ISDS Meaningful Use Recommendation: Emergency Department and Urgent Care Data | International Society for Disease Surveillance


The International Society for Disease Surveillance (ISDS), in close collaboration with the Centers for Disease Control and Prevention, developed syndromic surveillance standards and guidelines that will be used by the Office of the Coordinator of Health Information Technology (ONC) to clarify the public health surveillance requirements of the Center for Medicaid and Medicare Services (CMS) Meaningful Use Programs. Development of the ISDS Final Recommendation brought together leaders in syndromic surveillance from throughout the public health community, and gathered input from all stakeholder groups, including eligible providers and hospitals, EHR technology vendors, and public health decision makers.

View the Final Recommendation:



A pillar of current U.S. health reform efforts is promoting the effective use of health information technology to transform how health care is delivered and population health is improved. Of immediate importance for public health authorities (PHA) is getting ready for implementation of the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs (“Meaningful Use” programs), a major component of the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of 2009 American Recovery and Reinvestment Act legislation, developed through a joint effort by the Office for Civil Rights (OCR), ONC, and CMS.

In the absence of appropriate standards for the public health syndromic surveillance (PHSS) Meaningful Use objective, it was deemed necessary to document PHSS business processes and define a core set of EHR requirements to support contemporary syndromic surveillance practice and provide a current-state picture for system redesign.

On August 1, 2010, the BioSense Program supported ISDS in recommending standards that support PHA efforts to make meaningful use of EHR technology during stage 1 of the Meaningful Use programs.

The “Final Recommendation: The Core Processes and EHR Requirements of Public Health Syndromic Surveillance,” was delivered to CDC on December 31, 2010. The document details 3 core PHSS business processes and 32 core data elements. The recommended standards: 1) define the core objectives of contemporary PHSS; 2) describe the model core workflows, inputs and outputs of PHSS; and 3) provide a holistic picture for understanding how an EHR can add value and efficiently interface with a PHA.

As ISDS carried out its charge, the CDC worked in close collaboration with ISDS to expedite the translation of the requirements into a HL7 2.3.1 and 2.5.1 messaging guide for syndromic surveillance. ISDS facilitated consultations for the CDC with expert syndromic surveillance practitioners to develop a draft PHIN Messaging Guide for Syndromic Surveillance, scheduled for release by the CDC in early 2011.

Development Process

A community consensus-driven process was used to develop the recommendation. Input from an ISDS Workgroup of local and state PHSS experts served as the basis for early iterations. Workgroup members represented key public health stakeholder professional organizations (e.g., Council of State and Territorial Epidemiologists, Association of State and Territorial Health Officials, and National Association of County and City Health Officials). Input from all Meaningful use stakeholders on a provisional recommendation document was collected during an open comment period. Stakeholder input then informed ISDSʼs final recommendation.

ISDS will post the results of stakeholder comment analysis and ISDS’s response to common thoughts and questions here.


The BioSense Program of the CDC Office of Surveillance, Epidemiology and Laboratory Services is providing funding to support these activities through Cooperative Agreement Number 5U38HM000515-03.

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