MCPHD and RI created a legal memorandum of understanding so that MCPHD could share the names and date of births of suspect cases to the programmers at RI. The alert went into effect in July of 2010. When a healthcare provider's search is also one of the suspected names, an alert appears on the screen informing the provider that this person should have a chest x-ray as part of a follow-up to a TB outbreak investigation. A phone number of a MCPHD nurse on call is provided. The suspect list is periodically updated to remove names of patients who have been located in other medical settings. The novel aspect of this system is that normal methods of locating these individual such as phone or address was not available. Additionally, other traditional public health methods to contact these patients had not proved successful.