Automatically identifying reportable clinical results from a variety of clinical sources and delivering these results to public health stakeholders is a challenging process with many moving parts. The Regenstrief Institute has implemented and for nearly a decade has maintained a "Notifiable Condition Detector" that automatically detects and forwards notifiable results to local and state public health stakeholders. This presentation will describe: • Factors that created a favorable environment for implementing and sustaining such a system • The design and operation of the system • Key challenges faced with real-world clinical data from a variety of sources • Future directions for the NCD