In 2011, the Nebraska DHHS implemented a near-real—time inpatient (IP) surveillance system, to enhance the surveillance of Cardiovascular Disease (CVD). An IP database was created in ESSENCE and algorithms were defined for myocardial infarction (MI) and for the detection of 5 risk factors for CVD. The number of monthly MIs was tracked and the frequency of each risk factor analyzed. Results of this study demonstrate the applicability of ESSENCE for near-real-time monitoring of risk factors and CVD events. Such timely detection holds potential to enhance prospective monitoring of CVD trends in populations and impact efforts towards CVD prevention.