Since mid-2008, NKIDHD receives electronic disease reports and surveillance support for what is now the 18 most prevalent disease conditions in the community. SEMC (6 facilities) has realized 75%Á90% reduction in public health reporting effort as a result of the capabilities provided by HealthSIS. Since mid-2009, LFCHD receives syndromic surveillance data from ambulance runs, initially to support preparations for the 2010 Alltech-FEI World Equestrian Games; LFCHD began receiving electronic disease reports for 9 prevalent disease conditions in mid-2010 from CBH and UKMC. Since late 2009, LMPHW receives electronic disease reports for 5 prevalent disease conditions from BHE and notifications of same from JHSMH; in 2011, NHC began participating in the disease-reporting process.