Stage 1 - Syndromic Surveillance Electronic Data Submission Frequently Asked Questions

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The following frequently asked questions address most of the information required for an eligible professional (EP), eligible hospital (EH) or critical access hospital (CAH) that chooses to meet the meaningful use Stage 1 requirements by submitting electronic syndromic surveillance data to a public health agency. This submission demonstrates meaningful use compliance with electronic health record (EHR) technology as required in the Health Information Technology for Economic and Clinical Care Act of 2009 (HITECH). Visit the eHealth web site for more information about meaningful use and contact information if you still have other questions.

Frequently Asked Questions (FAQ)

Where do I submit the syndromic surveillance data?

Please contact your local health department (LHD) as to whether they can accept syndromic surveillance data in compliance with meaningful use standards.

What do I do if I do not collect syndromic surveillance data?

An EP, EH or CAH who does not collect any reportable syndromic surveillance on their patients during the EHR reporting period may receive an exclusion from reporting syndromic surveillance.

• EP exclusion information may be found on page 44568 of the CMS Final Rules, 42 Code of Federal Regulations (CFR) 495.6(e)(10)(iii).
• EHs and CAHs exclusion information may be found on page 44570 of the CMS Final Rules, 42 CFR 495.6(g)(10)(iii).
• EP exclusions information for non-applicable objectives may be found on page 44566 of the CMS Final Rules, 42 CFR 495.6(a)(2).
• EH and CAH exclusion information for non-applicable objectives may be found on page 44567 of the CMS Final Rules, 42 CFR 495.6(b)(2).

When may I submit the syndromic surveillance data?

Medicare meaningful use reporting timelines and other important dates may be found at the CMS web site.

Medi-Cal meaningful use reporting timelines and other important dates may be found at the Department of Health Care Services (DHCS) web site.

What types of syndromic surveillance data do I retrieve, record and submit?

Please refer to the CDC PHIN Messaging Guide for Syndromic Surveillance (scroll down to the syndromic surveillance section at the bottom of the page).  

For my test message, may I submit "dummy" data instead of "real" syndromic surveillance data from an actual patient? 

Yes. The use of test information about a fictional patient that would be reporting the same data elements as that of an actual patient would satisfy this objective.

If my EHR technology is capable of submitting batch files to my public health agency, is that sufficient for demonstrating compliance with the meaningful use certification criterion?  

Yes. Submitting batch files to an LHD, provided that they are formatted according to one or both of the adopted standards, is not prohibited by this certification criterion and would be acceptable.  Check with your LHD to determine if their syndromic surveillance system is able to receive batch files.

What do I do if my public health agency is not able to receive my data?

EPs, EHs and CAHs may be eligible for an exclusion from this objective and measure if no public health agency to which the EP, EH, or CAH submits data has the capacity to receive the data electronically.  Contact your LHD to make this determination.

• For the EP exclusion, refer to page 44568 of the CMS Final Rules, 42 Code of Federal Regulations (CFR) 495.6(e)(10)(iii).
• For the EH and CAH exclusion, refer to page 44570 of the CMS Final Rules, 42 Code of Federal Regulations (CFR) 495.6(g)(10)(iii).

Where may I test my syndromic surveillance message submission? 

Please contact your LHD regarding instructions for sending test messages.

What if my submission fails?

A failed attempt would meet the measure.  EPs, EHs, and CAHs should work with their vendors and the receiving entity with whom they tested to identify the source of the failure and develop remedies. However, for Stage 1 of meaningful use, a failed attempt would meet the requirements. Only one test is required for EPs practicing in a group setting that share the same certified EHR technology.

When do I attest to meaningful use?

Start and end dates to attest for the EHR Incentive Program are different for Medicare versus Medi-Cal programs and EHs versus EPs. 

• Visit the CMS web site for reporting timelines and other important dates for Medicare.
• Visit the DHCS web site for reporting timelines and other important dates for Medi-Cal.

How do I attest for meeting meaningful use?

CMS and Medi-Cal will accept a yes/no attestation to verify that the EP, EH or CAH has fulfilled the objective and measure of submitting electronic syndromic surveillance data in the first year reporting period. For auditing purposes, CMS also states that all providers attesting to receive an EHR incentive payment for either Medicare or Medicaid EHR Incentive Programs should retain ALL relevant supporting documentation (in either paper or electronic format used in the completion of the Attestation Module responses) for six years post-attestation. Documentation to support payment calculations (such as cost report data) should continue to follow the current documentation retention processes.

Please contact your LHD for appropriate documentation to support attestation for this meaningful use objective.

Medicare EPs, EHs and CAHs:

• Visit the CMS web site for more information on attestation.
• CMS has prepared a Meaningful Use Attestation Calculator to assist you prior to submitting your attestation to see if you would be able to meet all of the necessary measures to successfully demonstrate meaningful use and qualify for an EHR incentive payment.
• Also, review the CMS Attestation User Guide (PDF, 6.4 MB)for hospitals and CAHs to provide step-by-step instructions for login and completing attestation. For the public health objectives, see pages 19 to 23 of the user guide.
  

Medi-Cal EPs, EHs, and CAHs:

• Visit the DHCS web site for more information on attestation.
• DHCS has also prepared an Attestation Workbook (Excel)to assist you in preparing for an attestation.  

To whom do I send my attestation?

Medicare EPs, EHs and CAHs may attest to meaningful use through the CMS web-based Registration and Attestation System.

Medi-Cal EPs, EHs and CAHs may attest to meaningful use through the Department of Health Care Services web site.

I have heard that the states are able to change the requirements for submitting syndromic surveillance information as an objective for the Medi-Cal Incentive Program.  Has California changed any requirements for submission of syndromic surveillance data? 

No. While states do have the option to modify requirements for public health objectives/measures such as syndromic surveillance information submission under the Medi-Cal Incentive Program. California has not modified any requirements to date.

National Resources and FAQs Regarding Meaningful Use

What are the CMS regulations with which I must comply to fulfill the public health objective of submitting syndromic surveillance data to a public health agency?

Also see CMS Final Rules for the EHR Incentive Program.

What are the CMS Frequently Asked Questions regarding meaningful use?

CMS Frequently Asked Questions

What are the Office of the National Coordinator for Health Information Technology (ONC) regulations with which I must comply to fulfill the public health objective of submitting syndromic surveillance data to a public health agency?

ONC regulations refer to standards and specifications of the EHR technology itself, rather than the actions of healthcare providers. For more details, please  refer to the ONC Final Rule on Standards and Certifications.

What is the link to the ONC Frequently Asked Questions regarding meaningful use?

ONC Regulations Frequently Asked Questions

What is the link to the Association of State and Territorial Health Officials’ (ASTHO) Frequently Asked Questions regarding meaningful use?

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