National Electronic Disease Surveillance System (NEDSS)

Public Health Informatics and Data (PHID)

The Texas National Electronic Disease Surveillance System (NEDSS) is one of several important systems maintained by the Public Health Informatics and Data Exchange team. Please send NEDSS related inquiries to NEDSS@dshs.texas.gov.

Background

The Texas National Electronic Disease Surveillance System (NEDSS) is the primary statewide integrated infectious disease surveillance system utilized by public health epidemiologists and surveillance staff across Texas to monitor and respond to most notifiable infectious disease conditions. Since 2004, NEDSS has played a critical role in preventing the further transmission of infectious diseases in Texas. It serves as the primary system for processing and distributing electronic laboratory reports (ELRs) which trigger public health investigations of notifiable disease conditions.

The Texas National Electronic Disease Surveillance System (NEDSS) facilitates the electronic exchange of public health surveillance data from healthcare systems to public health departments. NEDSS helps connect the healthcare system to public health departments and those health departments to CDC by:

• Providing leadership and resources to state and local health departments to adopt standards-based systems needed to support national disease surveillance strategy;
• Enabling health agencies to use information technology more effectively by developing patient-centered systems that helps health departments identify issues such as co-morbidities (multiple diseases or conditions) that occur in the same individual over time;
• Defining the content (i.e., disease diagnosis, risk factor information, lab confirmation results, and patient demographics) of messages sent using the HL7 messaging standard;
• Implementing content standards that the healthcare industry currently uses (e.g., LOINC as the standard for transmitting laboratory test names and SNOMED as the standard for transmitting test results) for increased interoperability between states and the healthcare industry; and
• Providing the NEDSS Base System (NBS), a CDC-developed information system, to help reporting jurisdictions manage reportable disease data and send notifiable diseases data to CDC.

Today, all 50 states and Washington, D.C., use a NEDSS-compatible system to send case notifications to Nationally Notifiable Disease Surveillance System (NNDSS). To be considered NEDSS compatible, states must have information systems meeting these requirements:

• Disease data entry directly through an Internet browser-based system, thereby creating a database accessible by health investigators and public health professionals,
• Electronic laboratory reporting that enables labs to report cases to health departments,
• Integration of multiple health information databases into a single repository, and
• Electronic messaging capabilities, enabling states to share information efficiently with CDC and other health agencies. 

Public Health Infectious Disease Surveillance

Public health epidemiologists and surveillance staff routinely conduct disease investigations based on ELRs assigned to their area through NEDSS. The purpose of disease investigations is to identify cases, assess their close contacts, apply mitigation efforts, and reduce further spread of the disease. Public health staff capture results of those investigations in NEDSS and utilize the data to identify and monitor disease trends in their communities. The data captured through investigations also helps to identify vulnerable populations, pockets of need, and changes in disease epidemiology. view more information on notifiable diseases and public health infectious disease surveillance.

Latest Improvements and Enhancements in NEDSS

Texas NEDSS has recently undergone extensive system updating. A number of enhancements have been implemented in the system to improve data capture and overall user experience. NEDSS saw an increase in ELR processing with surges in COVID-19 labs where daily averages were over 3000 percent higher than pre-COVID-19 daily averages. The sheer volume of labs maintained by Texas NEDSS surpasses every other state. Texas NEDSS has been able to successfully transform and adapt to COVID-19 response needs. Custom data marts for SARS-CoV-2 ELRs and CoVID-19 cases were developed.

NEDSS has migrated to a new server to improve system processing capacity. As a result, the ETL process run time to update the reporting database was reduced by 50 percent. NEDSS has upgraded to the latest release version and serves as a beta testing site for the CDC. Several new condition specific reports have been developed. PHID team continues to work with users to identify and prioritize enhancements needed to improve public health surveillance efforts across Texas.

• NEDSS is currently in the latest CDC approved release version
• Increase in number of users from 500 to 1000+
• Migrated from physical hardware to AWS cloud environment
• Moved from legacy investigation page to a more robust page builder
• The process by which reports are generated and updated are now automated
• NEDSS onboarding time has drastically reduced
• Several new condition specific reports have been developed
• System is able to integrate workflow decision support algorithms to reduce manual burden on public health staff

The DSHS Public Health Informatics and Data Exchange (PHID) Unit serves as the primary connection point for providers, health care facilities, and laboratories who are required to submit electronic laboratory reports and electronic case reports of Texas notifiable conditions to public health.