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H H S Department of Health and Human Services
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Health Information Technology and Quality

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How do I support the provision of electronic syndromic surveillance data to public health agencies?

The EHR Incentive Program Final Rule describes the following objective and measure for syndromic surveillance:

Objective for Eligible Professionals and Hospitals:

  • Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.


  • Perform at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an eligible professional submits such information has the capacity to receive the information electronically).


  • Any eligible professional that does not collect any reportable syndromic information on their patients during the EHR reporting period.   

Syndromic surveillance is an important tool used by federal, state and local governmental public health agencies to improve the detection and control of outbreaks.  Syndromic surveillance focuses on the automated collection of pre-diagnostic data from clinical information systems by public health agencies.  Its purpose is to monitor disease indicators in real-time so that disease outbreaks are detected earlier than would otherwise be possible with traditional public health methods.  Pre-diagnostic data is sorted by sophisticated computer programs into syndrome alerts that are triggered when the number of reports for a particular syndrome exceeds what is normally expected in the population.

Even with a certified EHR, the exact data elements, periodicity of reporting and method of sending syndromic surveillance data to a governmental public health agency will vary from jurisdiction to jurisdiction.  You will need to check with the agency in your jurisdiction to confirm these details.  

As discussed in the introduction to this module, submission of syndromic surveillance data is a menu set objective in the EHR Incentive Program Final Rule. When deciding whether or not to implement this option, it is important to consider that syndromic surveillance data collection approaches are currently geared towards emergency departments (ED), thus adding complications for providers practicing outside of an ED who choose to implement this option. Hospitals need to contact their national, state and local governmental public health agencies for more details on what should be reported and what capabilities they have to receive the data.

Related Resources:

Overview of Syndromic Surveillance: What is Syndromic Surveillance? – This Morbidity and Mortality Weekly Report (MMWR) supplement provides a review of the rationale, goals, definitions, and realistic expectations for these surveillance, and a review for current syndromic surveillance systems.
Syndromic Surveillance in North Carolina, 2003 go to exit disclaimer– This web course describes the categories of surveillance, with special emphasis on syndromic surveillance.  Data sources for syndromic surveillance are also discussed.
Syndromic Surveillance from Chief Complaints go to exit disclaimer– This website from the International Society for Disease Surveillance includes consensus syndrome definitions for syndromic surveillance.  The site also includes a bibliography of resources for chief complaint classifications, syndrome definitions, and a comparison of the use of chief complaints versus other types of data for syndromic surveillance.  

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