As mandated in the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, CDC’s BioSense program was launched in 2003 with the aim of establishing an integrated system of nationwide public health surveillance for the early detection and prompt assessment of potential bioterrorism-related illness. Over the following several years, as awareness grew about the limits of syndromic and related automated surveillance systems, including BioSense, in providing early and accurate epidemic alerts, increased emphasis was placed on their use in providing timely situation awareness throughout the course of public health emergencies. In practice, a key application of these systems has been their use in tracking the course of seasonal influenza and, in 2009, the impact of the H1N1 influenza pandemic. While retaining the original purpose of BioSense of early event (or threat) detection and characterization, we believe the most efficient and effective approach to achieve the program’s long-term business case is to build on existing systems and programs. This will have additional public health benefits that can improve the nation’s health at all times, including: 1. Public health situation awareness, 2. Routine public health practice, 3. Improving health outcomes and public health; and 4. Monitoring healthcare quality

4. BioSense: Facilities (N ≈ 2,000)

5. BioSense: Pharmacies (N ≈ 27,000)

10. BioSense Next Options for your Consideration

16. BioSense Next: Approach Options

22. Are there other options YOU might like to present? BioSense Next: What Are Your Thoughts?