Michigan Syndromic Surveillance System (MSSS)

Syndromic surveillance detects unusual or sudden increases in patients reporting symptoms that could signal public health threats—providing states with an early warning before diagnoses are available.

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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.

Our Approach

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. 

Michigan Syndromic Surveillance System (MSSS) Contact

Contact Us

Lakshmi Atluri

Lakshmi Atluri  - MS

Senior Director, Public Health Information Technology Systems

Areas of Expertise
  • Disease Surveillance
  • Public Health Informatics
  • Software Development

For over 12 years, Lakshmi Atluri has focused on public health informatics in various roles at Altarum, from software engineer to technical leader to her current role as senior director of Public Health Information Technology (IT) Systems. Lakshmi has overseen the successful deployment of a variety of applications for the Michigan Department of Health and Human Services and currently manages new module development and maintenance of disease, outbreak, and other public health surveillance and reporting systems. Lakshmi holds a master's degree in information systems from Eastern Michigan University.