Oregon ESSENCE?
Must it be updated daily, weekly, monthly or ?
Would the only reason for getting this be to meet Meaningful Use?
Is syndromic surveillance useful for hospitals?
Don't most EHR systems have this capability? Is this system redundant?
Does ESSENCE overlap with the State’s Hospital Capacity Web Site (HOSCAP)?


What is syndromic surveillance?

Syndromic surveillance is the automated real-time, or close to real-time, collection and interpretation of pre-diagnostic data. Examples of data sources include: emergency department, prescription filling, or school absentee data. In Oregon, the syndromic surveillance project (called Oregon ESSENCE) analyzes emergency department, reportable disease, vital statistics and poison control center call data. 

What does it take to participate in Oregon ESSENCE?

Participation in Oregon ESSENCE is defined as ongoing daily submission of emergency department records. Most facilities choose to fulfill Meaningful Use criteria through their participation in Oregon ESSENCE, though this is certainly not a requirement (just a happy coincidence for us!).

Who in the hospital sends the data to Oregon ESSENCE?

Your facility’s or health care system’s electronic health record (EHR) sends the data to Oregon ESSENCE.  The data is sent as an automated feed, meaning that an IT person or two manages the connection between your EHR and our databases, but that there are no manual triggers for sending info.To put it another way, there is no “Submit” button on the workstations in the ED; instead, the EHR is programmed to send message updates as each patient goes through each visit (first it sends a “registration” message when the patient registers, and then different types of “Update” messages as more information becomes available, and a final message when the patient is discharged from the ED). EHR products certified for Meaningful Use should be able to produce a standard syndromic feed.

Must it be updated daily, weekly, monthly or ?

The records are updated in real-time, and are either sent to us in real time or are collected for a 24 hour period (on your, the sender’s, side) and delivered all at once (in a batch) once daily.

Would the only reason for getting this be to meet Meaningful Use?

Meaningful Use (MU) is a big reason why facilities tend to participate in Oregon ESSENCE. Beyond the incentive dollars associated with MU, the following are several reasons why your facility may choose to participate. In addition, the data you provide Oregon ESSENCE will be used primarily by local health department communicable disease nurses and epidemiologists for public health practice. 

Is syndromic surveillance useful for hospitals?

While a novel system in Oregon, we know that elsewhere facilities are using syndromic surveillance in the following ways:
ESSENCE may be used to help understand resource issues by enabling ED professionals to look at visits by time of day, and perhaps even type of visit (by querying chief complaint or triage notes) to understand when, and which type, of resources are commonly needed in the ED. When is the ED most busy? When and what type of complex patients are seen? How many “refill-seekers” typically come in on a daily, weekly or monthly basis? By querying ESSENCE, one can find the answers to these and other common questions.
There is also a potential for this system to be used for rumor control. For example, in the event you get questions from the community about that strange zombie disease that's going around the region (insert your disease of choice here!) you can query the visits at your facility to see whether the number of visits you’ve seen is more than that which you’d expect. Often, astute clinicians have some sense as to whether there is something of public health importance going on, but should an event span multiple shifts, it’s unlikely that any one person would have enough information to track trends. We use ESSENCE during planned events (major sporting events) and unplanned events (norovirus season) to assess the burden of disease in a major metropolitan community in the state. We rely on ESSENCE to provide assurance during high-stakes events to say with certainty that no activities of public health importance (e.g., outbreaks) are going on in the region.
During a communicable disease outbreak (for example, a pertussis outbreak), ESSENCE can be used to backtrack chief complaints of patients with a confirmed diagnosis who visited the ED. A list of these chief complaint terms can be used by providers at the facility to help more quickly and accurately identify patients with the same infection.

Don't most EHR systems have this capability? Is this system redundant?

Most EHR systems may be able to show visits by time of day – and some are able to export these in a list format or show them in a chart. What sets ESSENCE apart is that it shows changes in visits with statistical alerts. These alerts indicate that there are more visits than expected (they take into account the recent pattern of disease and whether the disease is rare or common). Using these analytical features, you can create time series charts, maps, and graphs. Another feature of ESSENCE is that it allows you to query visits by a specific chief complaint, diagnosis code (i.e., ICD-9 code) or triage note term (if available). ESSENCE also has predefined chief complaint syndromes, which are collections of related terms for major symptom groups (e.g., chief complaints associated with fever, gasterointestinal complaints, or influenza-Iike illness).

Does ESSENCE overlap with the State’s Hospital Capacity Web Site (HOSCAP)?

ESSENCE doesn't so much overlap HOSCAP as much as complement it. Where HOSCAP can show you how many inpatient beds/resources are in use, ESSENCE will give you more of a real-time measure of pre-diagnostic disease burden -- so you might have a several hour (or day) heads up about the impact coming to your inpatient ward (more of a real-time, pre-diagnostic look at disease in the community).

Get in touch

Contact Oregon ESSENCE epidemiologists if you have questions about participating not answered here.