Michigan Syndromic Surveillance System (MSSS)


Altarum created MSSS for the Michigan Department of Health and Human Services in 2003 and continues to serve as the state’s development, enhancement, maintenance, and provider-outreach partner. By using MSSS to track symptoms reported at urgent care facilities and emergency departments in real-time, public health officials can quickly develop focused intervention strategies. For example, a rash of heat stroke amongst seniors in southeast Michigan might prompt local health departments to set up cooling stations.


Because MSSS receives about 100,000 HL-7 messages daily, we designed the system to be responsive to large workloads. This ensures data from emergency and urgent care visits across Michigan are processed quickly. Algorithms run continuously to detect increases in patient symptoms and alert public health staff when these occur.

Altarum provides technical assistance to emergency and urgent care facilities and performs extensive testing to confirm that the visit data they submit meets both Michigan and national interoperability requirements. To ensure data is received in real time, MSSS dashboards monitor “tardy” facility feeds and Altarum staff reach out to alert facilities and resolve delays.

Over the past 18 years, we have evolved MSSS into a tailored system with far more analytic power. The system is customizable, allowing users to create filters to search visit data for new public health threats, such as Covid-19, and conduct analysis directly within the system.   


The Michigan Syndromic Surveillance System receives real-time chief complaint data from over 200 Michigan facilities and analyzes data from over 5 million emergency and urgent care visits annually. Altarum also maintains the feeds that share de-identified MSSS data with the CDC’s National Syndromic Surveillance Program, where it is available for additional analysis and monitoring for public health concerns. 


Raj Borde
Software Engineering Director, Public Health Interoperability and IT Systems
John Christensen
Project Leader, Public Health IT Systems