Sprinting Toward the Next Generation of Case Surveillance

What does it take to modernize case surveillance? When we assess our technologies, processes, and policies, what are the steps we can take to determine what’s working best—or could be improved—for the people who use them?

To answer these questions, CDC and the U.S. Digital Service (USDS) are taking an in-depth look at the current technologies, processes, and policies around disease surveillance data. The ambitious goal is to create the next generation of case surveillance for public health.

First, we needed to understand CDC programs’ and public health jurisdictions’ capabilities and needs and determine what a shared vision of a modernized, sustainable system could look like.

The approach: A discovery sprint

In May 2022, we launched a 12-week “discovery sprint” focused on examining the flow of case reporting and notification through the National Notifiable Diseases Surveillance System (NNDSS).

Discovery sprints are useful when you need to quickly build a common understanding of a complex system. The idea behind a sprint is to create paths toward solutions by identifying specific, actionable next steps for the people at the organization who will carry that work forward.

To collect and accelerate best practices, CDC connected with public health partners such as the Council of State and Territorial Epidemiologists (CSTE) and the Association of Public Health Laboratories, and with state, local, and territorial health departments.

The case surveillance discovery sprint started with a joint team of USDS technologists and CDC epidemiologists, who interviewed 148 people representing 19 state and local health departments—as well as partners at CSTE and the National Association of County and City Health Officials—to discover areas for improvement. The sprint team looked at the full lifecycle of the data, starting at the point of care and ending in public health action.

The result: Current approach is complicated

When the team put together the results from the interviews, they discovered that the current case surveillance approach is too complicated, and processes do not work smoothly. For example:

• Too much time and too many resources are spent on counting, cleaning, and collating case data that do not always meet the needs of users, such as jurisdictions and CDC programs.
• State and local health departments are faced with competing priorities. They also find it difficult to meet the many demands placed on them with the workforce, systems, and processes they have.

The recommendations: A new approach is needed

The team made the following recommendations to help develop a strategy and an execution plan for developing next-generation case surveillance that would:

1. Support jurisdictions in collecting and sending case data quickly in a cost-effective manner.
2. Provide jurisdictions with a single place at CDC to submit their case data.
3. Take advantage of opportunities to enhance national public health through streamlined data sharing and situational awareness.