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

JOHN SHEEHAN:

This is Public Health Review Morning Edition for Monday, April 27, 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 health care 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.