Guidelines for constructing a statewide hospital syndromic surveillance network

The process to initiate a comprehensive and inexpensive statewide hospital emergency department-based syndromic surveillance system (HEDSS) in Connecticut can serve as a template for others.

With limited financial resources, the Connecticut Department of Public Health (CDPH) determined the requirements necessary to establish and routinely conduct hospital emergency department (HED)-based syndromic surveillance.

A statewide survey assessed ability and willingness of Connecticut hospitals to participate in HED syndromic surveillance. The New York City HED-based system protocol and analysis programs, available without financial charge, were modified for use in Connecticut. This system is based on hospitals sending daily standardized files of chief complaint data through encrypted e-mail or an FTP protocol to CDPH with subsequent categorization into syndromes using a SAS program. Anticipating regional surveillance needs during the Republican National Convention in New York City (RNC), CDPH initiated HEDSS in August 2004.

Most Connecticut HEDs were willing and able to participate on a voluntary basis. Beginning in July 2004, hospital recruitment began. By the time of the RNC, 11 of 32 Connecticut hospitals participated in HEDSS. Since then, an additional six HEDs have joined.

Establishing a voluntary statewide HEDSS was possible using an existing, readily available protocol with minimum financial resources and consensus from a statewide workgroup over a several-month time period.