Purpose
Milestones
These milestones, and the nation’s public health data goals, will be met through collaboration and partnership between state, tribal, local and territorial (STLT) public health departments, healthcare partners and federal agencies.
PHDS Milestones by Public Health Data Goals
2024 milestones
2025 milestones
Why this matters
Milestone 1.01:
65% of Epidemiology and Laboratory Capacity (ELC)-funded jurisdictions connected to APHL Informatics Messaging Services (AIMS) for electronic case reporting (eCR) are processing eCR data into production disease surveillance systems, up from 59% in 2023.
75% of ELC-funded jurisdictions connected to AIMS for eCR are processing eCR data into production disease surveillance systems.
Reduces STLT burden to manually ingest case data into disease surveillance systems.
Learn more about electronic case reporting (eCR).
Milestone 1.02:
100% of ELC-funded jurisdictions connected to multiple intermediaries such as AIMS, ReportStream or Health Information Exchanges, for laboratory data.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
Reduces STLT-level overhead of managing individual point-to-point connections with laboratories for electronic laboratory reporting.
Learn more about electronic laboratory reporting.
Milestone 1.03:
100% of state public health laboratories have implemented electronic test orders and results (ETOR) via web portal, direct integration, or use of intermediary with at least one healthcare partner for at least one laboratory program up from a baseline of 92% in 2023.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
Enables laboratories to better forecast testing needs and share test results faster with healthcare facilities to enhance patient care and with public health authorities to accelerate the time it takes to make public health decisions.
Learn more about ETOR initiative.
Milestone 1.04:
75% of CDC infectious disease laboratories send laboratory test results to state public health laboratories and jurisdictions via electronic laboratory reporting, and 50% of state public health laboratories and public health departments are able to accept electronic laboratory reporting from CDC infectious disease laboratories.
100% of CDC infectious disease laboratories send laboratory test results to state public health laboratories and jurisdictions via electronic laboratory reporting, and 75% of state public health laboratories and public health departments are able to accept electronic laboratory reporting from CDC infectious disease laboratories.
Enables laboratories to share test results faster with facilities and public health authorities.
Milestone 1.05:
Reduced time to send mortality data to and receive coded cause of death data from CDC for at least 15 of the 57 total jurisdictions through use of Fast Healthcare Interoperability Resources (FHIR®)-based exchange.
Reduced time to send mortality data to and receive coded cause of death data from CDC for at least 30 total jurisdictions through use of FHIR-based exchange.
Supports faster sharing of mortality data, which can enable more robust national-level situational awareness.
Learn more about the National Vital Statistics System (NVSS).
Learn more about Fast Healthcare Interoperability Resources (FHIR).
Milestone 1.06:
CDC receives and ensures access to commercial laboratory data from at least three major national and regional commercial laboratories to enable situational awareness across multiple conditions, up from two major national laboratories in 2023.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
Increases geographical coverage of commercial laboratory data across multiple conditions which can improve national situational awareness.
Milestone 1.07:
82% of U.S. non-federal emergency departments (ED) send data to CDC and coverage increased to greater than 30% for 30 low-coverage Health Service Areas to increase visibility on ED encounters in currently low-coverage areas.
84% of U.S. non-federal EDs send data to CDC and coverage increased to more than 30% for 60 additional low-coverage Health Service Areas.
Enables more comprehensive monitoring of emerging and ongoing public health threats and impacts, particularly among areas with low NSSP coverage today.
Learn more about the National Syndromic Surveillance Program (NSSP).
Milestone 1.08:
55% of ELC-funded jurisdictions connected to eCR receive electronic case reports for at least 75% of their jurisdictional reportable conditions, up from 45% in 2023.
65% of ELC-funded jurisdictions connected to eCR receive electronic case reports for at least 75% of their jurisdictional reportable conditions.
Improves completeness and timeliness of critical case data across multiple conditions in STLT-level disease surveillance.
Milestone 1.09:
At least 25%, or 13 out of 51, of jurisdictions (all states and the District of Columbia) are submitting SARS-CoV-2 wastewater results to CDC within 7 days of sample collection for at least 80% of samples.
At least 50%, or 26 out of 51, of jurisdictions (all states and the District of Columbia) are submitting SARS-CoV-2 wastewater results to CDC within 7 days of sample collection for at least 80% of samples.
Enables faster detection of emerging public health threats.
Learn more about the National Wastewater Surveillance System (NWSS).
Milestone 1.10:
Anonymized electronic initial case reports, for at least two notifiable conditions, are sent to CDC to support early detection and response, in collaboration with participating STLTs.
Anonymized electronic initial case reports for at least five notifiable conditions are sent to CDC via Trusted Exchange Framework and Common Agreement (TEFCA), using FHIR-based exchange, to use in visualizations and analyses, in collaboration with participating STLTs.
Enables national level early detection of public health threats and rapid response.
Milestone 1.11:
Six jurisdictions have established an automated data feed and are submitting near real time hospital bed capacity data to CDC daily, up from two jurisdictions in 2023.
12 jurisdictions have established an automated data feed and are submitting near-real time hospital bed capacity data to CDC.
Reduces reporting burden on hospitals and STLT partners and enables more accurate and timely tracking of hospitalizations.
Learn more about the National Healthcare Safety Network (NHSN).
Milestone 1.12:
CDC ready and able to accept in-patient hospitalization data via admission-discharge-transfer feeds.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
Reduces data reporting burden on hospitals and STLTs and can enable faster situational awareness on hospitalizations.
Learn more about the National Syndromic Surveillance Program (NSSP).
FHIR® is a registered trademark of Health Level Seven International and use of this trademark does not constitute an endorsement by HL7®.
2024 milestones
2025 milestones
Why this matters
Milestone 2.01:
Critical Access Hospitals (CAHs) in production with eCR increased to 40%, up from a baseline of 28% in 2023.
CAHs in production with eCR increased to 60%.
Enables faster detection of anomalies in health status among rural communities at the STLT and national levels.
Milestone 2.02:
Manual time spent on preparing and harmonizing public health data to enrich jurisdictional public health investigations reduced by 20%, for at least four STLTs.
Manual time spent on preparing and harmonizing public health data to enrich jurisdictional public health investigations reduced by 25%, for at least 10 STLTs.
Reduces STLT manual burden to ingest and harmonize disparate data streams for disease surveillance.
Milestone 2.03:
At least two automated reports using CDC’s healthcare databases provided to CDC programs and jurisdictions to identify and address health disparities.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
Enables STLTs and CDC programs to maximize insights from healthcare data sets to identify, prevent and mitigate disproportionate impact on populations.
Milestone 2.04:
CDC offers for immediate adoption a modernized National Electronics Disease Surveillance System Base System (NBS) for case surveillance in a CDC-supported cloud. environment.
Modernized NBS used by at least three jurisdictions for case surveillance in a CDC-supported cloud environment.
Reduces STLT overhead to coordinate hosting and management of CDC-provided disease surveillance systems.
Learn more about the National Electronic Disease Surveillance System Base System (NBS).
Milestone 2.05:
CDC releases a plan for how the agency will leverage artificial intelligence (AI) and launches three AI use cases.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
CDC safely and responsibly uses AI to improve public health efficiency, response-readiness, and outcomes.
Milestone 2.06:
Foundational efforts to meet 2025 milestone currently underway.
50% of CDC centers report new social determinants of health-related data elements in reports/visualizations they release.
Enables STLTs and CDC programs to more effectively identify and address health disparities, based on a wider range of health equity measures.
Milestone 2.07:
At least three tribal nations receive eCR data directly or Tribal Epidemiology Centers (TECs) receive data on behalf of one or more tribes.
At least six tribal nations receive eCR data directly or TECs receive data on behalf of one or more tribes.
Improves completeness and timeliness of case data available to tribal nations and TECs for situational awareness.
2024 milestones
2025 milestones
Why this matters
Milestone 3.01:
Expanded public access to data and visualizations for four core data sources, including visualizations using county-level ED data to support public health decision-making.
Expanded public access to integrated data and visualizations for five of the nation’s most urgent public health threats to support public health decision-making.
Enables partners, including the public, to monitor the burden of various health conditions, and gain access to actionable insights on high priority public health threats.
Milestone 3.02:
Integrated data and visualizations from across multiple data sources, such as case and ED data, available on a single platform within 2-3 days from when CDC receives data, for CDC programs and jurisdictions for at least five nationally notifiable conditions.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
Enables faster access to integrated data and visualizations for STLTs and CDC programs.
Milestone 3.03:
Number of active CDC users of ED and laboratory data, increased by 40%, up from baseline of 100 users in 2023.
Number of active CDC users of ED and laboratory data, increased by 60% from a baseline of 100 users in 2023.
Increases use of critical emergency department data, which can enable earlier detection of public health threats among CDC programs.
2024 milestones
2025 milestones
Why this matters
Milestone 4.01:
CDC launches at least two public health use cases for TEFCA such as to query data from healthcare settings for urgent public health investigations.
CDC launches two additional use cases for TEFCA, and scales implementation of use cases launched in 2024.
Lays the foundations for faster exchange of more interoperable data between health care and public health while reducing the complexity of point-to-point connections.
Learn more about the Trusted Exchange Framework and Common Agreement (TEFCA).
Milestone 4.02:
Data access and use under common, established terms signed across at least 15% of ELC-funded jurisdictions for core data sources.
Data access and use under common, established terms signed across at least 30% of ELC-funded jurisdictions for core data sources.
Facilitates faster and more seamless sharing of critical public health data and insights and reduces variation in data usage and sharing.
Milestone 4.03:
Minimal data elements for public health response published in line with United States Core Data for Interoperability (USCDI) and USCDI+ standards for multiple data sets, along with a process to maintain and update the list.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
Reduces data reporting burden on CDC’s partners, including STLTs and laboratories, particularly during public health emergencies.
Learn more about the United States Core Data for Interoperability (USCDI) and USCDI+.
Milestone 4.04:
Number of public health data sets published by CDC with metadata utilizing Findability, Accessibility, Interoperability, and Reuse (FAIR) open data principles increased by 10%.
Follow-on milestone efforts to be assessed during 2025 PHDS revision process.
Makes critical health data and insights easier to access.
Learn more about FAIR.
Milestone 4.05:
One NHSN Collaborative (CoLab) site is submitting healthcare measures to CDC via the NHSN through the use of FHIR-based exchange.
Five NHSN CoLab sites are submitting healthcare measures to CDC via NHSN through the use of FHIR-based exchange.
Reduces reporting burden on hospitals and enables faster sharing of critical healthcare data.
Learn more about the NHSN Collaborative (NHSN CoLab).
Milestone 4.06:
Foundational efforts to meet 2025 milestone currently underway.
Standardized data release guidance is established to improve CDC’s response to tribal and TEC requests for data.
Enhances tribal and TECs access to public health and epidemiological data from CDC.