As automation in surveillance activities has increased, participation rates of facilities improved as well. Hospital staff became more engaged when there was a more defined purpose to reporting ED visits and admissions (e.g., The Republican National Convention and the H1N1 Novel Influenza A outbreak). Based on the improvements observed, the state is undertaking a project to move all NJ EDs into a real-time, syndromic surveillance system. This implementation is expected to further enhance data reporting and increase response rates beyond the current 86.4%. 