Prior to June 2016, there were 45 registered users of syndromic surveillance data in Washington State, with 29 (64.4%) representing 5 of Washingtonâs 35 local health jurisdictions and 16 (35.6%) at the state level. Of those registered users, 9 (8.8%) had logged into ESSENCE at least once in the 6 months before October 2016. In June 2016, the Washington State syndromic surveillance program began accepting Meaningful Use data and sought to increase its user base.