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ISDS 2016 Conference Abstracts

Delay between Discharge and Admit Time Delay in 
ADT-A03 messages via LEEDS
Jose A. Serrano*
Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA

Objective
To explore the difference between the reported date of admission 

and discharge date using discharge messages (A03), from hospital 
emergency departments participating in the Louisiana Early Event 
Detection System (LEEDS.

Introduction
The Infectious Disease Epidemiology Section (IDEpi) within the 

Office of Public Health (LaOPH) conducts syndromic surveillance 
of emergency departments by means of the Louisiana Early Event 
Detection System (LEEDS). LEEDS accepts ADT (admit-discharge-
transfer) messages from participating hospitals, predominately A04 
(registration) and A03 (discharge), to obtain symptom or syndrome 
information on patients reporting to hospital emergency departments. 
Capturing the data using discharge messages (A03) only could result 
in a delay in receipt of data by LaOPH, considering the variability in 
the length of stay of a patient in the ED.

Methods
Emergency department data from participating hospitals is 

imported daily to LEEDS and processed for syndrome classification. 
IDEpi syndromic surveillance messages received for the period of 
CDC week 1632 and 1636 (8/8/16-9/8/16) using MS Access and 
Excel to calculate the difference (in days) between the reported admit 
date and discharge date in A03 messages.

Results
88.1% of the A03 messages submitted in the 4 week analysis 

period exhibited no delay (delay=0 days) between the admit date and 
the reported discharge date, compared to only 10.7% showing a delay 
of one day (delay = 1 day) and 1.06% showing a delay of 2 days or 
more (delay ≥ 2 days). Less than 0.2% of the messages had missing 
information regarding discharge date (Table 1).

Conclusions
Syndromic surveillance systems operate under a constant need for 

improvement and enhancement. The quality of the data, independent 
of the quality of the system, should always strive to be of the highest 
pedigree in order to inform disease-specific programs and detect 
public health aberrations. In order to identify these potential concerns, 
it is imperative that the data be submitted to public health agencies 
in a timely manner. Based on this analysis, the lapse in time between 
admit and discharge results in little to no patient syndromic data delay 
for those hospital ED’s that exclusively send A03 messages. This 
statement is supported by the finding that close to 99% of messages 
demonstrated a delay between admit date and discharge date of one 
day or less.

Table 1. Delay between reported Admit and Discharge date in A03 messages 
submitted to LEEDS

Keywords
Syndromic; Surveillance; Quality

*Jose A. Serrano
E-mail: jose.serrano@la.gov

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e34, 2017