Rapid Health Information Network (RHINO)

Syndromic surveillance at the Washington State Department of Health
Blue front half of rhinocerous followed by text RHINO

The Rapid Health Information NetwOrk (RHINO) program is responsible for syndromic surveillance data collection, analysis, and distribution at the department. Syndromic surveillance data is collected in near real-time from hospitals and clinics from across the state. Key data elements reported include patient demographic information, chief complaint, and coded diagnoses. This robust system is the only source of Emergency Department (ED) data for Washington.

Participating in RHINO

If you are interested in submitting your facility's data to RHINO, please refer to our Onboarding webpage for eligibility requirements.

What is syndromic surveillance?

Syndromic surveillance is a real-time, population-based monitoring system. It is used to identify, investigate, and design data-driven, rapid responses to emerging public health threats. These data can provide insights into chronic disease burden, environmental threats, and injury trends. Because the data are so versatile, syndromic surveillance is rapidly growing into a basic tool for public health practitioners and their partners.

Revised Code of Washington (RCW 43.70.057)

RCW 43.70.057 requires the automated, electronic reporting of syndromic surveillance data from all Washington State emergency departments. The Department of Health is currently considering rulemaking to implement this legislation which will formalize processes for onboarding and data validation, data elements and formatting required in syndromic surveillance messages, timeliness of messages, and requirements for data access and usage.

Although the statute only applies to emergency departments, the RHINO program welcomes data from other healthcare facilities, including outpatient (primary, specialty, and urgent) care settings. If your organization would like RHINO staff to present on the proposed rule or would like to submit comments, please email RHINO@doh.wa.gov.

How do we use syndromic surveillance?

There are many potential uses for the surveillance data, including:

  • Evaluating the effectiveness of population health interventions
  • Tracking outbreaks and emerging conditions
  • Identifying notifiable conditions (e.g., Zika, measles)
  • Monitoring trends in illnesses that are not reportable (e.g., varicella, Guillain Barré Syndrome)
  • Monitoring asthma-related emergency department (ED) visits
  • Monitoring trends in traffic-related injuries
  • Monitoring trends in opioid overdose incidents
  • Tracking ED visits for respiratory irritation during wildfire events that impact air quality.

What happens to syndromic surveillance data that is collected?

Hospitals and clinics report syndromic data to the DOH in specialized messages. The RHINO team checks the data's quality and completeness and, once validated, forwards the data to the Centers for Disease Control and Prevention's (CDC) National Syndromic Surveillance Program (NSSP). Participation in NSSP allows Washington State's data to contribute to the national picture of public health.

Who has access to syndromic surveillance data contributed to NSSP?

Public health practitioners affiliated with a legally recognized public health authority are granted access to records contributed to NSSP. Public health practitioners can compare trends in local data with other regions across the nation by viewing health patterns in this larger context.

In the event of a public health threat involving people from outside Washington, records may be released to public health practitioners outside of Washington State for the purpose of ensuring the public health threat is quickly identified and controlled. In these events, the minimum amount of data necessary will be released to the fewest number of people, for the least amount of time to address the threat. In addition, data sharing agreements ensuring appropriate use and disclosure of the data will be established with these partners in advance.

RHINO Community of Practice

The Community connects users of RHINO data within the state of Washington to facilitate collaboration among public health practitioners around topics in syndromic surveillance. Membership allows users to:

  • Crowdsource issues that arise in the course of data usage
  • Share best practices and the latest developments in the field of health informatics
  • Access resources related to using these critical data sets.

To join the Community of Practice or to request additional information, please contact RHINO@doh.wa.gov.

RHINO in the News

June 2018 NSSP Update (PDF)

  • RHINO mentioned for collaborating with the CDC to create a Chief Complaint Discharge Diagnosis category for sexual violence encounters at emergency departments. The query is available in production and staging environments of NSSP ESSENCE.
  • RHINO team creates an All-traffic Injury Chief Complaint and Discharge Diagnosis query for identifying traffic-related injuries encountered at Washington State emergency departments in collaboration with the Washington Traffic Safety Commission.

October 2018 NSSP Update (PDF)

  • Sexual Violence and Intimate Partner Violence - Surveillance and Action presented by RHINO and the CDC.

Contact Us

Please email syndromic.surveillance@doh.wa.gov with any questions about syndromic surveillance in Washington State.