Electronic medical records for public health; meaningful use; interoperability; cloud Introduction Domains go through phases of existence, and the electronic disease surveillance domain is no different. This domain has gone from an experimental phase, where initial prototyping and research tried to define what was possible, to a utility phase where the focus was on determining what tools and data were solving problems for users, to an integration phase where disparate systems that solve individual problems are tied together to solve larger, more complex problems or solve existing problems more efficiently. With the integration phase comes the desire to standardize on many aspects of the problem across these tools, data sets and organizations. This desire to standardize is based on the assumption that if all parties are using similar language or technology, then it will be easier for users and developers to move them from one place to another.