Electronic Syndromic Surveillance System (ESSS)

The New York State (NYS) Electronic Syndromic Surveillance System (ESSS) is a near-real time data surveillance system used to monitor public health events, track disease trends, and detect disease outbreaks. The ESSS works with NYS hospital emergency departments (EDs) and their electronic health records (EHR) vendors to receive ED patient data across NYS outside of New York City (NYC). Currently 132 (100%) NYS hospital EDs outside of NYC are reporting near-real time data to the ESSS.

How ESSS process the records

When a patient comes to the ED, his/her visit data is submitted within 24hrs to the ESSS in the HL7 format (Introduction to HL7 Standards | HL7 International). Patient record is then processed and categorized into one or multiple syndromes based on patient's chief complaint (i.e., patient's self-stated reason for visiting the ED) and his/her diagnosis codes (i.e., ICD-10 codes). Customized software runs CuSum (Cumulative Sum) statistics daily to detect unusually high syndrome counts by comparing to the past 28-day baseline expected syndrome counts of a hospital, a county, and a region. An alert is then generated in the ESSS if the syndrome count is higher than baseline plus three standard deviations at each surveillance level.

Steps of the ESSS process. See below for text version.

ESSS Process

  1. Patient visits the ED
  2. ED sends the record to NYS ESSS via ECLRS within 24hrs
  3. The record is proccesed and categorized into one or multiple syndromes based on cheif complaint and diagnois code
  4. Statistics are run daily to detect unsually high syndrome counts using the past 28 days baseline
  5. Alert is generated in the ESSS if the syndrome count is higher than baseline plus three standard deviations

Data elements include:

ESSS collects multiple data elements from ED that includebut not limited to

  • ED visit date and time
  • Date of birth
  • Sex
  • Race
  • Ethnicity
  • Chief complaint
  • Diagnosis codes
  • Discharge disposition
  • Patient residential zip code
  • Patient residential county

Syndromes currently available (lower-level bullets indicate sub-syndromes):

  • Acute respiratory illness
    • COVID-19 |
    • Influenza |
    • Respiratory syncytial virus (RSV)
  • Asthma
  • Cannabis
    • Cannabis overdose
  • Carbon monoxide poisoning
  • Cold related illness
  • Drug overdose
    • Cannabis overdose |
    • Heroin overdose |
    • Opioid overdose |
    • Stimulant overdose
  • Fever
  • Fire/Smoke inhalation
  • Gastrointestinal (GI)
  • Heat related illness
  • Neurological
  • Rash
  • Suicide related
  • Synthetic cannabis
    • Synthetic cannabis overdose

Accessing the ESSS

Currently the ESSS data is restricted to the participating EDs, county, region and state syndromic surveillance staff, and CDC grant funded projects. To access the ESSS user interface, you should first register to the New York State Department of Health (NYSDOH) Health Commerce System (HCS), and follow the step-by-step instructions to obtain the ESSS data access via Syndromic Surveillance System (commerce.health.state.ny.us).

Recent activity/updates

The ESSS program is actively wrapping up the year-long project that will be replacing existing ESSS user portal with an interactive Tableau Dashboard. The upcoming new user portal will offer better data visualizations including syndrome count maps and trend graphs by user selected syndrome, hospital, county, region, gender, age group, race, ethnicity, and patient discharge disposition. System users will also be able to export customized tables using these variables. The data range of the portal will be three years contrast from the current two years up. The available syndromes increased from 17 to 22 as of May 2024. The interactive Tableau Dashboard is anticipated to be launched in the third quarter of 2024.