ESP performs disease detection for diabetes to conduct surveillance for diabetes prevalence, incidence, care, and complications. ESP provides public health practitioners with more detailed and timely data to identify priority areas for intervention compared with traditional surveillance tools. Public health departments currently rely primarily on voluntary, anonymous telephone surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) to assess chronic disease and health behavior patterns. However the BRFSS has significant limitations such as cost, reliance on self-reporting, restriction to respondents with telephones, limited language coverage, and capacity for only a limited number of questions. Estimates are not possible for certain populations or geographic areas because of sample size limitations. BRFSS also lacks clinical information such as medications, laboratory tests, or vital signs. ESP overcomes many of these limitations by harnessing the wealth of data routinely captured by EHR systems.