In a series of posts, Myers and Stauffer will highlight parts of the American Rescue Plan Act of 2021[1] that can have tremendous impact on delivery and financing of services by state health and human services programs.

As part of our series on the American Rescue Plan Act (ARPA) of 2021, this next installment focuses on Section 2404, which provides $500 million, available until expended, to the Centers for Disease Control (CDC) for initiatives that modernize public health data surveillance and analytics infrastructure. The CDC must also establish, expand, and maintain efforts to modernize the United States’ disease warning system to identify and forecast hotspots for COVID-19 and its variants as well as other emerging threats. It is expected that $200 million will be used to establish the National Center for Epidemic Forecasting and Outbreak Analytics.

This latest round of federal funding will support and enhance current efforts underway at the CDC through the Data Modernization Initiative, launched in 2019, which seeks to move public health responses from tracking threats to predicting them. Modernization efforts focus on the following:[1]

  • Strengthening “early warning” systems for real-time, lined data on emerging health threats.
  • Fostering innovation towards “pandemic-ready” solutions for fast, accurate data reporting to the CDC.
  • Building the public health workforce.
  • Integrating standards for efficient data access and exchange.

This new funding will support the modernization of our public health infrastructure. The COVID-19 pandemic has shown that this investment in modernizing our public health infrastructure at all levels is critical to provide state and local health departments the detailed, patient-level data they need to better understand disease burden by population and to take immediate action to investigate and implement solutions. Investments must be made in scalable approaches and manpower to support the fast, efficient movement of complete and accurate data. These solutions must be generic and flexible to adapt as needs change.

One example focus area cited by the CDC was in regard to detailed laboratory data, which is a common need at the state and local level. Initial case notifications are generally reported to state or local public health departments directly from labs. However, basic demographic information often does not flow from the ordering electronic health record to the laboratory information system. As a result, critical data elements for case investigation are missing when labs report data to public health departments. This has greatly slowed local response efforts.

The CDC has created a Roadmap of Activities and Expected Outcomes for the Data Modernization Initiative.[2] The important first step in this Roadmap is to “coordinate people and systems” to begin to create interoperable systems between federal, state, and local public health authorities and the healthcare community. The CDC and its partners are focused on making public health “data sharing easier through common policies, practices and standards” and at the same time, developing the next generation tools and predictive analytics to anticipate and best respond to disease outbreaks.

The CDC has seen rapid advancements since last year.

  • All 50 states, D.C., and 11 large local jurisdictions are now capable of receiving COVID-19 electronic case reports, up from only a handful of jurisdictions in late 2019.
  • Fifty-six jurisdictions have reported over 300 million COVID test results since April 2020 directly to the CDC.
  • Completeness of race information in syndromic surveillance (the CDC system that gathers data on patient symptoms to monitor for large scale outbreaks or disease clusters) went from 80 percent to 91 percent in 2019.

The CDC awarded the first round of funding to states for data modernization and systems interoperability initiatives in 2020, and will continue to partner with state, local, and tribal public health authorities on the Data Modernization Initiative. By strengthening early-warning systems, integrating nationwide standards, bolstering data sharing and analytics, and building the public health workforce, the U.S. can begin to move from siloed public health data to a connected system that delivers timely, actionable insights to improve public health response in the future.

[1] Available here: https://www.cdc.gov/surveillance/pdfs/dmi_basics_external_audiences-March_2021.pdf

[2] Available here: https://www.cdc.gov/surveillance/pdfs/318212-A_DMI_LogicModel_July23b-508.pdf

Contact the Contributors:

Kelly Gonzalez, MS, PMP, CUA
Director
kgonzalez@mslc.com		 Amy Caron, MPH
Health IT Senior Manager
acaron@mslc.com