The project very early identified the need for a computing component to reside within the firewall of a health system, connected to the hospital's HL7 message router. This component would function as a case detector in a distributed public health surveillance scheme linking laboratory and radiology data to increase the specificity of case detection. It has proven very difficult to disseminate this technology, perhaps due to the complexity of the idea. Nevertheless, the threat of bioterrorism has created a need for such technology, and this approach, or something with equivalent function, must be deployed.