The CPCSSN pilot and feasibility stages I and II have been a remarkably successful venture resulting in the association of nine primary care research networks from six different provinces using seven different electronic medical record systems. Approximately 140 sentinel physician practices were recruited between 2008-2010. CPCSSN’s goal is to have between 600-1000 sentinel physician practices by 2015. A national network of data managers, network directors strategized and effectively partnered with the CFPC throughout the two years of the feasibility project. A fully functional, secure, de-identified central repository was established at the High Performance Computing Virtual Laboratory at Queen’s University for use by governments and academic researchers for both monitoring Canadian chronic disease rates and improving health care outcomes. Internally, plausible disease prevalence rates across all networks for all five chronic conditions initially under study were produced. Also, a viable denominator methodology using the yearly contact group was developed for chronic disease surveillance in Canada. CPCSSN has taken advantage of the unique opportunity to embrace our current EMR technology for the purpose of primary healthcare surveillance. After a successful 2 year pilot project the College of Family Physicians of Canada (CFPC) signed a 5 year agreement with the Public Health Agency of Canada (PHAC) to continue surveillance on 5 chronic diseases (COPD, depression, diabetes, hypertension, and osteoarthritis) using various EMRs. Family physician offices working within nine (9) local primary care/practice-based research networks (PCPBRNs) across Canada form the Canadian Primary Care Sentinel Surveillance Network (CPCSSN).