ABSTRACT
This chapter presents a number of real-world case studies taken from peer-reviewed literature and the authors’ personal experiences to outline models for successful scale-up and long-term sustainability of electronic disease surveillance systems without attempting to be prescriptive or normative. It highlights some of those considerations through the use of case studies in order to raise awareness and hopefully show how smart design and held-fast determination among the systems’ stewards can allow electronic disease surveillance systems to grow into functional and indispensable elements of national and regional health security. The chapter explores the challenges and suggest a number of considerations for both data system design as well as strategic planning. It argues that scale-up and sustainability are highly dependent on the early design of the system with growth and longterm use in mind. The Defense Medical Surveillance System is a system that began large and has grown to be immense.
