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Establishing an Automated Surveillance System
Stanley S. Cho,1 S. Hackmyer,2 J. Li,1 J. Lipsman,1 O. Meruelo,2 D. Mottola,3 K. Mulvey,2 M. Pereira,2 R. Recchia1
1Westchester County Department of Health, New Rochelle, New York; 2Westchester County Department of Information Technology,
White Plains, New York; 3Applied Systems Group, Inc., Tuxedo, New York
Corresponding author: Stanley S. Cho, 145 Huguenot St.,
8th Floor, New Rochelle, NY 10801. Telephone: 914-813-5979; Fax:
914-813-5044; E-mail: ssc1@westchestergov.com.
Abstract
Introduction: In January 2003, Westchester County Department of Health (WCDOH) launched its
Community Health Electronic Surveillance System (CHESS). CHESS receives daily data electronically from multiple hospital information systems, automatically analyzes data to detect elevated levels in each syndrome category, and generates electronic reports of results.
Objectives: This article describes the construction and implementation of an automated syndromic
surveillance system in Westchester County.
Methods: WCDOH and multiple health-care providers reached agreement for daily acquisition, encryption,
and transmission of data files. Providers were not required to use a standard file format. When files are not received by a specified time, the system automatically e-mails reminders to providers. Files of varying formats, based on
scripts written individually for each provider, are automatically detected, decrypted, and loaded into the main database. CHESS was adapted from the syndromic surveillance methods developed by the New York City Department of Health and Mental Hygiene and CDC.
Results: CHESS analyzes data from a majority of the county's 12 emergency departments. Analysis and
reporting are scheduled at given daily intervals and results are automatically e-mailed to WCDOH staff for appropriate action.
Conclusions: CHESS is advanced in the surveillance arena for its flexibility in accepting data from providers
in varying file formats and its automation of internal processing and communication of results, allowing for ongoing system refinements. WCDOH has demonstrated the possibility of creating a local syndromic surveillance system that minimizes reporting burden on providers and maximizes use of internal resources and technical support.
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