Installing and maintaining electronic disease and syndromic surveillance to support public health agencies is possible without large budgets and without massive systems upgrades within health care provider organizations; benefits are clearly measurable Á independent study in Washington state in 2010 confirms benefit of the concept (5). Emergint's HealthSIS software and the Community Surveillance solution implemented in Kentucky presents a systems approach that can be replicated across the country, whether fed by providers or HIEs and regardless of meaningful use certification status. 