From Onboarding to Insight: How Commercial Laboratory Data Broadened the Reach of Syndromic Surveillance

Did you know that InductiveHealth supports CDC’s National Syndromic Surveillance Program (NSSP) across the full life of a data source — from initial onboarding, to designing and standing up the data flow, to integrating a new source alongside emergency department data so that public health practitioners can actually use it?

Commercial laboratory data is one of the clearest illustrations of what that work makes possible.

Why a New Data Source Matters

Syndromic surveillance was built around emergency department visits, and that foundation remains essential. But an ED record tells you that someone sought care and describes why. It doesn’t tell you what a laboratory test confirmed.

Commercial laboratory data fills part of that gap. It offers near real-time visibility into what is being tested for, how often, and how frequently those tests come back positive — across a large national footprint, and outside the walls of any single health system. Paired with ED data in a common platform, it gives analysts a fuller picture: not just who is showing up sick, but what is being found.

What Onboarding Actually Involves

“Onboarding a data source” is a short phrase for a long body of work. Over the years, InductiveHealth teams supporting NSSP have contributed to:

Establishing and maintaining the data flow. Building the pipelines that move data reliably and securely from source to platform, and keeping them healthy as volumes, formats, and requirements change.

Standardization and mapping. Translating incoming data into consistent structures and vocabularies so that it can be queried, trended, and compared rather than interpreted case by case.

Data quality and monitoring. Watching for gaps, delays, and anomalies, and resolving them so that they aren’t mistaken for real changes in disease activity.

Integration with existing sources. Making a new source usable next to emergency department data, so users can look across both instead of switching between disconnected systems.

Access and enablement. Getting data into the hands of the people who need it — routinely, and during an outbreak, epidemic, or pandemic, when the timeline collapses.

None of this is visible in a published figure or a dashboard. All of it is what makes the figure and the dashboard possible.

What it Enabled

The most direct measure of a data source’s value is what practitioners and researchers do with it once it’s there.

During the 2022 mpox outbreak, that value was immediate. As CDC has described publicly in NSSP Supports CDC’s Mpox Response, NSSP monitored near real-time data from a large national commercial laboratory — receiving orthopoxvirus test orders and results and making them available to NSSP participants, alongside monitoring for increases in testing volume for conditions that present similarly to mpox. Emergency department data showed who was seeking care; laboratory data showed what was being tested and found. Together they gave responders a view neither source could provide alone.

Beyond outbreak response, NSSP commercial laboratory data has appeared in a steadily growing body of peer-reviewed literature. Published analyses have used it to examine:

Trends in Bordetella testing and positivity as pertussis activity shifted

The reemergence of Mycoplasma pneumoniae infections in children and adolescents following the COVID-19 pandemic

Testing for blastomycosis, coccidioidomycosis, histoplasmosis, and cryptococcosis — endemic and opportunistic fungal diseases that are frequently underrecognized

COVID-19 surveillance after the expiration of the federal public health emergency declaration

Disruptions to HIV, chlamydia, and gonorrhea testing during the pandemic

Reported Lyme disease patterns in 2020

Acute hepatitis of unspecified etiology and adenovirus testing in children

That range is the point. The same data source supports respiratory disease monitoring, sexually transmitted infection surveillance, vector-borne disease, mycology, and pandemic recovery analysis. It was not onboarded for any one of those purposes. It was onboarded well, and the uses followed.

What Comes Next

The same capability that mattered in 2022 matters again whenever large numbers of people gather. As CDC prepares to support public health surveillance around the 2026 FIFA World Cup — sixteen host cities, millions of visitors, and jurisdictions that will need to see signals quickly and share them across borders — the underlying question is the same one onboarding answers: can the right data get to the right people fast enough to act on?

Syndromic surveillance is built for exactly that kind of moment, and every source successfully brought into the platform widens the aperture. The work of onboarding is what turns a mass-gathering surveillance plan into something that can actually run.

The Broader Takeaway

Modernized public health infrastructure is often discussed in terms of platforms and dashboards. In practice, its value is determined by something less glamorous: whether new data sources can be brought in reliably, standardized, integrated, and made usable — and whether that can happen without a multi-year project every time.

When it can, a single onboarding effort compounds. It serves routine surveillance on an ordinary Tuesday, it serves an emergency response, and years later it turns up in the methods section of a paper nobody anticipated writing.

That is the work InductiveHealth is proud to support.

Why a New Data Source Matters

What Onboarding Actually Involves

What it Enabled

What Comes Next

The Broader Takeaway

Further reading