The DoD and VDH both maintain local ESSENCE installations to monitor the health status of their military and civilian populations, respectively, and submit syndromic surveillance data to the NSSP ESSENCE to foster data sharing and collaborative initiatives among public health entities. Military Treatment Facilities (MTFs), housed on DoD installations, provide healthcare to all service members and their beneficiaries stationed in the area.

With increasing awareness of SyS systems, there has been a concurrent increase in demand for data from these systems – both from researchers and from the media. The opioid epidemic occurring in the United States has forced the SyS community to determine the best way to present these data in a way that makes sense while acknowledging the incompleteness and variability in how the data are collected at the hospital level and queried at the user level.

Most countries do not report national notifiable disease data in a machine-readable format. Data are often in the form of a file that contains text, tables and graphs summarizing weekly or monthly disease counts. This presents a problem when information is needed for more data intensive approaches to epidemiology, biosurveillance and public health. While most nations likely store incident data in a machine-readable format, governments are often hesitant to share data openly for a variety of reasons that include technical, political, economic, and motivational issues1.