Syndromic Surveillance FAQ

  1. Is my facility eligible to participate in the Houston Health Department syndromic surveillance program?
    Beginning January 2016, registration opened for hospitals with emergency departments, free-standing emergency centers, and urgent care centers to register their intent to submit data to the Houston Health Department syndromic surveillance program.
  2. Are hospitals the only health care facilities that can connect to Houston Health Department ESSENCE?
    Currently, we are focusing on facilities that have an electronic health record and provide emergency or urgent care. Our primary goal is to connect hospitals with emergency departments, free-standing emergency centers, and urgent care centers to Houston Health Department ESSENCE.
  3. What type of agreement is required for data providers to connect to Houston Health Department ESSENCE?
    Data providers that intend to connect to Houston Health Department ESSENCE must complete a provider packet which is obtained by submitting a request to
  4. How do data get into Houston Health Department ESSENCE? Does each facility have to manually input data? How often is it updated?
    The patient’s data are captured from the EHR and sent automatically to Houston Health Department ESSENCE. Houston Health Department IT staff work directly with the facility’s IT staff to set up the data transfer protocols. Facilities do not have to manually input the data outside the normal entry in their EHR and there is not any change in the clinical process of the patient visit.  
    The goal is to have as near real-time data as possible, given the technology constraints of each facility. The frequency of submission is established as the connection to the data provider is made.  Data providers are strongly encouraged to submit data at least once every 24 hours.
  5. What data elements are collected from the EHR? What level of detail is shown in ESSENCE?
    The limited Data Set or Houston Health Department ESSENCE data elements include:
    1. Basic message information
    2. Patient demographics
    3. Patient- visit information
    4. Diagnostic and pre-diagnostic information
    5. Vitals
    6. Risk factors
  6. What are the technical specifications for Houston Health Department ESSENCE?
    Houston Health Department ESSENCE is configured to support the PHIN Messaging Guide for Syndromic Surveillance. 
  7. Who determines what users will have access to Houston Health Department ESSENCE and what level of access will they have?
    Each organization determines who has access to view data in Houston Health Department ESSENCE and the Houston Health Department assigns user accounts for those individuals. It is the responsibility of the data provider to notify the Houston Health Department when users should no longer have access to ESSENCE.
  8. Are data in Houston Health Department ESSENCE confidential? Can the data be re-identified?
    Data in Houston Health Department ESSENCE are protected health information (PHI). All data are stored in a secure database and accessed only by authorized users. 
    In the event of an alert that results in an investigation and follow-up with potential cases, the users in the appropriate jurisdiction can work with the data provider(s) to re-identify patients during the investigation.
  9. What are the syndromes in Houston Health Department ESSENCE?
    The patient’s chief complaints are grouped into broad syndrome categories. The analysis software is customizable regarding syndromes and ad hoc queries. Houston Health Department ESSENCE uses a set of 13 syndromes, which are the typical set used in other states. These syndromes include botulism-like, exposure, fever, gastrointestinal illness, hemorrhagic illness, influenza-like illness, injury, neurological, rash, reportable diseases/records of interest, respiratory, shock/coma, and others.
  10. Is ESSENCE used for reportable conditions?
    No. Most of the data in ESSENCE are symptomatic data, not laboratory confirmed diagnosis data. In addition, some elements required for a notifiable condition report are not collected, such as name, date of birth, and address. Therefore, there is not any change in how reportable/notifiable conditions are reported.
  11. How are baseline data established? How are alerts generated? Are there protocols for responding to an alert?
    Historic data from data providers is incorporated into the ESSENCE system, as available, to help establish the baseline. The system generates alerts based on aberrations above the baseline. Users can see the expected number of cases for a particular syndrome versus the observed number of cases on a given day, as well as the geographic distribution of those cases. These alerts can be further analyzed to determine if there is a potential outbreak.
  12. How is ESSENCE beneficial for data providers?
    Data providers can use the system for:
    1. Integration into existing ER tracking or infection control procedures
    2. Forewarning about health trends affecting neighboring regions
    3. Analysis of data
    4. Collaboration with public health while protecting hospital/patient confidentiality
    5. Monitoring population health of catchment area
    6. Participation in the Promoting Interoperability Program
  13. How is ESSENCE beneficial for public health officials?
    Data providers can use the system for:
    1. Querying data for symptoms or syndromes of concern
    2. Situational awareness, especially with rapidly spreading gastrointestinal or respiratory illness
    3. Mapping of clusters
    4. Early event detection
    5. Outbreak case identification
    6. Natural disaster or severe weather impact assessment
    7. Exposure contact identification
    8. Exposure source investigation
    9. Targeted education
    10. Hospital acquired infection tracking
    11. National disease trend monitoring
  14. Does submitting to Houston Health Department ESSENCE qualify for the Merit -based Incentive Payment System?
    Providers participating in either the Medicaid EHR incentive program or MIPS can utilize their participation in syndromic surveillance to meet certain federal requirements. MIPS is part of the Quality Payment Program (QPP) under The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). 
  15. Can eligible professionals register intent to submit data?
    Eligible Professionals in urgent care centers or free-standing emergency centers can register their intent to submit data to Houston Health Department ESSENCE. 
  16. How do I get documentation needed for Promoting Interoperability attestation?
    Requests for Promoting Interoperability public health reporting documentation for syndromic surveillance should be sent to The facility’s name and attestation period should be included in the request.