As technology becomes more accessible, many developing countries are turning to implementing electronic systems to enhance their disease surveillance capabilities and move toward complying with the International Health Regulations. The purpose of this study is to contribute to the evidence base of electronic disease surveillance systems implementation in developing countries by building a framework that will identify key elements in this process and serve as guidance to implementers. This study reflects findings associated with three aims a are view of the scientific and gray literature on electronic disease surveillance systems implementation experience b an expert consensus workshop on the same topic and c the development of a disease surveillance system model using the qualitative approach of Grounded Theory and informed by qualitative data provided by 34 surveillance stakeholders in Peru. The researcher triangulated findings from each of the three aims to validate, complement and generate a revised model. She developed this model based on the confluence of several factors atdifferent levels. The model indicated the institutional administrative level as a starting point for disease surveillance system implementation. High-level administrators commitment to implement and sustain the surveillance system by enacting legislation and allocating resources proved to be key to the successful implementation of such a system. National and regional surveillance teams performed the critical functions of disease surveillance-related training, monitoring, supervision, and feedback. The teams addressed the critical needs of surveillance staff, contributing to the motivation of reporting staff and ensuring high performing staff at surveillance sites. Finally, surveillance staff found it motivating to observe the outcomes of their work, including appreciating the usefulness of the data they reported in guiding decision-making.