1113: Data Modernization Is a Long Game: Progress, Partnerships, and Policy

JOHN SHEEHAN:
This is Public Health Review Morning Edition for Monday, April 27th, 2026. I'm John Sheehan
with news from the Association of State and Territorial Health Officials.

Today, we discuss public
health data modernization's multi-decade transformation with Dr. Jen Layden, ASTHO's senior
vice president for population health and Innovation. She'll discuss data modernization's progress
across the country and the challenges that remain. She recently attended the Healthcare
Information and Management Systems Society, or HIMSS, conference, which highlighted key
advancements like the expansion of electronic case reporting, improved syndromic surveillance,
and ongoing efforts to modernize vital statistics systems.

JEN LAYDEN:
To me, a big takeaway or thing to emphasize is that data modernization is a long game, right?
We're not going to make all the changes we need to in one year. If you look at the health care
modernization, data modernization, that would spend a multi-decade effort, and we're just in the
first five, six years of that for public health.
So, I think that's important to emphasize. Where I think we see continued progress across the
nation is in the continued use and expansion of electronic case reporting, continued use of
syndromic surveillance, and novel ways to use that for monitoring for health threats across our
communities, and then the continued work to support modernization of vital statistics. CDC has
done some great work on their data platform called 1CDP, that I think, with time, will see some
benefits to jurisdictions, which is great.
But I think, to continue to navigate these challenging times, but continue to see progress at the
same time has been really exciting.

SHEEHAN:
And your session highlighted challenges to ongoing data modernization efforts. I'm sure there are
a lot of them, but which feel most urgent?

LAYDEN:
Yeah, it's a great question. I look at what's in our control and what's out of our control and what
we can influence. Certainly top of mind for a lot of folks are the financial constraints and
wondering about the sustainability, longevity of that.
The legislative line for data modernization has continued. It's actually increased compared to last
year, which is phenomenal, especially when you look at other lines. But it's still a very challenging
time for jurisdictions, especially with the COVID-related funding going away, where I think we're

continuing to see some need and interest, but it's also some of the challenges is how we work
differently, how we work with healthcare, how we integrate our systems with the health IT and our
operability.
It requires us to work differently, think differently, have different solutions, to work with private
partners differently. But I think those are all things that really will help public health in the long
run.

SHEEHAN:
And certainly policy and advocacy in government can be one of those factors that really pushes
modernization forward. Can you connect the dots on how that's really necessary to get change
happening?

LAYDEN:
Yeah, no, absolutely. When I think of data modernization, it's not just the technology. There's the
workforce and continuous skill and training that we need.
And then there's the policy aspect of it. One big challenge that we've seen across public health is
data sharing and data access that is needed for jurisdictions, needed for communities, and those
are policy challenges. So, those are hurdles in which we need to come up with solutions to
address.
You look at some state laws and not all states have state laws that say you need to exchange
data electronically, automatically from healthcare systems to public health. Those are policy
legislative work efforts that need to continue. We've also seen those successes, and that I think
speaks to the importance of policy.
So, if you look how meaningful use has been used to support some of the interoperability between
health care and public health, that's improved syndromic and electronic case reporting. And then
the launch of TEFCA, and the having that trusted exchange of data between health care, and other
entities, including public health, those policy efforts have really helped support the safe, secure
exchange of data for public health, among other use cases.

SHEEHAN:
And of course, always, always a challenge: funding, funding sources, funding availability
continues to be one of those limiting factors.

LAYDEN:
Yeah, always, always is for public health. We're chronically underfunded. That's not a new
challenge.

I think we are seeing and feeling the struggle with the boom and bust cycle of funding, in which
you get a lot of money. That's often very challenging for jurisdictions to spend. And now, we're at
the tail end of that, coupled with some of the evolving financial landscape from federal funding.
I think it forces us to think differently and look at other ways to support funding. So, there's been a
lot of interest in public-private partnerships, which is great. Looking for ways to work across
jurisdictions for shared infrastructure, recognizing that even in the best of worlds, the funding for
data modernization is not going to be sufficient for all the changes we need to make.
And so, looking at other ways to support the resource needs will continue to be critical for public
health.

SHEEHAN:
Another aspect you've named as essential is this idea of partnerships, and you've sort of been
describing around them today, partnerships between health care and public health, and then
looping in third parties, and private companies, and market suppliers, all of them working together.
Can you describe a scenario that's been particularly successful?

LAYDEN:
Yeah, I mean, I'll talk about electronic case reporting. I've mentioned it a couple of times now. It's
the way that we have cases that are nationally notifiable, critical public health threats sent almost
automatically, instantaneously from health care settings to public health.
That requires the support and buy-in, as well as working with health care, as well as the vendors,
the electronic health record vendors, such as Epic, and Cerner, and MEDITECH, that are vendors
that are supporting the health care systems, because they are the ones that have the systems
that help to exchange that data. So, working closely with them for solutions, for adoption across
health care systems, is really critical. So, to me, that's an example of public health working, not just
with healthcare systems, but also private tech to improve it, and we've seen tremendous
progress.
We now have all states: public health jurisdictions can receive electronic case reporting for a
whole host of conditions. We have over 56,000 healthcare facilities that are sending
instantaneous electronic case reporting to public health, and that wouldn't happen if we didn't
have the partnership, the collaboration with health care, and the vendor community.

SHEEHAN:
Your panel was part of a broader conference that was, you know, that's all about information
systems and management systems. Did you track any broader themes from the conference that
would have an impact on data modernization?

LAYDEN:
Yeah, I think a key theme across it was the concept of public-private partnerships. How do we
work from the public health side? How do we work with private industry that's many years ahead
of us, as far as the technology and solutioning, have the capacity, the technical expertise that we
often don't have and can't have?
And so, the concept of working differently, thinking differently, partnering with private industry, was
a common theme from my perspective, as well as thinking through how we look at different ways
to resource, revenue source, the data technology infrastructure that we need across public
health.

SHEEHAN:
And lastly, could you make the case why someone is considering going to this event, which, you
know, is absolutely public health, you know, involving public health, but it's sort of like the data
side, the information side, make the case why that's important to pay attention to.

LAYDEN:
Yeah, no, it's a great question. So, I've attended this conference for several years and, you know,
going back four years ago, you know, we had very little public health presence. It really was
exciting to see this year such a large number of public health practitioners, not just from ASTHO,
but from states, cities, territories, federal level, at this meeting.
I think public health being at the table and talking with health care, talking with tech industry, to
me is really important for us to help create solutions. We have to define the problems that we
need tech companies and whatnot to help solve with us. So, us being there, I think is really
critical.
That was noted, I think, throughout the week. I heard a lot of great feedback of really impressed
by the increased participation from public health individuals.

SHEEHAN:
Dr. Jen Layden, thanks so much for the update.

LAYDEN:
Yep, absolutely. Anytime. Good to see you.

SHEEHAN:
Dr. Jen Layden is ASTHO's senior vice president for population health and innovation.

In the
upcoming webinar, Driving Impact with Flexible Funding, participants will explore how state

health agencies can move beyond traditional funding silos to create more agile, high-impact
public health initiatives. Through real-world examples and strategic analysis, we will examine the
pathways to successfully adopting and expanding flexible funding models in a governmental
setting.
Find the link to register in the show notes.

Join ASTHO for part two of the ASTHO Policy Institute
Lunch and Learn webinar series focused on strengthening public health surveillance and
reporting systems through policy work and the implications for STIs and infectious diseases. As
part of ASTHO's Policy Institute, this webinar will explore key challenges within current reporting
systems, including duplication, interoperability gaps, administrative burden, and how these
barriers impact STI data quality, timeliness, and action.
Learn more at the link in the show notes.

This has been Public Health Review Morning Edition.

I'm John Sheehan for the Association of State and Territorial Health Officials.