*If you have questions about the NSSP CoP, its highly collaborative user groups, the NSSP CoP Slack Workspace (a collaboration platform), or syndromic surveillance, please email syndromic@cste.org.

Community Highlights

2021 Syndromic Surveillance Symposium

To support the growing community of epidemiologists and public health professionals practicing syndromic surveillance, the Council of State and Territorial Epidemiologists (CSTE), in collaboration with the CDC NSSP, will hold the 2nd Annual Syndromic Surveillance Symposium the week of November 15, 2021. (Final dates will be determined closer to the event.) The symposium will be virtual this year.

The symposium provides a forum for the syndromic surveillance community to exchange experiences, best practices, and ideas in a broad range of areas (e.g., data sharing, syndrome development, data quality, and analytic methods). Attendees can learn about the latest methods and topics related to syndromic surveillance practice, discuss ideas for building syndromic surveillance capacity, and share thoughts about future NSSP Community of Practice (CoP) activities.

Learn more about the symposium at nsspcommunityofpractice.org. Please email questions to syndromic@cste.org. We look forward to your participation!

Project Notification: Reviewing Federal Access and Use of NSSP Data

CSTE has convened a workgroup of state, tribal, local, and territorial (STLT) public health decision-makers and surveillance and informatics experts to comment on the current federal data access policy for the NSSP BioSense Platform and to recommend ways in which the policy could be improved to provide greater use of the data.

Workgroup members will collaborate with a third-party consultant to develop a report on NSSP data access that includes considerations and implementation strategies for revising federal access and use of the data. CSTE will share the report with state epidemiologists and the syndromic community for comment. More information will follow. If you have questions, please email Hayleigh McCall at hmccall@cste.org.

Promoting Interoperability Program Strengthens Incentives for Syndromic Surveillance

The Centers for Medicare & Medicaid Service (CMS) is taking action to promote sustainability and readiness to respond to future public health emergencies. This aims to strengthen syndromic surveillance in public health jurisdictions that participate in NSSP and those that have locally run systems that can receive syndromic data.

The final rule requires hospitals with emergency departments (EDs) to attest they are in active engagement with a public health agency to submit data for measures related to nationwide surveillance for early warning of emerging outbreaks and threats. Hospital submission of syndromic data supports public health agencies as they prepare to respond to both future health threats and long-term COVID-19 recovery.On August 2, 2021, CMS published the final rule for changes to the Medicare Promoting Interoperability Program. The rule revises the requirements for eligible hospitals and critical access hospitals (CAHs) participating in the Medicare Promoting Interoperability Program by now requiring four of the measures associated with the Public Health and Clinical Data Exchange Objective: Syndromic Surveillance Reporting, Immunization Registry Reporting, Electronic Case Reporting, and Electronic Reportable Laboratory Result Reporting. These four measures are currently optional. Under this change, an eligible hospital or CAH will receive 10 points for the Public Health and Clinical Data Exchange objective if they report a ‘‘yes’’ response for all aforementioned measures. The rule will take effect beginning with the reporting period in calendar year 2022.

NSSP encourages all public health jurisdictions to attest to their readiness to receive syndromic data. Jurisdictions can do this by receiving messages in a locally administered syndromic surveillance system or sending messages directly to the NSSP BioSense Platform, which makes data available to the jurisdictions’ authorized users. The NSSP onboarding team will help sites coordinate with the facilities to set up data feeds and begin transmission. The NSSP Community of Practice plans to discuss readiness and implications of this final ruling in an upcoming monthly meeting.

Links:
FY2022 IPPS/LTCH PPS Final Rule fact sheetexternal icon
FY2022 IPPS/LTCH PPS Final Rule on the Federal Registerexternal icon
This article includes excerpts from a CMS.gov press release external icondated August 2, 2021.

NSSP Community of Practice Monthly Call

Karl Soetebier (NSSP/CDC) kicked off the August 2021 NSSP Community of Practice call by sharing program updates:

• Loren Rodgers is on a detail through the remainder of 2021 to lead the implementation of a vaccine distribution system. Soetebier will serve as the acting NSSP lead and is available to the community.

• The NSSP CoP Data Sharing workgroup calls and efforts are temporarily paused.
• Recently fulfilled external data requests include the following:
  • An academic investigator requested U.S. Department of Health and Human Services (HHS) region-level counts of emergency department (ED) visits for suicide attempts and suicide ideation. No record-level or state- or sub-state-level data were shared, and the appropriate suppression rules and data quality filters were applied.
  • NSSP fulfilled four requests related to a recent Morbidity and Mortality Weekly Report (MMWR) article on heat-related illness in HHS region 10. No state or sub-state data were included in the data tables.
    • Two major U.S. media outlets requested a summary table containing the same HHS region information displayed in the MMWR-published figure.
    • A media outlet requested similar information for all HHS regions.
    • An international medical journal requested the number of ED visits for heat-related conditions and mental health conditions for HHS regions.
• NSSP also received requests for state-level data that are being routed to the appropriate public health departments for response.
• Publications:
  • NSSP is developing a proposal to publish results of an evaluation that CDC and Utah conducted to validate the COVID-19-like illness syndrome against medical records.
  • NSSP data are being included in broad efforts across CDC to assess the impact of the Delta variant on children and adolescents and to assess whether the burden differs by population vaccination rates.
  • Presently, more than a dozen other publications are in progress. All focus on national-level analyses. The publications using national-level NSSP data cover topics including drug overdoses, other injuries, environmental exposures, mental health, COVID-19, and other infectious diseases.
• ESSENCE feature:
  • Additional ICD-10 and Clinical Classification Software Refinement (CCSR) groupings are now available in ESSENCE 2.
  • A demo of this feature can be found on the August 2021 NSSP ESSENCE user call.

The Syndromic Surveillance and Public Health Emergency Preparedness, Response, and Recovery (SPHERR) Subcommittee Co-chairs Bill Smith (Maricopa County, AZ) and Fatema Mamou (MI) hosted this month’s NSSP Community of Practice topic on “All Hazards Approach to Syndromic Surveillance.” The remainder of the call featured a panel of presentations from federal, state, and local health agencies.

• Kathleen Hartnett and Abby Gates (CDC/NSSP) gave an overview of CDC resources on hurricanes and other severe weather:
  • Gates introduced the new myESSENCE dashboard—NSSP Severe Weather Winter Storms, Hurricanes, and Tropical Storms—that was recently uploaded to the myESSENCE sharing library. This dashboard provides a surveillance overview for numerous conditions and outcomes. Gates described the dashboard’s development, demonstrated how to find and download it, and explained why winter storms, hurricanes, and tropical storms were combined into one dashboard.
  • The second resource referenced a report created using data from a Disaster Medical Assistance Team, or DMAT. Gates shared an example of the report and reviewed its components. The report includes daily, total, visit volume, age breakdowns, distribution of primary diagnosis, and elements such as maps with clinical findings.
  • The final resources shared include two recently developed wildfire-related queries: 1) Air Quality Related Respiratory Illness v1 and 2) Fire and Smoke Inhalation v1. Both queries are available in ESSENCE.

• Linc Allen (TX) shared his experience with modifying NSSP–ESSENCE queries for local use across Texas’s varying syndromic surveillance systems. Allen demonstrated how the COVID-19-like illness query was revised to meet the needs of a local public health jurisdiction. Allen also highlighted the value of using additional data sources such as medication refill and oxygen tanks during the recent Texas winter storm. Lastly, Allen encouraged community members to develop queries for new and worsening weather patterns as they become more frequent.
• Jessica Bonthius (ME) presented Maine’s near real-time heat illness dashboard that uses syndromic surveillance data. She described its purpose, the development process, and lessons learned. The dashboard is updated daily and includes data from all hospitals (except those associated with the Veterans Administration) from 2017 to the present. Bonthius highlighted how the dashboard served as a resource for public health messaging, and she encouraged community members to look at it and provide feedback.
• Lastly, Aaron Gettel (Maricopa County, AZ) shared Maricopa County’s experience integrating heat data with syndromic surveillance. Notably, Gettel explained how syndromic surveillance data have been used to better understand the risks of heat-related illness in populations including homebound and mobile home residents and to initiate community outreach efforts. Gettel described Maricopa County’s efforts to work with the National Weather Service’s Phoenix office to improve public health messaging and community outreach.

NSSP CoP Core Committee

• Krystal Collier (AZ)—Core Committee Chair
• Yushiuan Chen (Tri-County, CO)—Core Committee Deputy Chair
• Data Quality Subcommittee Co-Chairs: If you’re interested in working with others and co-chairing this subcommittee, we are looking for a co-chair. Please email syndromic@cste.org.
• Diksha Ramnani (WI)—Data Quality Subcommittee Co-Chair
• Teresa Hamby (NJ)—Knowledge Repository Curation Subcommittee Chair
• Bill Smith (Maricopa Co., AZ)—Syndromic Surveillance and Public Health Emergency Preparedness, Response, and Recovery Co-Chair
• Fatema Mamou (MI)—Syndromic Surveillance and Public Health Emergency Preparedness, Response, and Recovery Co-Chair
• Rasneet Kumar (Tarrant Co., TX)—Syndrome Definition Subcommittee Co-Chair
• Rosa Ergas (MA)— Syndrome Definition Subcommittee Co-Chair
• Natasha Close (WA)—Technical Subcommittee Co-Chair
• Caleb Wiedeman (TN)—Technical Subcommittee Co-Chair

Data Quality (DQ) Subcommittee

• The Data Quality subcommittee is seeking a co-chair. Please email syndromic@cste.org for details.
• During the August 2021 call, subcommittee members discussed two topics related to the Centers for Medicare and Medicaid Services (CMS) Ruling: 1) CMS Hospital Inpatient Payment System Final Rule Release and 2) CMS Proposed Physician Payment Rule. Members were encouraged to review the final ruling and to consider submitting comments for the physician payment ruling. The remainder of the call focused on developing one-pagers for various data quality topics and on seeking feedback and volunteers for this activity. Several topics were identified along with a small workgroup of volunteers. To develop the one-pagers or learn more about the activity, please email sydnromic@cste.org.
• Link to previous call recordings and other resources from the DQ Subcommittee here.

Knowledge Repository (KR) Curation Subcommittee

• Check out the newly added content:
  • August 2021 Data Quality Subcommittee Call
  • August 2021 NSSP CoP Monthly Call
  • August 2021 NSSP ESSENCE User Group
  • August 2021 NSSP R User Group Call
  • August 2021 Race and Ethnicity Data Quality Improvement Workgroup Call
  • August 2021 SPHERR Subcommittee Call
  • August 2021 Syndrome Definition Subcommittee Call
• Do you have syndromes, resources, or anything else related to syndromic surveillance to add to the KR? If so, please email syndromic@cste.org.
• Email syndromic@cste.org if you have issues with the KR.

Syndrome Definition (SD) Subcommittee

• During the August Syndrome Definition call, members were asked to discuss how their COVID-19 surveillance has changed over the past year and how their findings have changed with the recent surge in cases. Attendees also shared their experiences with using syndromic surveillance data for ED visits associated with post-vaccine symptoms. The call included a discussion on non-COVID-19 surveillance efforts for heat, wildfires, and drownings.
• Check out previous call recordings and other resources from the SD Subcommittee here.

Syndromic Surveillance and Public Health Emergency Preparedness, Response, and Recovery (SPHERR) Subcommittee

• The August 2021 SPHERR call focused on recently developed CDC chemical, occupational, and hazmat queries presented by Abby Gates (CDC/NSSP).
• Check out previous call recordings and other resources from the SPHERR Subcommittee here.

Technical Subcommittee

• Check out previous call recordings and other resources from the Technical Subcommittee here.external icon