### PHIN MESSAGING GUIDE FOR SYNDROMIC SURVEILLANCE: QU ESTIONS & ANSWERS

PHIN SS Guide Q and A (final).docx Page 1 Question # 1: What is the relationship between the “ Final Recommendation: The Core Processes & EHR Requ irements of Public Health Syndromic Surveillance ” (PHSS) 1 document released by the International Society for Disease Surveillance (ISDS) and the PHIN Messaging Guide for Syndromic S urveillance?

Answer:
The ISDS document 1 , in Section 1.1, states that its purpose is “...to d efine the core of PHSS practice and the EHR data requirements widely needed to support the core.” CDC’s PHIN Messaging Guide for Syndromic Surveilla nce provides technical specifications and implementatio n guidance to support the exchange of the core synd romic surveillance data from healthcare to public health in accordance with the ISDS document.

Question # 2: How will the PHIN Messaging Guide for Syndromic Sur veillance be maintained and updated in the future?

Answer: The CDC will issue new versions of this guide as ne cessary to incorporate additions and modifications to the syndromic surveillance business standards and data requirements. The CDC will collaborate with IS DS to address and incorporate modifications based on but not limi ted to ISDS input; public comments; feedback from C DC, state and local public health agencies and vendors; and i nput from public health partner organizations in th e development of future versions of this guide. Note: Refer to Section 2.5 for a more details

Question # 3: What data source(s) does the PHIN Messaging Guide f or Syndromic Surveillance support?

Answer:
Within the ISDS document 1 , Section 1.2.1 defines the most important data sou rces for syndromic surveillance: emergency department (ED) and urgent care (UC) pati ent visits captured by health information system an d sent to a public health authority. These data sources are in scope of the ISDS Recommendations 1 and provide the foundation for the PHIN Messaging Guide for Syndromic Surveill ance. In the future, ISDS will extend the scope of data sources for syndromic surveillance and updated versions of the PHIN Messaging Guide for Syndromic Surveillance will be published.

Question # 4: The PHIN Messaging Guide for Syndromic Surveillance indicates (see Section #6) the PHIN Message Qualit y Framework (MQF) will support real time validation o f syndromic surveillance messages. How will MQF support the validation of these messages?

Answer: Implementers will be able to use MQF to validate me ssages they create during their development and tes ting phases. The MQF tool will perform several validat ions on syndromic surveillance messages based on th e technical specification contained in the PHIN Messaging Guide for Syndromic Surveillance.

Question # 5:
If a sender does not have a value for a data elemen t with a usage type of “RE” and the data element is sent in an OBX segment, is it necessary to include an OBX segmen t for that data element with an empty OBX-5 field?

Answer: No. Since the usage is “RE” and the sender does n ot have a value for the data element it is not nece ssary to include an OBX segment for that data element.

1 International Society for Disease Surveillance, Final Recommendation: The Core Processes and EHR Re quirements of Public Health Syndromic Surveillance. International Society for Disease Surveillance, Bri ghton, MA (January 2011); http://www.syndromic.org/projects/meaningful-use

### PHIN MESSAGING GUIDE FOR SYNDROMIC SURVEILLANCE: QU ESTIONS & ANSWERS

PHIN SS Guide Q and A (final).docx Page 2 Question # 6: Can a single batch contain different types of syndr omic surveillance messages?

Answer: Yes. For example, a batch may contain Admin/Visit Notifications (ADT^A01) and Discharge/End Visit (ADT ^A03)

messages.

Question # 7: Are receivers required to acknowledge all syndromic surveillance messages?

Answer: The guide includes the specifications for the ackno wledgement messages, but the sender and receiver wi ll decide whether or not to use acknowledgement in their spec ific data exchange implementation.

Question # 8: Why didn’t the CDC publish separate PHIN Messaging Guides for Syndromic Surveillance for each of the s upported HL7 Versions (2.3.1 and 2.5.1)?

Answer: Based on the currently recommended by ISDS core sy ndromic surveillance data elements, there are just two basic differences between the syndromic surveillance mess age for HL7 version 2.3.1 and 2.5.1 - HL7 2.3.1 doe sn’t have the MSH-21 (Message Profile Identifier) and the ENV-7 ( Event Facility) fields. Therefore, the guide ide ntifies how to construct both HL7 2.3.1 and HL7 2.5.1 messages to accommodate these differences. (Note: See Section 2.4 for additional details.)

Question # 9: Our state requires triage notes for a patient visit and the clinical impression of the diagnosis for s yndromic surveillance. However the PHIN Messaging Guides fo r Syndromic Surveillance specifies the usage of the triage notes and clinical Impression data elements to be optiona l. Can we make these data elements required for o ur jurisdiction?

Answer: Yes. As necessary, states may add data elements, m odify the data element usage and/or constrain messa ge elements to support their specific requirements, la ws and regulations.

Question # 10: Why are three syndromic surveillance data element t ables provided in Section 4?

Answer: The table in Section 4.2.1 contains the syndromic s urveillance core data elements that ISDS identified as the minimum set commonly used by public health for synd romic surveillance. The other two tables, in Sect ions 4.2.2 and 4.2.3, are provided to inform implementers of t he other data elements identified by ISDS that may be used by jurisdictions to extend the core data set or that w ill be considered for inclusion into the core minim um data set in
the future.