This article discusses the ongoing efforts to modernize public health data systems in the U.S., particularly concerning chronic disease surveillance. Historically, underfunding and fragmented, disease-specific systems have led to outdated and inflexible data infrastructures. Recent investments aim to create an integrated data ecosystem that enables a better understanding and prevention of chronic diseases. Challenges include the lack of policy levers for collecting granular data and limited access to necessary data due to governance and data exchange policies. The article emphasizes the importance of collaboration across various public health agencies and partners to improve surveillance, health equity, and reduce the burden of chronic diseases. 

The CDC’s Data Modernization Initiative (DMI), launched in late 2019, is a comprehensive effort to transform public health data systems across the United States and modernize data infrastructure at the state, tribal, local, and territorial (STLT) levels. The initiative aims to enhance disease surveillance, promote interoperability, and foster a culture of continuous improvement in data utilization. The DMI lays out five key priorities that will strengthen and unify critical public health data across our nation to better serve the American people: build the right foundation; accelerate data into action; develop state-of-the-art workforce; support and extend partnerships; and manage change + governance.

CSTE’s data modernization portfolio blossomed from the white paper “Driving Public Health in the Fast Lane: The Urgent Need for a 21st Century Data Superhighway. The report provided a snapshot of the current state of the public health data infrastructure and guided the priorities and direction for STLT modernization. CSTE advocates for sustained funding for public health surveillance through the Data: Elemental to Health project and captures members’ success in their data modernization journey through the DM Stories from the Field. This project highlights innovative data modernization solutions across the United States and shares stories of public health jurisdictions meeting the needs outlined in the CDC’s Data Modernization Initiative. Epidemiologists from dozens of jurisdictions have written and submitted nearly 80 stories about DM successes. 

CDC awarded three national partners, The Association of State and Territorial Health Officials (ASTHO), National Network of Public Health Institutes (NNPHI), and the Public Health Accreditation Board (PHAB) a total of $255 million to accelerate, stand-up, and expand the capacity of four Implementation Centers (ICs). These ICs provide technical assistance to STLT health departments to improve public health data exchange across public health jurisdictions, healthcare, and other data providers (e.g., laboratories). The IC Program provides direct technical implementation services and community support to STLTs, enhancing data exchange capabilities through cutting-edge health IT standards. The program’s overarching goal is to improve the timely prevention and detection of public health threats by reducing the burden of data exchange between public health agencies, health care, and the communities they serve. 

PHIG is a major federal funding initiative through the CDC that supports the critical infrastructure needs of STLTs, including workforce, foundational capabilities, and data modernization. The purpose is to create a stronger, more resilient public health system that is ready to face future health threats. 

Defines the minimum data elements that all electronic health records (EHRs) should be able to exchange. Health departments can reference USCDI when thinking about the data elements available in EHRs. Note that just because USCDI includes data elements that doesn’t mean EHRs collect the data or the quality of that data. USCDI+ extends the core data elements in USCDI for specific domains or use cases like public health reporting.

A technical and governance structure designed to facilitate nationwide data exchange. As TEFCA participation grows, connected health departments can query participating health information networks – a collection of hospital and provider EHRs – to get data on individual or multiple patients.

The automated, real-time exchange of case report information between EHRs and public health agencies. Often considered a tool for infectious disease reporting, health departments can tailor the requirements for any condition they deem reportable. Check out the Association of Public Health Laboratories’ eCR page for more information on nationwide eCR tools and services on their AIMS platform.

An NACDD project that demonstrates using EHR data from many health systems to generate timely prevalence estimates of chronic disease risk measures at national and local levels. MENDS collects data from health systems and Health Information Exchanges that participating health departments use to monitor trends, inform policies, plan programs, and evaluate outcomes to improve the health of the population.