Syndromic Surveillance

Syndromic Surveillance messaging allows both outpatient and inpatient facilities to report medical visit 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 surviellance.

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:

  • North Dakota Syndromic Surveillance Messaging Guide
  • Provides detailed information on expected message content, structure, and transport. (Temporarily removed for updating, please see condensed specification, and feel free to contact us with questions.)
  • 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.

As the first and second phase of syndromic surveillance messaging consists of information exchange between NDDoH and the facility, NDDoH will need to know which EHR the facility is using in addition to their ability to send an HL7 message. Currently, North Dakota is utilizing secure ftp (sFTP) for direct connection. Providers can also connect to Disease Control via a connection through the North Dakota Health Information Network (HIN). Providers/vendors wishing to connect to NDDoH through a connection with the 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 objectives for syndromic surviellance must register their intent to do so. An online registration of intent may be submitted here. (Vendors or providers registering providers and/or facilities at several locations should leave the identification number field blank and will be asked to submit this information for each location during the onboarding process.) After your registration of intent has been received, NDDoH will contact you.

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

Although the HIN will assist with setting up your syndromic feed, it is important to remember that the HIN does not represent NDDoH. Queueing, onboarding, and being in production status with the 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 HIN will not receive an exception because they are waiting to work with the 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 HIN once the HIN syndromic feed is established. Facilities and providers unable to send messages via SFTP that have not yet starting working with the HIN do not yet have the capability to send a syndromic message and therefore are not yet eligible to register their intent to attest for Syndromic Surveillance Meaningful Use with NDDoH.


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