1. 1. Facility identifier (NPI or ODI) Must be unique for each Facility address)
2. 2. Visit Identifier
3. 3. Admission date and time (MMDDCCYYHHMMSS) Only one value (earliest) can be provided per visit.
4. 4. Patient Class
5. 5. Patient birth date (MMDDCCYY) and Age
6. 6. Patient sex
7. 7. Patient Race
8. 8. Patient Ethnicity
9. 9. Patient ZIP
10. 10. Discharge Disposition
11. 11. Discharge date and time (MMDDCCYYHHMMSS)
12. 12. Facility Name
13. 13. Facility Address
14. 14. Unique Patient Identifier (Medical Record Number)
15. 15. Chief Complaint. This must be in an OBX HL7 segment and sent with every message as soon as it is available in the EMR. It should be the free text of the patient’s self-reported reason for visit. If the complaint is captured as from a pick list, all complaints shall be sent. If both free-text and pick list chief complaints are captured in the EMR, both shall be sent to the Department.
16. 16. Diagnosis codes -Admitting, Working or Final. (ICD-10 codes only; as many as available)
17. 17. Triage Note
18. 18. Clinical Impression
19. 19. Discharge date and time (MMDDCCYYHHMMSS)
20. 20. Pregnancy Status
21. 21. Death Data and Time
22. 22. Smoking Status
23. 23. Procedure Codes
24. 24. Patient Country
25. 25. Date of Onset
26. 26. Insurance Type
27. 27. Initial Temperature
28. 28. Initial Pulse Oximetry
29. 29. Initial Blood Pressure
30. 30. International Travel History (Country and dates)
31. 31. Problem List
32. 32. Body Mass Index (or Weight and Height)
33. 33. Patient Assigned Location
34. 34. Hospital Unit
35. 35. Event Date and Time (MMDDCCYYHHMMSS)
36. 36. Message Date and Time (MMDDCCYYHHMMSS)
37. 37. Initial Acuity
38. 38. Patient name (first, middle, last, suffix)
39. 39. Patient address (PO Box or street address, apartment number, city, state, and zip code)
40. 40. Medications Prescribed
41. 41. Attending Physician (National Provider Index)
42. 42. Facility Visit Type
43. 43. Event data and time (MMDDCCYYHHMMSS) and
44. 44. Any element adopted for use by CDC’s PHIN or HL7 standards organization in Version 2.5.1 of the Syndromic Surveillance Messaging Guide on HL7.org (July 26, 2019). Elements supported by the Department will be added as a submission requirement accompanied by sufficient notification to all submitting facilities and health care systems. Notice will be provided no less than 90 days in advance of the submission requirement.

Data elements are to be submitted by messages in HL7 standard format. Data elements are R (Required), RE (Required but may be empty in messages where the information has not been recorded in the Electronic Medical Record (EMR)) or O (Optional data elements that should be sent if they are available in the EMR).

Detail Data

(Source: Added at 47 Ill. Reg. 4017, effective March 10, 2023)