Building a valid data set for syndromic surveillance is the most time-consuming aspect of the onboarding process. Careful and deliberate planning should be exercised.
Syndromic Implementation Guide
The BioSense Platform is based on the PHIN Messaging Guide for Syndromic Surveillance: Emergency Department, Urgent Care, Inpatient and Ambulatory Care Settings. During HL7 message development, pay careful attention to including all required data elements.
Excluded Data Elements Containing PII
While not emphasized well in the PHIN Messaging Guide for Syndromic Surveillance, personally identifiable information (PII) should NOT be sent to the BioSense Platform. The following table lists the data elements to exclude from HL7 messages to the BioSense Platform.
|HL7 Segment/Field||HL7 Description|
|PID.6||Mothers Maiden Name|
Note: Patient Zip, County, and City are required.
|PID.11.8||Patient Address Note: Patient Zip, County, and City are required.|
|PID.13-17||Patient Phone Number|
|PID.19-21||SSN, Driver's License #, Mother's ID|
|PID.30.2||Patient Death Indicator|
|NK Segments||Next of Kin|
|MRG.7||Merge Patient Information|
|IN1.16||Name of Insured|
|IN1.19||Address of Insured|
|GT1.3-6||Guarantor Name, Address, Phone|
|GT1.19||Guarantor Employee ID Number|
The onboarding team gives each site an MFT (Excel spreadsheet template). This table lists facilities authorized to send data to the BioSense Platform. Facility information will be linked and, when appropriate, mapped from the MFT to each record on the BioSense Platform.
Facility Mapping Considerations
Facility mapping is critical for accurate analysis in the BioSense Platform. Historically, many sites put the Treating Facility in MSH4.2. This practice is strongly discouraged. Follow the guidelines below to make sure data are ready to validate.
- Specify the Sending Facility ID in MSH-4.2.
- Specify the Treating/Event Facility in EVN-7.2.
- Make sure the Master Facility Table (Excel spreadsheet template) contains every facility included in HL7 messages for the site. These facilities will be checked during Data Validation. Missing facilities will not be correctly processed and may cause the connection to be disrupted.
Required Data Elements
The BioSense Platform must receive all "R" and "RE" data elements defined for syndromic surveillance in the PHIN Messaging Guide for Syndromic Surveillance. To view a table which summarizes the PHIN Messaging Guide for Syndromic Surveillance, Section 4.2, Syndromic Surveillance Data Elements of Interest, click here.
One of the characteristics of syndromic surveillance data is its timeliness. Therefore, data must be submitted at least within 24 hours of the date and time of the patient's initial encounter. Subsequent updates to a patient's record must also be submitted within 24 hours of the information (transaction) being added to the patient record. NSSP's BioSense Platform team recommends that senders batch and submit syndromic data hourly. Batched files must be transmitted at least once every 6 hours.
The following table lists the recommended message characteristics.
|Message size||0 bytes||Cannot be empty|
The BioSense Platform can receive syndromic surveillance data for all facility types. Still, site administrators may want to exercise caution when deciding whether to receive all message types in their jurisdiction. The BioSense Platform has limited availability to support non-ED onboarding. Also, when considering ambulatory care, caution should be taken to consider the impact that the new data trends might have on existing analysis processes. It is wise to start with a limited number of large practices and get experience with the different characteristics and volume of the data.
The BioSense Platform accepts the following message types (in priority order):
- Emergency Data (ED)
- Urgent Care (UC)
- Inpatient (I)
- Ambulatory Care (AC)
- Requires onboarding team's approval
- Requires site administrator's approval
Valid message triggers are:
- ADT^A04 - Emergency Department Registration
- ADT^A03 - Discharge / End Visit
- ADT^A01 - Inpatient Admission
- ADT^A08 - Updates to previously sent A01 and A04 messages
Data validation is the process of confirming whether data meet a minimal level of compliance. Data validation is not a complete evaluation of data quality. Instead, the facility's ability to send visit data that includes all of the required data elements of interest is assessed. Data validation does not check the received data for accuracy.
The onboarding team offers training and support. They can help site administrators perform data validation tests to onboard new facilities. Site administrators and epidemiologists should work together with facilities to implement processes for testing and evaluating data quality.
The onboarding team recommends joining the ISDS Data Quality Work Group for more information and advice on evaluating data quality: http://www.syndromic.org/cop/nssp-workgroups/data-quality
Data Compliance Report
To successfully onboard to the BioSense Platform, every facility must pass minimum BioSense Platform data compliance tests and satisfy requirements for the site to which the facility or vendor is submitting data. Each facility and vendor feed must be approved by both the NSSP BioSense Platform onboarding team and the site administrator.
The BioSense Platform provides each site administrator access to daily compliance measurements through SQL views. Site administrators can download and import results into the data compliance report template available for download here: Data Compliance Report Template