In 2011, NH DPHS initiated a project with Orion Health to build a Rhapsody integration engine (1) portal to receive the three types of Public Health data. A Syndromic surveillance pilot was chosen since 25 of 26 hospitals were already sending real-time data in HL7 format to the statewide syndromic surveillance system. NH DPHS collaborated with the NH Regional Extension Center (REC) to host MU guidance and brokered with Orion Health, the Office of the National Coordinator (ONC), and CMS to offer hospitals the option to use a modular certification for MU public health measures by selecting the Orion Health module (2) . Selecting this module allows hospitals to send data to the NH DPHS Rhapsody portal in whatever format they choose; then, the NH DPHS Rhapsody system converts these messages to the approved ONC standards for public health reporting. Orion Health contractors set up the Rhapsody server, configured data routes and built validation, filtering, and mapping logic. Mapping to HL7 2.5.1 was performed, but additional mapping to 2.3.1 was done before sending data to the syndromic surveillance application. Hospitals were directed to reroute data transmissions to the new Rhapsody VPN IP address and port, and Rhapsody was configured to pass traffic to the original surveillance application address and port. Additionally, data was sent through the normal VPN connection to compare the accuracy and performance of the new path.