On May 5, 2016, registration opened for hospitals with emergency departments, free-standing emergency centers, and urgent care centers to register their intent to submit data to the TxS2 program. DSHS continues to only accept registrations from these data providers. 

On May 15, 2017, the statewide syndromic surveillance program became operational.

In November 2017, DSHS completed onboarding with the National Syndromic Surveillance Program (NSSP) to share data collected within the TxS2 program.

In July 2018, Tarrant County Public Health completed onboarding with the TxS2 program. 

By the Summer of 2019, all data providers with the former TALHO system that contacted DSHS were integrated into the statewide system to complete the statewide view. 

On August 2019, data from the Poison Control Registry were added as a programmatic data source and made available for LHDs and DSHS staff to review. 

In June 2021, death records data received from the Texas Center for Vital Statistics was added as a programmatic data source and, made available for LHDs and DSHS staff to review. Shortly after air quality observation data provided by AirNow and weather event observation data provided by the National Weather Service were added.

In November 2022, Inductive Health, a technical provider for surveillance systems across many government jurisdictions, became the data vendor for the statewide syndromic surveillance system.

In October 2025, the Houston Health Department completed onboarding with the TxS2 program.