Prior to ARRA 2009/Meaningful Use, KHA, KY CHFS and ETI created an electronic disease-reporting solution for hospitals and associated local public health. The Community Surveillance project operates in 3 population centers within Kentucky and provides real-time surveillance and disease reporting for up to 18 prevalent disease conditions across more than 20 provider locations and 6 provider organizations within the Northern Kentucky, Lexington/Fayette County and Louisville Metro communities. The software solution, ETI's HealthSIS, is able to accept meaningful use certified messaging, uncertified messaging formats and custom data streams for both reportable disease and syndromic surveillance information from a single stream within each provider location. The messaging stream used for identifying reportable or syndromic conditions is a copy of the content generated by normal hospital operations; specialized or additional data input is not required from health care provider staff. HealthSIS is configured to submit only data relevant to surveillance goals of the community from source systems; this configurable filtering capability allows for reduced resource requirements, reduced data management resources, and a manageable data set for analysis.