We describe VA''s experience developing innovative and alternative uses for a surveillance system. We reviewed use cases for new data elements; enhancements to system analytics and functionality; and novel use cases for original outpatient data elements. Enhancements and innovations to influenza surveillance (immunization tracking, %ILI for primary care settings, telephone triage data, inpatient influenza data, geospatial mapping); epidemiologic reviews and lookbacks (identifying ERCP procedures for a CRE review); and infection control activities (SSI procedure dominators, pneumonia hospitalizations for Legionella testing review and needlestick injury queries) were highlighted. These activities were essential for demonstrating usefulness and maintaining system support within VA.