Multi-State EHR-Based Network for Disease Surveillance


About Mends


In 2018, the Centers for Disease Control and Prevention (CDC) funded the National Association of Chronic Disease Directors (NACDD) to pilot a surveillance project modeled after a project that was successful in Massachusetts. Called MENDS (Multi-state EHR-based Network for Disease Surveillance), the demonstration will use electronic health record (EHR) data collected in clinical settings leading to a real-time, chronic disease surveillance model to plan and evaluate short-term outcomes of policies and program interventions. For a brief overview of the project, download the MENDS 2-pager.



Groups guiding the MENDS project include:

  • National Association of Chronic Disease Directors
  • University of Massachusetts Medical School
  • Commonwealth Informatics
  • Harvard Medical School’s Department of Population Medicine
  • Public Health Informatics Institute

Partners piloting the MENDS project include:

  • North Dakota Department of Health
  • Washington State Department of Health
  • Louisiana Public Health Institute
  • AllianceChicago

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How MENDS Works Infographic – High-level infographic outlining the steps of MENDS, beginning with the health care encounter by a patient, progressing through data preparation through ESP software, and ending with data visualization and analysis for public health practice.

Overview Infographic Overview of the story, abilities, and goals of MENDS.

Use Cases Infographic – Visual depiction of the various use cases for MENDS data in public health practice.


Pilot Sites

Phase One of the MENDS project involves four pilot sites. The opportunity to participate in MENDS was widely publicized to all state health departments (SHDs). After a preliminary assessment of responses received, 18 SHDs were interviewed. Current pilot states are: North Dakota and Washington. Additional partners participating as pilot sites include the Louisiana Public Health Institute and AllianceChicago.


EHR-based Surveillance Learning Community



The EHR-based Surveillance Learning Community is co-led by NACDD and the Public Health Informatics Institute. It is a series of 60-minute, monthly calls and is intended for state and local public health departments and their potential data partners including clinical organizations and health information exchanges. The content and discussion of these calls will include both MENDS-specific topics as well as more foundational surveillance and data analytics topics.

The goals of the EHR-based Surveillance Learning Community are to:

  • Build public health capabilities to describe and advocate for the MENDS project and other EHR-based surveillance opportunities
  • Discuss critical implementation issues such as articulating the rationale, developing a compelling value proposition, securing executive sponsorship, developing effective and inclusive governance, using effective project management and change management methods, and identifying enablers and common barriers
  • Enable peer-to-peer learning through webinars and open discussion
  • Help NACDD to understand the challenges and and opportunities for growth in EHR-based surveillance and project governance


Who Should Join and Participate?

The EHR-based Surveillance Learning Community is intended for program and epidemiology staff in your chronic disease unit, as well as department-level epidemiologists and informaticists. Health system data partners might also be interested in participating in the community.


Since the purpose of the EHR-based Surveillance Learning Community is to build chronic disease surveillance capabilities in your health department, we encourage you to identify a core team of chronic disease program, surveillance and informatics staff to regularly participate in the calls, and to ensure that at least one member of your team is on each call.


Format of the EHR-based Surveillance Learning Community

The EHR-based Surveillance Learning Community calls last 60 minutes. The first portion of the calls are educational and focused on related topics critical to an EHR-based surveillance program design and implementation; the second portion is a facilitated discussion and open Q&A. The slides and recordings will be posted on the NACDD MENDS website following the calls.


How do I join the community?

The calls are on the 3rd Tuesday of every month from 3-4:00 p.m. ET. To register for the community, click  here.


Upcoming Calls:

  • June 16 – Topic: Weighting
  • July 21 – Topic: Modeling 


Previous Call Materials & Recordings:


  • May – cancelled due to COVID-19 response
  • April – cancelled due to COVID-19 response
  • March – cancelled due to COVID-19 response
  • February – “EHR-Based Surveillance Learning Community”

Description: This month’s topic is the highly requested discussion of Using Case Definitions for EHR-based Surveillance. The call includes an introduction to electronic case definitions, using standards and indicators, and creating your own definitions.


Speakers: Hilary Wall (CDC) and Dr. Joseph Gibson (Marion County Public Health, Indiana)



Click the links to access: Speaker BiosPresentation Slides | Recording


  • January – “EHR-Based Surveillance Learning Community”

Description: The rapid adoption of health information technologies in the U.S. over the past decade has had profound impacts, including increasing accessibility of digital health information for a wide variety of purposes. This month’s topic is an overview of the health information technology landscape in the U.S. and its impact on healthcare, public health surveillance, and population health improvement. It includes a presentation by Dr. Noam Arzt, Ph.D., FHIMSS, FAMIA from HLN Consulting, on the state of Health Information Exchanges in the country.


Speakers: Bill Brand (Public Health Informatics Institute); Dr. Naom Arzt (HLN Consulting)



Click the links to access: Presentation Slides |  Recording*


*Start of recording delayed. Please review slides for full presentation.


  • December – “EHR-Based Surveillance Learning Community”

Description: This month’s topic is analysis and visualization reporting tools, including a demonstration by Sara Schmidt and Greg Budney of the CHORDS (Colorado Health Observation Regional Data Service) dashboard and maps. Additionally, Dr. Noelle Cocoros will share options for visualizing EHR data via RiskScape.


Speakers: Bill Brand (Public Health Informatics Institute); Sara Schmitt (Colorado Health Institute) and Greg Budney (Denver Public Health); and Dr. Noelle Cocoros (Harvard Medical School and Harvard Pilgrim Health Care Institute)



Click the links to access: Speaker Bios |  Presentation Slides Recording


  • November – “EHR-Based Surveillance Learning Community”

Description: November’s call included practical tips to help with building support for EHR-based surveillance for Chronic Disease with Deirdre Browner, from the County of San Diego Health and Human Services Agency, sharing lessons learned from the field. Additionally, we explored critical success factors to implementing surveillance systems for Chronic Disease Surveillance.


Speakers: Bill Brand and Emily Kraus (Public Health Informatics Institute); Deirdre Browner (County of San Diego Health & Human Services Agency)


Deirdre Browner, MPH is a senior epidemiologist and evaluation manager for the Maternal, Child and Family Services Branch at the County of San Diego. Her team works on surveillance, epidemiology, and evaluation for San Diego’s REACH and 1817 Grants from CDC, and SNAP-ed (CalFresh) and Tobacco Programs from the California Department of Public Health. She began her career at the University of California, San Diego as a research epidemiologist working on various projects from cardiovascular epidemiology to health services research.


Click the links to access: Presentation Slides and Recording


Additional Resources: You can find guidance on creating a project charter and conducting a stakeholder analysisin PHII’s Toolkit for Planning an EHR-based Surveillance Program here .


  • October – “EHR-Based Surveillance Learning Community”

Description: Presentations on EHR-based Surveillance for Chronic Disease, with an example from the Utah Department of Health, and the Multi-State EHR-based Network for Disease Surveillance (MENDS) Project.


Speakers: Bill Brand and Emily Kraus (Public Health Informatics Institute); Theron Jeppson (Utah Department of Health)