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At least sixteen Illinois cases are now linked to the reports of elevated lead levels in recalled cinnamon applesauce pouches. To learn more about the recall, go to https://www.cdc.gov/nceh/lead/news/lead-poisoning-outbreak-linked-to-cinnamon-applesauce-pouches.html. If you or a family member consumed this product, consult your health care provider.

Frequently Asked Questions

General

Opioid Overdose Reporting

Validation

Opioid Antagonist Administration Reporting

General

Who is my hospital Portal Registration Authority (PRA)?

Your PRA is the main contact or liaison between your facility and IDPH. Some health systems assign one PRA for their health system or assign each facility their own PRA. Email dph.dpsq@illinois.gov if you need assistance determining your PRA.

Which hospital staff should be given access to review the opioid overdoses reported for our hospital?

While that is an internal decision for your hospital, it should be individual(s) who know the emergency department (ED) data in the hospital electronic medical record (EMR) and would be responsible for reporting cases.

If multiple hospitals are part of a health system, users can be identified to report and to have access to multiple facilities. The PRA must indicate this on registration.

Can my facility PRA assign more than one user access to report our ED opioid overdose reporting?

Yes, they will just have to fill out a Syndromic User Request for each user.

What should we do if our facility needs additional guidance or technical support regarding submission of the opioid antagonist administration data?

Email IDPH’s Division of Patient Safety and Quality at dph.dpsq@illinois.gov.

Opioid Overdose Reporting

Does the 48-hour reporting time frame exclude weekends? Can weekends be reported the following business day?

No. The data is sent to the Illinois Department of Public Health automatically in near-real time every 15 minutes. There is no manual process that would be stopped on the weekends.

We currently have a syndromic surveillance interface between our system and the Illinois Department of Public Health (IDPH), and the patient's chief complaint is submitted to IDPH over this syndromic surveillance interface. Is the state wanting to make sure we note opioid overdose in the chief complaint, or does it need to be in a specific format, different from the chief complaint? If so, are there interface specs for this?

Yes. IDPH wants to confirm that the chief complaint text includes enough specificity for an overdose to be determined and to capture that visit as reportable. The query IDPH uses has flexibility to search more broadly to improve the visits captured, leveraging diagnosis codes, or even triage notes, if necessary. If the chief complaint is not free-text and / or limited to entries of ”overdose” only without reference to likely cause, then we will need to evaluate the interface further with the hospital one-on-one.

What electronic medical record (EMR) vendors are submitting syndromic surveillance data to the Illinois Department of Public Health?

IDPH works with all major vendors that send syndromic surveillance data. For any vendor specific questions, send an email directly to dph.dpsq@illinois.gov for response.

Is this reporting mandatory or voluntary?

Both syndromic surveillance and the opioid overdoses in the emergency department are mandatory reporting.

Validation

Will the validation process deadline be extended since some user access to ESSENCE took longer than expected?

Yes, that is possible.

What dates are to be used for the validation period?

A recent 90-day period. That is a moving window based on the data you query in the EMR.

Can you send us a screenshot of the REDCap form that we need to send in for the validation process?

Where do we submit our validation file?

The link for uploading the data is built into our REDCap application: https://redcap.link/HspOODValidation2022

What is REDCap?

REDCap is an application that IDPH is using to build electronic forms to capture information from the hospitals on user access and validation data. The reference to REDCap is common language in IDPH, but hospitals do not need any special access to REDCap.

When our hospital conducts queries looking for overdoses, often the "substance" is either unknown or a mixture of substances. How should that be handled?

Only heroin or opioid overdoses seen in your hospital’s ED are reportable. If additional causes or substances are listed in the chief complaint, it will not interfere with detection of the reportable cases.

How do we report dead on arrival (DOA) persons that had an opioid overdose?

If they were not seen in the ED as patients, they are not reportable. If they were registered or admitted to the ED, they would be reportable regardless of final disposition.

How can we verify who currently has access to ESSENCE from our hospital?

The Portal Registration Authority (PRA) at your hospital is responsible for requesting access and notifying IDPH when a hospital user should no longer have access. Therefore, the PRA can verify all persons who have access. If still unknown, contact dph.dpsq@illinois.gov.

Will non-opioid overdoses be inadvertently captured from the chief complaint/diagnosis?

The query that is used to detect overdoses has been validated in Illinois and nationally to minimize errors.

What is meant by “overdoses admitted to emergency departments?” Does this include direct admits to inpatient units or just emergency rooms proper?

The reporting requirement is for opioid overdose cases presenting to the emergency departments, regardless of whether or not the patient was subsequently admitted into the facility.

Will there be ESSENCE training available?

Yes, we will be scheduling trainings in the future. Check the current training resources on our Syndromic Surveillance website at https://dph.illinois.gov/data-statistics/syndromic-surveillance.

I have access to multiple hospitals. Are all combined on the ESSENCE dashboard? How do I view data for an individual hospital?

The dashboard shows each hospital separately. You will only see data for hospitals that your account is associated with. All others will be zero.

Why is my query for opioid overdoses in the emergency department different from the Illinois Department of Public Health (IDPH) query?

IDPH uses a query that was built to take into consideration a wide range of data content sent from all hospital EDs in Illinois. Data can vary in quality. Some chief complaint text may be too limited or structured to allow free text entries. Others send diagnoses that are incomplete or take more than 48 hours to be received. Further guidance nationally suggests that some combinations of symptoms and ICD codes may not indicate an acute poisoning is a true overdose. The definition is developed to help IDPH understand trends to the opioid crisis in Illinois and to be able to respond locally, using a stable baseline of data to detect increases in a community as well as magnitude. As needed, IDPH will work with hospitals one-on-one to improve search queries for complete opioid overdose reporting from the ED.

Opioid Antagonist Administration Reporting

Are emergency medical services (EMS) reporting opioid overdoses when they administer an opioid antagonist in the field?

Not relevant for this reporting.

Should the opioid antagonist (i.e., Naloxone) reporting from hospital EDs include emergency medical services (EMS) distribution?

No. The antagonist reporting is limited to any opioid antagonist administered in the emergency department.

Should the hospital ED reporting include when emergency medical services (EMS) administer an opioid antagonist (i.e., Naloxone) to patients in the field, and brings the patient to a facility, but the patient does not require additional opioid antagonist?

No. You only need to report the opioid antagonist administered in the emergency department.

How will the emergency medical services (EMS) drug exchange affect the data reporting?

You do not need to report the opioid antagonist given to EMS to replace the one they administered in the field.

How do we handle opioid antagonists (i.e., Naloxone, Narcan) we give out and not administer ourselves?

You do not need to report the opioid antagonist you have not administered.

Does the Illinois Department of Public Health expect us to report opioid antagonist (i.e., Naloxone) usage hospital-wide, or specific to emergency departments?

You only need to report the opioid antagonist administered in the ED.

Is there a list of opioid antagonists that are required for reporting?

Any opioid antagonist administered needs to be reported.

What do I report if an opioid antagonist was given in the emergency department for a "presumed" overdose, but lab clarification determined it was not an overdose but instead a syncope episode?

All opioid antagonists administered in the ED must be reported.

We utilize an outside pharmacy that is not open on Sundays. Can we request a waiver for the daily input of the information for this day of the week?

No. By statute, you must report the opioid antagonist within 48 hours.

I am building the query to generate this report, but the dosage and unit are stored in different fields in our electronic health record (EHR). Your document specifies a pipe or comma delimited file, but our report would be dosage/unit. Is this going to present a problem when parsing this data?

Yes, all the required fields need to be in the exact order as the template. You should calculate the dosage in milligrams and populate the dose column with that calculated value.