Layout 1


ISDS Annual Conference Proceedings 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and
reproduction in any medium, provided the original work is properly cited.

ISDS 2012 Conference Abstracts

Evaluation of Emergency Department Data Quality
following PHIN Syndromic Surveillance Messaging
Guide
Hwa-Gan Chang*1, Charlene Weng1, Charlie DiDonato2, Dave DiCesare1, Jian-Hua Chen1
and Debra Blog1

1NYSDOH, Albany, NY, USA; 2NTT Data, Albany, NY, USA

Objective
To evaluate the readiness and timeliness of ED data submitted by

hospitals following PHIN syndromic surveillance messaging guide
and to evaluate the availability of minimum data elements. To vali-
date the accuracy and completeness of data from ADT messages com-
pared with data currently reported to the NY syndromic surveillance
system.

Introduction
The final rules released by the Centers for Medicare and Medicaid

Services specified the initial criteria for eligible hospitals to qualify
for an incentive payment by demonstrating meaningful use of certi-
fied Electronic Health Record (EHR) technology. Syndromic sur-
veillance reporting is one of three public health objectives that
eligible hospitals can choose for stage 1. The PHIN messaging guide
for syndromic surveillance was published for hospitals to construct
emergency department data using Admit Discharge Transfer (ADT)
messages, with the minimum dataset that is standard among hospitals
and public health agencies. 

Currently New York hospitals are reporting emergency department
(ED) visit data to the NY syndromic surveillance (SS) system. Pa-
tient chief complaint data are monitored for trends of illness at the
community level in order to detect possible outbreaks and situational
awareness.

Methods
12 hospitals using three EHR certified vendors pilot tested syn-

dromic surveillance data for MU. Hospitals started to transmit ED
data in HL7 v 2.5.1 to the NY pre-certification server beginning Oc-
tober 2011. The month of data from July 2012 was evaluated for
availability by data elements listed in the implementation guide. The
ADT message types were analyzed and the timeliness of reporting
was calculated from visit date to report date of the first message type.
The data from the pre-certification server was matched against data
from the production SS system by medical record number and visit
date to evaluate the data content.

Results
There were 5 hospitals from vendor A, 3 from vendor B and 4 from

vendor C participating in the pilot testing; 5854, 9882, and 13316 ED
visits were reported from the three vendors respectively for the month
of July. The type of first message by vendor is shown in Table 1. The
availability of data elements is listed in Table 2. There were 79%,
82%, and 87% ED visit records received within 24 hours for vendor
A, B, and C respectively. One hospital from vendor A, 3 hospitals
from vendor B and 4 hospitals from vendor C also reported ED data
to the production system, and their comparison with pilot testing data
is shown in Table 3.

Conclusions
The types of ADT messages first reported varied by vendor and

hospital. Not all data elements specified in the implementation guide
were available or complete, and varied by vendor. An average 83%
of first messages were received within 24 hours and the chief com-
plaint from ADT messages did not match well with the current ED
system in production. It is a very time consuming and resource de-
manding process to move a hospital from successful attestation stage
to production and requires public health, EHR vendor, and hospital IT
to work together. The learning experience from these three vendors
in implementing syndromic surveillance for MU will help public
health and EHR vendors to prepare for stage 2.

Table 1: Type of First ADT Message by Vendor

Table 3: Percent Matched Data Content by Vendor

Table 2: Data Element Availability by Vendor

Keywords
Syndromic surveillance; Meaningful Use; PHIN messaging guide

*Hwa-Gan Chang
E-mail: hgc04@health.state.ny.us

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e50, 2013