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Surveillance Systems and Informatics

Syndromic Surveillance

Syndromic surveillance is the real-time collection and analysis of health-related data, such as age, sex, zip code, and reported symptoms, which usually precedes diagnosis and lab results. While syndromic surveillance systems were originally developed with the intention of identifying instances of bioterrorism, today syndromic surveillance is also used as a method for identifying disease clusters and sentinel cases. Data from a syndromic surveillance system can also be used after an outbreak is identified to determine its characteristics.


The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) is a syndromic surveillance system developed by the Johns Hopkins University Applied Physics Laboratory. ESSENCE collects and analyzes data from participating hospital emergency departments in Indiana. First started in Indiana in 2006, the data collected includes the patient's chief complaint or symptoms, age, sex, zip code, date and time of visit, and the hospital visited. Emergency departments are required to report syndromic data to the Indiana State Department of Health in accordance with Indiana Administrative Code 410 IAC 1-2.4.

Meaningful Use

CDC Meaningful Use Information

State Law Information

Hospitals with emergency departments are to report all of the emergency department visits at the hospital within 24 hours from time of visit. Further guidance can be found on pages 4-7 of the Indiana Administrative Code 410 IAC 1-2.4
Electronic Reporting of Emergency Department Visits (410 IAC 1-2.4)

Additional Resources

User Guide

Indiana ESSENCE User Guide

Quick Guides

ESSENCE - Creating a Query
ESSENCE - Creating a Percent Query
ESSENCE - Mapping Data


ESSENCE Online Training Course by JHUAPL

Examples of ESSENCE use:

Influenza-like illness: U.S. Airforce Academy, Colorado, 2009
Sodium Azide Poisoning: Dallas County, Texas, 2010

ESSENCE Submitters:

CDC Resources 
Syndromic Surveillance
National Syndromic Surveillance Program (NSSP)

Contact Information

Meaningful Use Contact: