Electronic Syndromic Surveillance System (ESSS)

The New York State (NYS) Electronic Syndromic Surveillance System (ESSS) is a near-real time disease 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 ED Records

When a patient comes to the ED, the patient’s visit data is submitted within 24 hours 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 (aka, patient's self-stated reason for the ED visit) and patient’s diagnosis codes (aka, ICD-10 codes). Customized software runs CuSum (Cumulative Sum) statistics twice a day to detect unusually high syndrome counts by comparing to the past 28-day baseline counts of a hospital, a county, and a region. An alert is then generated 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 Data Flow

  1. Patient visits the ED.
  2. ED sends the patient record to NYS ESSS within 24 hours.
  3. The record is processed and categorized into one or multiple syndromes based on patient chief complaint and diagnosis codes.
  4. Statistics are run twice a day to detect unusually high syndrome counts using the past 28 days baseline.
  5. Alert is generated if the syndrome count is higher than baseline plus three standard deviations.

ESSS Syndromes

ESSS’s User Portal currently has 40 syndromes under surveillance. As follows, the lower-level bullets indicate sub-syndromes of the higher-levels:

  • Acute Respiratory
    • COVID-19
    • Influenza-Like Illness
    • Respiratory Syncytial Virus (RSV)
  • Alcohol-Related
  • Asthma
  • Cannabis
    • Cannabis Poisoning
  • Carbon Monoxide
  • Cold-Related Illness
  • Drug Overdose (OD)
    • Benzodiazepine (Benzo) OD
      • Unintentional Benzo OD
    • Cannabis Poisoning
    • Cocaine OD
      • Unintentional Cocaine OD
    • Fentanyl OD
      • Unintentional Fentanyl OD
    • Methamphetamine (Meth) OD
      • Unintentional Meth OD
    • Opioid OD
      • Unintentional Opioid OD
      • Heroin OD
        • Unintentional Heroin OD
    • Stimulant OD
      • Unintentional Stimulant OD
    • Synthetic Cannabis Poisoning
  • Fever
  • Fire/Smoke Inhalation
  • Gastrointestinal (GI)
  • Heat-Related Illness
  • Neurological
  • Rash
  • Self-Harm
    • Intentional Drug OD
  • Suicide-Related
    • Suicide Attempt
    • Suicide Ideation
  • Synthetic Cannabis
    • Synthetic Cannabis Poisoning
  • Tobacco-Related

Access the ESSS Public Dashboard

The ESSS Public Dashboard displays aggregated data reports generated from the ESSS. The reports include the following syndromes: 1) Respiratory Conditions, including Acute Respiratory, Asthma, COVID-19, Influenza-like Illness, and RSV syndromes, 2) Environmentally Related Conditions, including Carbon Monoxide, Cold-Related Illness, Heat-Related Illness, and Fire/Smoke Inhalation syndromes, and 3) Other Syndromes, including Fever, GI, Neurological, and Rash syndromes.

ESSS Public Dashboard

ESSS Public Dashboard

All dashboard reports follow the same format regardless of the selected syndrome. Each report includes a map that shows visits by county and a chart that shows the rates and percentages of ED visits over time for the selected syndrome and period. Footnotes and titles change automatically based on the selection to help users understand the information. The dashboard is updated monthly on the first Monday of every month.

Access the ESSS User Portal

The ESSS User Portal is restricted to participating ED, county, region and state syndromic surveillance staff, and CDC grant funded projects. To access the ESSS User Portal, you should first register to the NYS  Department of Health (DOH) 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).