The Public Health Security and Bioterrorism Preparedness and Response Act of 2002 mandated establishing an integrated national public health surveillance system for early detection and rapid assessment of potential bioterrorism-related illness. In 2003, CDC created and launched the BioSense software program. At that time, CDC’s focus was on rapidly developing and implementing Web-based software to collect hospital emergency department data for analysis to detect and monitor syndromes of public health importance.

SyS systems have great potential to prevent morbidity, injury, and mortality by monitoring population health and providing realtime data to inform public health department decisions. Electronic health information technology and federal, state and local incentives and investments have helped to facilitate their rapid and widespread implementation. As a result, SyS systems operate in the context of laws and regulations that determine their success. An understanding of the effects of this legal environment is crucial to insuring that SyS systems fulfill their potential.