The Nebraska State
And Health Information Exchange
Benefits of Health Information
• Complete and accurate information.
– providers have the information they need to
provide the best possible care.
– Better access to information - Leads to better
coordination of care
– Patient empowerment - empower patients to
take a more active role in their health
– Save money – initial investment of time and
money will lead to savings
• NDHHS has been conducting HIE for
nearly 15 years (mostly ELR)
• After reviewing NU and the current status
of HIE in NE we decided to:
– Reorganize the immunization, lab, cancer and
Syndromic Surveillance databases under one
Program (Office of Health Statistics)
– Increase staffing to support health
information exchange and MU preparedness.
DHHS MU Readiness:
• Immunization, ELR, and Syndromic:
currently enrolling providers and accepting
• Cancer: currently installing and upgrading
software to testing Pathology and
• Other specialized registries: still
determining what those may be for NE
What is NESIIS?
• The Nebraska State Immunization Information
System (launched March, 2008)
Secure, statewide, web-based system that’s
been developed to connect and share
immunization information across the state of
Currently contains over 11,430,130
immunizations on over 1,494,384 clients
• Is capable of uni-directional and bi-directional
Is capable of accepting immunization
information in HL7 2.3.1 and 2.5.1 format
Currently accepting data from over 490
facilities/clinics (330 electronically)
Interfaces with NeHII to accept immunization
records (not required)
How can I get Imm info to NDHHS?
• You can manually use NESIIS in your facility via direct
You can work with NDHHS to electronically send
information to NESIIS, or
If your facility is participating in NeHII we can work to
get your information through them via electronic data
Register your intent at:
What is NDHHS Role?
• NDHHS must be ready to receive data
electronically in a secure manner.
NDHHS must be prepared to use this
information to improve the health of Nebraska
NDHHS must be able to share statistics
regarding this data back to providers
NDHHS will assist in certifying that providers
have met MU goals.
How Ready are we?
• NESIIS is prepared to accept and share
immunization information with providers
• NESIIS has succeeded testing data
exchange with NeHII (3-part project)
• NESIIS is prepared to help you meet
Meaningful Use Objectives
Why do we use NESIIS?
• #1 purpose is to capture complete
immunization records in order to:
– Reduce staff time needed to obtain scattered
– Reduce expenses and risk incurred by
administering duplicate imms
– Reduce missed vaccination opportunities
– Reduce staff time needed to forecast doses
– Prevent vaccine waste
NESIIS contains Standardized
• Vaccine activity –
• Assessment Report: produces a 6-8 page
detailed report on immunization rates (based off
of ACIP) within a specific clinic/organization
(also includes missed opportunities)
Benchmark: provides data on which clients met
age specific benchmarks
Reminder/recall: letters, postcards, mailing
labels for notices
Imm program uses NESIIS:
• for all VFC vaccine orders (started in
• track all VFC doses administered
• for CoCASA assessments
• Monthly VFC reporting
• Vaccine projections
• Public Imm Clinic attendance
DHHS Uses NESIIS to:
– immunization rates in NE
– immunization rates in outbreak areas
– uptake on new vaccines
– compliance to statutory vaccination
Who Accesses NESIIS:
• Healthcare providers across the state
• School nurses/representatives (look-up)
• Universities and Secondary Educational
• Correctional facilities
What is SSEDON?
• Syndromic Surveillance Event Detection of
• System used to accept Emergency
Department and Inpatient Syndromic data
• Is used by state and Local (County) Health
Departments for public health surveillance
• Accepts HL7 2.5.1 formatted data
• Originally established to track influenza
• Now used for many different health
– Heat related injuries
– Acute Cardiovascular Events
– Gastrointestinal Disease Outbreaks
– Animal bites/attacks
What is NEDSS?
• National Electronic Disease Surveillance System
• Internet-based system for public health
Used to accept reportable lab results
Used by state and Local (County) Health
Departments for public health surveillance
Accepts HL7 2.3.1 and 2.5.1 data
• Epi staff (state and LHD) have direct
access to monitor and analyze data in
• Monitor and analyze the data to identify
specific diagnoses of communicable and
• Epi staff provide follow-up, education,
prevention, and outbreak control.
Why is HIE Important for Public
• Allows PH to create and strengthen cross-jurisdictional
public health programs and collaborations.
Gives State and LHD’s a better understanding of the
communities’ health needs.
Provides information to develop better health promotion,
prevention, and treatment programs.
Near real-time data provides immediate analysis and
feedback to public health officials.
Improved detection of syndromes, diagnoses, and
How does NDHHS use all this
• Epidemiologists analyze data near real-time,
instead of waiting a year or more to receive
Can detect both syndromes as well as specific
Can detect and/or monitor outbreaks.
Can quickly communicate findings to appropriate
programs within DHHS and LHD’s for follow-up
and prevention measures.
• Electronic Surveillance System for Early
Notification of Community based
• Web-based system developed by John’s
• Installed at NDHHS in 2013
• Captures and analyzes indicators to detect
syndromes/events by Parsing chief complaint
text strings into syndrome groupings, and
applies algorithms for the detection of outbreaks
and other health events.
Creates charts, tables, graphs, and time series
Provides web-based information distribution
back to DHHS, LHD’s and providers.
• Nebraska Specific reports/functionality are being
NDHHS will use it to process and present ED,
Inpatient, death certificate and ELR data.
Exploring additional sources of data that can be
processed by ESSENCE (poison control, overthe-counter sales, cancer, etc.)
• Additional information on exchanging
Immunization, ELR, and Syndromic Data
with NDHHS can be found at:
Administrator, Office of Health Statistics
Or e-mail at: