Syndromic Surveillance On-Boarding Process 

Click the steps below for more information.

  • Stage 1: Complete Steps 1-3
  • Stage 2: Complete Steps 1-6

Step 1: Registration

Eligible Provider or Eligible Hospital notifies ADH of interest in submitting Syndromic data for Meaningful Use.
  1. Complete the Syndromic Surveillance Registration Process

Note for Eligible Professionals: *Completion of this step assumes the data submitter has acquired and implemented a certified health IT product capable of producing an HL7 2.3.1 or 2.5.1 syndromic surveillance message. HL7 2.5.1 is preferred for Meaningful Use Stage 1 and is required for Stage 2.

  • Each physician planning on attesting for Meaningful Use stage 2 will need to enroll with the Immunization Registry.
  • Completion of this step assumes the data submitter has acquired and implemented a certified health IT product capable of producing an HL7 2.5.1 ELR message
  1. Go to Step 2: Pre-testing

Step 2: Pre-testing

Eligible Provider or Eligible Hospital generates and evaluates Syndromic Surveillance electronic reporting test messages.
  1. Review the syndromic surveillance implementation guides:

Note: These guides serve as a reference for emergency departments and urgent care centers. The International Society for Disease Surveillance Meaningful Use Workgroup has developed recommendations for inpatient and ambulatory care data, but these recommendations have not yet been translated into a formal messaging guide. Until then, eligible hospitals and professionals may use the existing guides, to the extent possible, to develop syndromic surveillance messages for inpatient or ambulatory settings.

  1. Use the certified EHR system to create a set of test messages according to the specifications in the implementation guides. Use of HL7 version 2.5.1 is preferred for Stage 1 and is required for Stage 2. The set of test messages should include at least one of each Admit Discharge Transfer (ADT) Message Trigger Type (i.e. A01, A03, A04, A08) the eligible hospital or professional intends to include in future submissions.
  2. Validate the Hl7 message using the National Institute of Standards and Technology (NIST)Syndromic Surveillance HL7 V2.5.1 Validation Tool.

    • NIST Syndromic Surveillance Web Address:
      • Click on “Context-free Validation” and input message into the Message Content field.
        • The tool is intended for certifying 2014 Edition Meaningful Use EHR technology.
          Do not submit test messages containing personally identifiable health information
      • Save file as PDF and name the file: Message Validation Report.pdf
      • User will be asked to upload message validation report in the following step (Step 3: Testing).

    • User instructions can be found under the “Documentation” tab at the NIST.

 Additional testing tools below:

Please note: ADH will require the user to upload a validation report from NIST in order to place the provider/facility in a holding queue. Do not submit test messages containing personally identifiable health information.

  1. Address any errors identified by the va tool.

Step 3: Testing

Eligible Provider or Eligible Hospital submits Syndromic test message to ADH.

E-mail is not a secure mechanism of data transfer. Do not submit test messages containing personally identifiable health information though email. The agency reviews the messages, ensuring they meet standards specified for Meaningful Use. Once review is complete, the agency provides communication about the outcome of testing that can be used for attestation purposes.

For Stage 1 of Meaningful Use, completion of testing satisfies the requirements for attestation. Stage 2 will continue until production.

Step 4: In Queue

Eligible Provider or Eligible Hospital is placed on a waiting list for ongoing submission and additional validation.

Eligible hospitals or professionals who have successfully submitted qualifying test messages are placed into the queue. ADH Program Coordinators will notify eligible providers in order of registration.

We anticipate the length of the queue will grow as Meaningful Use progresses. To improve timeliness, please provide ADH with Message Quality Framework (MQF) message validation reports and test messages as early as possible in your attestation process(see Step 3: Testing).

Once an eligible hospital or professional reaches the front of the queue, they will be notified by an ADH program coordinator when it is time to move on to Step 5: Validation.

Step 5: Validation

Eligible Provider or Eligible Hospital establishes ongoing electronic Syndromic Surveillance data feed to ADH and work with Syndromic Coordinator for data validation.
  1. Select a data transport mechanism for ongoing submission of syndromic surveillance data.
    Arkansas Department of Health supports the following transport options: Virtual Private Network (VPN), Secure File Transport Protocol (SFTP), HTTPS Web Service (preferred transmission of choice), Public Health Information Network Messaging System (PHINMS), and the Arkansas State Health Alliance for Records Exchange (SHARE).
SFTP is a secure file transfer tool based on industry-standard Hyper Text Transfer Protocol Secure (HTTPS), hosted by Arkansas Department of Information Services (DIS). Click here to establish a connection through SFTP.
VPN stands for Virtual Private Network. A VPN allows you to create a secure channel of communication (a.k.a. a "tunnel") over a public network such as the Internet. Security is provided through authentication, to ensure that the entity connecting is authorized, and through encryption, to protect the data in transit.
HTTPS Web Service
*** Web Service to include all other public health objectives within ADH. (preferred transmission of choice) ***
PHINMS is the public health standard for reporting to the Centers for Disease Control and Prevention (CDC) and is a standard for national laboratories reporting to states. The software is freely available from the CDC.
The Arkansas HIE is implemented

  1. Set up a transport mechanism.

  2. Transmit a test message via the transport mechanism.

  3. Begin ongoing submission and participate in validation activities.

  4. Go to Step 6: Production

Step 6: Production

Eligible Provider or Eligible Hospital reports via Syndromic Surveillance electronic feed and participates in periodic quality assurance activities.
  1. Continue ongoing submission of Syndromic Surveillance data to public health.

    If public health identifies a need to follow-up on data indicating an event of potential public health concern, they will contact data providers.

    Eligible hospitals and professionals will be required to participate in periodic quality assurance checks to ensure accuracy of reporting. Arkansas Department of Health program coordinators will contact data providers to schedule these activities.

Do you want to know more about Meaningful Use activities at the Arkansas Department of Health? Please visit our Meaningful Use Website at

Meaningful Use Syndromic Surveillance On-Boarding Instructions
Checklist of Required On-boarding Activities

Questions? Please contact Syndromic Surveillance: