Despite years of effort and millions of dollars spent to create unified electronic communicable disease reporting system, the goal remains elusive. The timely monitoring and control of communicable infectious diseases is critical to maintaining the health of communities and is a primary activity of local health agencies . Post 9/11, the application of information technology (IT) to support disease monitoring efforts at public health agencies
has been a high priority . However, efforts to implement communicable disease (CD) information systems into public health practice have been slow, with costly mistakes . Independent implementations of in-house and commercial-off-the-shelf technology have resulted in great variability in purpose, function and capacity of these CD information systems . As a result, effective and efficient surveillance systems that support CD work remain a goal of the future.