Syndromic surveillance achieves timeliness by collecting prediagnostic data, such as emergency department chief complaints, from the start of healthcare interactions. The tradeoff is less precision than from diagnosis data, which takes longer to generate. As the use and sophistication of electronic health information systems increases, additional data that provide an intermediate balance of timeliness and precision are becoming available. Information about the procedures and treatments ordered for a patient can indicate what diagnoses are being considered. Procedure records can also be used to track the use of preventive measures such as vaccines that are also relevant to public health surveillance but not readily captured by typical syndromic data elements. Some procedures such as laboratory tests also provide results which can provide additional specificity about which diagnoses will be considered. If procedure and treatment orders and test results are included in existing syndromic surveillance feeds, additional specificity can be achieved with timeliness comparable to prediagnostic assessments.

Objective: To identify additional data elements in existing syndromic surveillance message feeds that can provide additional insight into public health concerns such as the influenza season.