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Core Pillars of Public Health Surveillance

            National public health surveillance has been built through a strong, long-standing partnership with CDC
            and state, territorial, local, and tribal public health departments. There are five core pillars and processes
            that serve as the foundation for modernization of the nation’s public health surveillance system. (More
            detailed descriptions can be found in Appendix A.)

            1.  Electronic case reporting (eCR)

                 •  eCR is the automatic submission of disease reports directly from clinical care electronic
                   health records (EHRs) at clinical care organizations to state, territorial, local, and tribal health

                 •  eCR implementation is under development and has the potential to transform data exchange
                   between health care providers and public health departments.

            2.  Laboratory information management systems (LIMS), including electronic laboratory reporting (ELR)

                 •  LIMS are computer applications that form the backbone of laboratory data collection,
                   management, storage, and sharing.
                 •  ELR is used to electronically report laboratory results from LIMS (private laboratory or public
                   health laboratory) to public health epidemiologists.

                                                 3.  Syndromic surveillance

                                                      •  Syndromic surveillance uses near real-time data collection
            The Public Health                           from hospital emergency department visits and data sources
            Enterprise                                  from other points of care in the community, such as urgent
                                                        care centers, poison center calls, or emergency medical
            Effective prevention,                       service runs for continuous monitoring of community health.
            detection, response, and
            policy development rely on                •  This system has evolved to include more data sources and
            coordinated efforts between                 advanced detection analytics.
            public health agencies at all
            levels of government—federal,        4.  Electronic vital records systems
            state, territorial, local, and
            tribal—working together                   •  The electronic vital records system is a national system of 57
            with health care providers,                 state and territorial vital records jurisdictions that provide
            the private sector, and the                 secure electronic collection of birth and death data from
            public. This collective effort              hospitals, funeral homes, health care providers, and medical
            to protect and promote                      examiners.
            the public’s health is the
            “public health enterprise.”               •  Electronic death registration systems (EDRS) provide
            As stakeholders work to                     mortality data.
            modernize public health
            data systems, improvements           5.  National Notifiable Disease Surveillance System (NNDSS)
            and investments must be
            understood and advanced                   •  NNDSS is the national disease system that collects,
            at the “enterprise level.”                  aggregates, and analyzes individual case investigations of
            Modernizing public health                   reportable diseases and conditions from state, territorial,
            data systems at the enterprise
            level will benefit all public               local, and tribal public health agencies from hospitals, health
            health programs at all levels               care providers, and laboratories.
            of the government for all
            diseases and conditions.
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