Page 36 - Driving Public Health in the Fast Lane

health care providers, private laboratories, and other public health partners within the laboratory’s
jurisdiction. Today, the AIMS platform connects more than 200 health care organizations, and
nearly every state is exchanging some data through the AIMS platform. This is moving public health
data to the fast lane. However, AIMS’ current functionality is limited to the diseases and conditions
that have program-specific funding, and is not employed broadly for enterprise-wide public health
surveillance. While AIMS provides the infrastructure necessary for laboratory data exchange,
investments are needed to speed up public health data at all levels of government to benefit all
public health programs.

4. Jurisidictional Improvement

State, territorial, local, and tribal jurisdictions have all increased efforts to move from paper-
based data collection and entry to automated, interoperable, and integrated electronic systems.
Focus group members each had examples where their health department took steps toward
interconnected data exchange. Some examples include:
• Software development to enable automated data transfer from vaccine registries;

• Implementation of electronic test ordering and reporting for laboratory results to priority health
care facilities;
• Barcodes on specimens to transfer patient demographic information directly into LIMS;

• Social media platforms and symptom-related key word searches on the internet that can be
leveraged by public health to identify health event trends in communities and pulled syndromic
surveillance databases;

• Implementation of eCR at two sites (Houston and Utah), with five additional sites positioned to
onboard.

Challenges: Stuck in the Slow Lane

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Despite progress in moving surveillance into the 21 century, antiquated, fragmented, and siloed data
sharing systems continue to impede public health action.

1. Manual Methods of Data Exchange: An Administrative Burden

Despite the progress in electronic data exchange, our focus groups revealed that the nation’s public
health surveillance system still heavily relies on manual processes, like paper-based data sharing,
phone calls, and faxes. The case studies highlight areas where reliance on these processes inhibits
timeliness, accuracy, and completeness. In one example, electronic systems support the exchange
of opioid use data between the public health laboratory and epidemiologists. Yet, data reported
by reference laboratories through email and fax are not integrated into the broader opioid use
surveillance data. This particular example highlights the consequences of modernizing only one data
system within the larger public health system. While comprehensive data exists and is reported to
the health department, the mechanical difference in data exchange results in a significant data set
being left unintegrated, and thus unable to inform the public health response to the opioid epidemic.

Progress Made, but Silos Remain 36