This presentation aims to highlight key activities, technical approaches, data discoveries, lessons learned and outcomes achieved while onboarding local hospitals for syndromic Meaningful Use Stage 2 through a local health information exchange. The federal meaningful use initiative is currently a major driver to enable greater establishment of syndromic surveillance capacity across the United States. The role and efforts by local and state public health agencies in the syndromic onboarding process varies greatly. We describe efforts from a local public health agency to onboard, validate and integrate meaningful use syndromic information.