Beginning with the 1999-2000 influenza season, physicians throughout Hawaii ordering a viral culture for patients with suspected influenza were also offered influenza rapid testing. We compared the number of viral respiratory cultures sent to the Hawaii Department of Health and the number of providers who participated in influenza surveillance over consecutive influenza seasons. The number of viral respiratory cultures rose from 396 to 2,169 between the 1998-1999 and 2000-2001 influenza seasons, and the number of providers submitting >1 influenza culture increased from 34 to 327, respectively. The number of influenza isolates obtained each season also increased (from 64 to 491). The available data suggest that the changes observed in Hawaii's influenza surveillance were not secondary to differences in influenza activity between seasons. This is the first evaluation of integrating influenza rapid testing into public health surveillance. Coupling rapid tests with cultures appears to be an effective means of improving influenza surveillance.