Syndromic Surveillance

Syndromic Surveillance messaging allows both outpatient and inpatient facilities to report chief complaint or reason for visit-type data to the North Dakota Department of Health (NDDoH) Division of Disease Control using an automated and secure process for the purpse of early detection of potential disease events. NDDoH is able to accept both test and continuous messaging from hospitals and ambulatory providers looking to fulfill requirements for stages one and two of Meaningful Use for Syndromic Surveillance.

Getting Started

First, your facility will need to determine if the facility's Electronic Health Record (EHR) can send an electronic file in Health Level 7 (HL7) format. Disease Control will accept ADT messages in either HL7 version 2.3.1 or HL7 version 2.5.1, with preference given to 2.5.1 when possible. Please use the following resources for specific information on expected message content and structure:

  • PHIN Syndromic Surveillance Guide Provides detailed information on the national standard for expected message content, structure, and transport.
  • North Dakota Condensed Specification Guide Designed as a quick reference guide for providors or vendors with an existing understanding of HL7 message structure and transport, this short guide includes instructions on connecting with the North Dakota Department of Health and a table with required fields for North Dakota.

These guides can be used by both facilities and ambulatory providers. NDDoH knows ambulatory providers may be concerned that the information they have to send is slightly different. In our experience, our ambulatory providers have been able to use these guides with little modification to the standard message structure. We will work with providers during the testing phase to ensure we are receiving the information that is most vital for the purposes of meaningful use public health objectives. Although Disease Control will be available to provide some assistance with mapping, the provider IT personnel and software vendors will be responsible for most of the coding and implementation.

Next, providers must decide how they will connect with the North Dakota Department of Health. North Dakota has identified two connection options:

  • Secure File Transfer Protocol (sFTP) is utilized to create a direct connection between your facility/practice and the NDDoH.
  • Facilities/providers may connect to NDDoH via a connection through the North Dakota Health Information Network (ND HIN). Providers/vendors wishing to connect to NDDoH through a connection with the ND HIN are responsible for establishing their connection to the HIN independently.

Generally, NDDoH expects to receive messages at least once per day for every day the facility is open. NDDoH sends information to our syndomic surviellance system three times per day, so large facilities may be asked to send information two or three times per day if possible.

Registration of Intent

Providers or vendors ready to begin working with NDDoH on Meaningful Use  Syndromic Surveillance objectives must register their intent to do so. An online registration of intent may be submitted here.  After your registration of intent has been received, you will immedeately receive a confirmation email. Following this, NDDoH will contact you directly to begin the onboarding process.


For Facilities and Providers Planning on Connecting via the HIN for Meaningful Use Stage Two

Although the ND HIN will assist with setting up your syndromic feed, it is important to remember that the HIN does not represent NDDoH. You will still work with NDDoH directly when completing your Syndromic Surveillance connection. Please be aware that queueing, onboarding, and being in production status with the ND HIN is not equivalent to queueing, onboarding, and being in production status with NDDoH or the NDDoH Syndromic Surveillance Program. Facilities and providers wishing to connect to NDDoH through the ND HIN will not receive an exception because they are waiting to work with the ND HIN. Facilities and providers who wish to attest for Meaningful Use Syndromic Surveillance measures before their connection with the HIN is established have the option to connect directly with NDDoH using SFTP. This connection can then be moved to the ND HIN once the ND HIN syndromic feed is established. It is the responsibility of the facility/provider to work with the ND HIN to ensure work initial work on establishing your syndromic feed is compatible with your attestation timeline.



If you have questions or require additional information not addressed on this page, please contact Jill Baber, Syndromic Surveillance Coordinator for the North Dakota Department of Health at or call 701.328.2378.