Background

Improving Disease Surveillance at CDC—A Strategic Approach

Public health surveillance and its essential health data is the nation’s portal for progress in protecting our health. CDC’s overarching goal for federally supported surveillance activities is to get the right information into the right hands at the right time.

In a renewed effort to better achieve this goal, and in response to the observations and recommendations of experts, the agency launched the CDC Surveillance Strategy in February 2014 that sets aggressive targets¹ to:

• Improve availability and timeliness of data
• Advance the use of electronic health records, mobile technologies, and cloud computing
• Retire redundant systems and reduce reporting burden on health departments
• Maximize performance and effectiveness of agency resources

The CDC Surveillance Strategy

CDC’s Surveillance Strategy is an agency priority. This cross-agency effort responds to requests from multiple stakeholders, including Congress, state public health leaders, and federal advisory committees asking for a strategy to transform and modernize CDC’s surveillance systems and approaches.

The Strategy addresses fundamental problems found through this review. It is not meant to be a national surveillance strategy; rather, it focuses on what CDC must do to drive progress and inspire trust with the agency’s surveillance partners in the field. It builds on previous work inside and outside CDC to arrive at a vision of public health surveillance for the 21st century. By embracing the current challenges as opportunities, fixing what needs to be fixed, and working closely with its state and local partners, CDC can help revitalize U.S. public health surveillance. ³

Supporting States Through Improvements at CDC

CDC aims to rapidly improve its activities in the short term, while laying the groundwork for ongoing evaluation and modification of surveillance systems in the long term. The Strategy guides CDC efforts to make U.S. surveillance systems more adaptable to rapidly changing technology, more versatile in addressing evolving health threats, more adept at accessing and leveraging health-care data, and more capable of meeting demands for timely, population-specific, and geographically-specific information.⁴

This step-wise course of action is improving the value of our data, beginning with how we interface with states—where information is first collected and shared with CDC. We are making progress on improving surveillance data for public health action at the local, state, and federal levels. Examples include advancing data timeliness, leveraging existing data platforms to address emerging needs, using nontraditional data sources, and improving the representativeness of data through better population coverage.³

A Step-wise Approach

The Strategy outlines 3 goals and 10 aims to improve surveillance capabilities, outcomes, and overall public health. Through steady leadership and partnership, it facilitates work to consolidate surveillance systems, eliminate unnecessary redundancies, reduce reporting burden, and improve data availability, quality, and timeliness for all stakeholders.⁵ Specific aims are contained within each of the three goals.

Goals and aims are building blocks to better connect systems and resources inside CDC with more than three thousand agencies at the federal, state, local, and territorial levels. Already we have moved beyond initial initiatives. The next phase of the Strategy concentrates on improved program and data integration, better connectivity between public health and healthcare, and more efficiency at CDC through shared IT services.

Progress in Reaching Goals 1 and 2 Include:

Pulse Check: Our Progress So Far

Through the Strategy, steady progress has been made at CDC in advancing systems and participation, and sets the stage for the next wave of improvements.

*Percentage changes in the table were furthered by the Strategy, with baseline numbers for some initiatives starting prior to 2014.
**~20M laboratory reports are received annually at health departments—80% are now received electronically
***Date of Information: July, 2017

For the Strategy’s third goal, 4 initiatives were initially selected for their importance to state and local health departments, their potential for quick results, and their foundational importance to CDC centers and programs.

Select Examples of Initial Impacts Include ³:

• Faster reporting of mortality records to know how people are dying and from what
• Reduced burden on states for reporting notifiable disease conditions
• Better and faster situational awareness through tracking emergency department visits nationally
• More timely reporting of laboratory results through improved electronic submission
• Increased connectivity with the medical community through electronic case reporting.
• Modernizing data platforms for increased productivity

Next Steps:

Going forward, strategic goals include:

• Enriched program and data integration
• Better connectivity between public health and healthcare
• Improved efficiency at CDC through shared IT services

¹ Richards CL, Iademarco MF, Anderson TC. A new strategy for public health surveillance at CDC: improving national surveillance activities and outcomes. Public Health Reports. 2014; 129(6):472-476. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187298/.

² Buehler JW; Centers for Disease Control and Prevention. CDC’s vision for public health surveillance in the 21^st century: Introduction. MMWR Suppl. 2012;61(3):1-2. https://www.cdc.gov/mmwr/pdf/other/su6103.pdf.

³ Richards CL, Iademarco MF, Atkinson D, Pinner RW, Yoon P, MacKenzie WR, Lee B, Qualters JR, Frieden TR. Advances in public health surveillance and information dissemination at the Centers for Disease Control and Prevention. Public Health Reports. 2017 [epub ahead of print]. http://journals.sagepub.com/doi/full/10.1177/0033354917709542.

⁴ Richards CL, Lee B. CDC Surveillance Strategy—A strategy for improving CDC activities in public health surveillance. Online J Public Health Inform. 2015;7(1):e49. http://europepmc.org/articles/PMC4512337.

⁵ Centers for Disease Control and Prevention. Surveillance Strategy. 2014. https://www.cdc.gov/ophss/docs/CDC-Surveillance-Strategy-Final.pdf.

⁶ Centers for Disease Control and Prevention. CDC Health Information Innovation Consortium (CHIIC). https://www.cdc.gov/ophss/chiic.

⁷ MacKenzie WR, Davidson AJ, Wiesenthal A, Engel JP, Turner K, Conn L, Becker SJ, Moffatt S, Groseclose SL, Jellison J, Stinn J, Garrett NY, Helmus L, Harmon B, Richards CL, Lumpkin JR, Iademarco MF. The Promise of Electronic Case Reporting. Public Health Reports. 2016;131(6):742-746. http://journals.sagepub.com/doi/full/10.1177/0033354916670871.