HAI Surveillance Enhancement within EpiCenter by Utilization of Triage Notes

Introduction In New Jersey, Health Monitoring Systems Inc.’s (HMS) EpiCenter collects chief complaint data for syndromic surveillance from 79 of 80 emergency departments (ED). Using keyword algorithms, these visits are classified into syndrome categories for monitoring unusual health events. HAIs are infections that patients acquire while they are receiving treatment for a health condition in a health care setting. Following the 2014 Ebola outbreak in West Africa, the New Jersey Department of Health (NJDOH) Communicable Disease Service (CDS) started recruiting EDs to include triage note data in addition to chief complaint data to enhance surveillance capability for Ebola and other HAIs. Research by the University of North Carolina suggests triage note data improve the ability to detect illness of interest by fivefold1. Currently, there are three NJ EDs with triage note data in EpiCenter along with ICD 10 codes which can be used for comparison. This pilot study will assess whether infections following a surgical procedure can be captured in triage note data along with ICD codes. Also, this evaluation will determine if triage note data can be used to create HAI custom classifications for syndromic surveillance. These classifications can potentially be used by surveillance and/or preparedness personnel and local health departments, as well as hospitals, to better prepare for detecting and preventing HAIs that are a significant cause of morbidity and mortality in the U.S.2