APHL, partners garner $550M for data modernization initiative

Image depicting data transfer

Like many aspects of public health, the effective, efficient movement of public health data has been chronically underfunded. Faced with this perpetual issue—combined with a sharp increase in data production from new laboratory techniques that have added great volumes of data to an overburdened system—APHL joined with the Council of State and Territorial Epidemiologists, the National Association of Public Health Statistics and Information Services, and the Health Information and Management Systems Society in 2019 to engage in the first serious effort to secure federal funding for improved handling of public health data.

APHL contributed to the production of materials that quickly and easily explained the problem and urged Congress to provide $1 billion over the next ten years, at a rate of $100 million per year. With these materials in hand, APHL met with interested partners on Capitol Hill to press the case for funding. It also organized a Hill briefing for Congressional staff where subject matter experts, such as APHL member Dr. Joanne Bartkus, presented on the challenges with existing data handling processes. Dr. Anne Schuchat, Principal Deputy Director of the US Centers for Disease Control and Prevention (CDC), highlighted these same challenges in virtually every hearing where she testified on public health emergencies.

These educational activities culminated when Congresswoman Rosa DeLauro took up data modernization as one of her key initiatives in the Labor-HHS appropriations bill. Congresswoman DeLauro successfully included the first installment of $100 million for CDC to pursue the data modernization initiative in the Labor-HHS appropriations bill for fiscal year (FY) 2020. This is an unparalleled achievement in the first year of any significant effort, and one made even more remarkable considering that data management is not a particularly trendy or exciting topic.

Though the Senate never produced a Labor-HHS bill for FY 2020, but indicated that it would not accept the House amount of $100 million for data modernization, APHL persevered, continuing to work closely with Senate staff to advance the funding of the data modernization initiative. Ultimately, Congresswoman DeLauro was able to include $50 million in the final version of the bill. The COVID-19 response allowed for an additional $500 million to be directed to data modernization, and it appears that the balance of the $1 billion ($450 million) could be included in the next emergency supplemental funding bill.

APHL continues to pursue additional annual federal funding for the data management initiative, beginning with fiscal year 2021, and production of the required CDC report to Congress detailing how these federal funds will be expended in 2020 and the spend plan for the subsequent nine years.

While APHL looks forward to more nimble response to public health emergencies, such as COVID-19, due to improved public health data management, the association remains energized by the benefits to result from the $550 million already allocated to the data modernization initiative.

The post APHL, partners garner $550M for data modernization initiative appeared first on APHL Lab Blog.

Coronavirus stimulus provides key investments in public health

US Capitol at dusk

FOR IMMEDIATE RELEASE

Silver Spring, MD, March 27, 2020 — The emergency aid package passed by Congress today makes key investments in public health, according to the Association of Public Health Laboratories (APHL). The measure, designed to bolster US response to the coronavirus (COVID-19), includes a tenfold increase to improve the management of public health data and a substantial boost in funding for state and local health departments, including public health laboratories.

“Public health department and laboratory staff have been on the front lines helping to protect our communities from this novel disease threat. They are over-burdened and short on critical supplies,” said Scott Becker, CEO of APHL. “This stimulus package provides important funding that will help strengthen our nation’s response to the pandemic and other pressing health challenges.”

The measure includes $500 million for the Centers for Disease Control and Prevention (CDC) to improve the management of public health data. This funding will help develop and deploy data and analytics that scale rapidly in emergencies, provide predictive capacity to identify emerging threats, ensure two-way information flow and more to better detect and monitor disease threats.

The bill also provides $1.5 billion to CDC to fund state and local health departments and their laboratories, in addition to the $950 million already provided for these activities in the first supplemental funding package. It will strengthen these critical agencies to enable them to respond nimbly to public health emergencies, including COVID-19.

“If we’ve learned anything during the first months of our COVID-19 response it’s that monitoring, testing for and tracking disease and preparing our communities for health threats are absolutely essential functions and must not be taken for granted,” said Becker. “This stimulus package includes long-overdue funding to help protect us against COVID-19 and other potential health threats.

“We look forward to the president enacting this measure and to our continued work with the administration and Congress to ensure adequate and sustained funding to protect public health.”

APHL also joined partners in issuing a statement applauding members of Congress for providing $500 million for the Data Modernization Initiative at the Centers for Disease Control and Prevention (CDC) that will transform public health data systems and save lives.

Contact: Michelle Forman at 240.485.2793 or michelle.forman@aphl.org

# # #

The Association of Public Health Laboratories (APHL) works to strengthen laboratory systems serving the public’s health in the U.S. and globally. APHL’s member laboratories protect the public’s health by monitoring and detecting infectious and foodborne diseases, environmental contaminants, terrorist agents, genetic disorders in newborns and other diverse health threats. Learn more at www.aphl.org.

The post Coronavirus stimulus provides key investments in public health appeared first on APHL Lab Blog.

APHL and partners: COVID aid package provides much needed funding for data modernization

Data illustration

FOR IMMEDIATE RELEASE
March 27, 2020

Washington, D.C. – Together, the Association of Public Health Laboratories (APHL), Association of State and Territorial Health Officials (ASTHO), Council of State and Territorial Epidemiologists (CSTE), Healthcare Information & Management Systems Society (HIMSS), National Association of County and City Health Officials (NACCHO), and National Association for Public Health Statistics and Information Systems (NAPHSIS) issued the following statement in response to the Coronavirus Aid, Relief, and Economic Security (CARES) Act:

We applaud members of Congress for providing $500 million for the Data Modernization Initiative at the Centers for Disease Control and Prevention (CDC) that will transform public health data systems and save lives.

The nation faces an unprecedented challenge to address the COVID-19 pandemic. Now, more than ever, it is critical to have a strong public health surveillance system that detects and facilitates immediate responses and containment of emerging health threats. The CDC—together with state, local, territorial, and tribal health departments—have taken important steps to improve the nation’s public health data infrastructure, but due to funding shortages, this has often been in a piecemeal approach.

The COVID-19 pandemic has exposed gaps in our nation’s outdated public health data systems and a workforce struggling to keep up. The United States currently relies on error-prone, sluggish and burdensome manual and paper-based data exchange methods such as faxing and phone calls to share critical public health data, especially with the health care sector. Simply put, the virus is moving faster than the data and when data move more slowly than diseases, the American people suffer. We are watching as our leaders struggle to make critical decisions without complete data.

An integrated, high-speed, networked health system—from laboratories to health care facilities to public health authorities—with fast and reliable data is necessary in order to protect Americans from COVID-19 and future health threats. Modernization is not just network upgrades; it is a commitment to building and sustaining a world-class data workforce and data systems that are ready for the next public health emergency. The funding provided in the CARES Act is an enterprise-level commitment to build a public health data superhighway of the 21st Century to speed the transmission of accurate, complete data.

We look forward to working with Congress to ensure sustained annual funding for CDC’s Data Modernization Initiative and with CDC in formulating its multi-year implementation plan.

Contact:  Erin Morton at 202.484.1100 or emorton@dc-crd.com

####

 

The post APHL and partners: COVID aid package provides much needed funding for data modernization appeared first on APHL Lab Blog.

APHL and Partners Urge Emergency Funding to Bolster Novel Coronavirus Response

US Capitol Building

FOR IMMEDIATE RELEASE
Contact: Michelle Forman, 240.485.2793

Silver Spring, MD — In a letter to the White House and Congress, the Association of Public Health Laboratories (APHL) and partners today requested supplemental appropriations to expand and strengthen public health capacity and coordination in response to the novel coronavirus outbreak.

“While it is too early to reliably predict the additional cost burden and supplemental needs of the COVID-19 response … we anticipate that an initial supplemental is warranted to respond to public health agencies’ critical need to rapidly detect changes and control the outbreak,” the organizations wrote.

The groups outline several urgent priorities, including funding for the Centers for Disease Control and Prevention (CDC) to support preparedness and response activities; an appropriation for the relevant offices and programs under the Public Health and Social Services Emergency Fund; and authority to reimburse uncompensated care for state and local costs, including obtaining and maintaining quarantine and isolation housing capacity and providing wraparound services.

“We are in the midst of a developing public health emergency,” said Scott Becker, CEO of APHL. “Our request identifies initial needs to bolster our response, but it is likely only the start. Public health laboratories and other critical agencies will need sustained funding to address this growing challenge and other public health threats.”

The letter was signed by APHL, the Association of State and Territorial Health Officials, the National Association of County and City Health Officials and the Council of State and Territorial Epidemiologists.

# # #

The Association of Public Health Laboratories (APHL) works to strengthen laboratory systems serving the public’s health in the U.S. and globally. APHL’s member laboratories protect the public’s health by monitoring and detecting infectious and foodborne diseases, environmental contaminants, terrorist agents, genetic disorders in newborns and other diverse health threats. Learn more at www.aphl.org.

 

The post APHL and Partners Urge Emergency Funding to Bolster Novel Coronavirus Response appeared first on APHL Lab Blog.

Supporting rapid exchange of public health data is urgent, crucial and laden with challenges

By Jody DeVoll, advisor, communications, APHL 

In an era when digital communications move at blazing speeds, public health laboratories still have to resort to fax, email or phone to exchange data with some partners. Yet, this is only one of the obstacles to rapid exchange of critical public health laboratory data needed for public health surveillance, emergency response and patient care.

The volume of public health laboratory data presents an obstacle in and of itself. Infectious diseases, environmental toxins, foodborne illnesses, radiological exposure, hazardous chemicals, high consequence pathogens, antibiotic resistance: public health laboratories test them all. Add to this exponential increases in volume from the expansion of advanced molecular technologies like next-generation and whole genome sequencing, and the result is terabytes of data that public health laboratories must manage, interpret, store and share.

In addition, dozens of different, stand-alone systems make programming and maintenance of laboratory reporting systems labor-intensive and costly. For example, the US Centers for Disease Control and Prevention (CDC) maintains over 100 surveillance programs, each with its own reporting system. Dari Shirazi, APHL’s health information technology manager, explains how these many systems affect public health laboratory operations: “It’s as though you have a houseful of furniture to arrange in dozens and dozens of different houses and, periodically, you receive shipments of additional furniture that also has to be arranged.”

Of course, CDC is not public health laboratories’ only data exchange partner. Other federal partners, state and local health agencies, hospitals and others also require laboratory data, and they too want it parsed and transmitted through their proprietary systems.

With all these demands, data scientists at public health laboratories face a mountain of work, yet their numbers are few. The number of graduates in public health informatics has not kept pace with demands for workers from public and private sector institutions. As a result, graduates can choose from an array of positions, and they often choose private sector jobs which tend to be higher paying and longer-term than lower-salaried, time-limited positions at a public health laboratory.

Huge data volumes, a multitude of reporting systems and a shortage of public health data scientists make data exchange a laborious, costly and frustrating enterprise for public health laboratories. However, the implications extend beyond laboratories to the populations the data is intended to protect, in other words, us. According to Peter Kyriacopoulos, APHL’s senior policy director, “We are fast approaching the confluence of events on the management of public health data that threatens the very relevance of governmental public health. The volume of data generated by new laboratory technologies adds to the burden of over 100 inefficient data reporting systems that each have been designed to move specific information to a point at CDC, which constrains the utility of that information.

Fortunately, there are signs of change. Four national health organizations — APHL, the Healthcare Information and Management Systems Society (HIMSS), the Council of State and Territorial Epidemiologists (CSTE) and the National Association for Public Health Statistics and Information Systems (NAPHSIS)  – launched the Data: Elemental to Health campaign calling for a $1 billion investment in congressional funding over the next decade to modernize public health data/IT systems and develop a skilled workforce of data/IT specialists. Under the plan, state, local, tribal and territorial health departments would receive direct funding for these purposes through the CDC.

Over the last six months, the campaign has convened stakeholders, made the case for improved data systems to congressional and administration staff, appeared before the House Appropriations Subcommittee, hosted Hill briefings and organized a Day of Digital Action. Already there are results:

  • The House appropriations bill includes $100 million in fiscal 2020 for public health data systems and workforce modernization
  • The House LIFT America Act authorizes $100 million per year for five years to develop public health data systems and train staff
  • The Senate Saving Lives Through Better Data Act authorizes $100 million per year for five years for systems and people
  • The Senate Lower Health Care Costs Act authorizes “such sums as may be necessary” over five years to modernize data systems.

How would legislation initiated through the campaign support public health laboratories? First and foremost, it would help them to strengthen their LIMS. Shirazi explains, “A LIMS is a living, breathing thing that has to grow with lab needs. These needs change every year as the lab takes on new and novel types of testing.” Building LIMS capacity would enable laboratories to expand capability for data capacity, exchange and analytics; eliminate manual entry of test results; and provide secure, instantaneous communication of results to health partners. In addition, legislation initiated through the campaign would underwrite laboratory systems for exchange of electronic health records, National Notifiable Disease Surveillance System data, vital health records (e.g., notices of births and deaths) and other public health surveillance data.

Looking forward, the US would do well to complement the advances initiated under the Data: Elemental to Health campaign with a data transfer solution that consolidates all public health data systems into one. Kyriacopoulos notes that: “the creation of a single reporting site, that multiple data providers and users can report to and receive information from, would be a significant improvement that would allow for the efficient and comprehensive use of this data throughout the federal/state/local public health system.”

 

Photo credit: James Marvin Phelps

The post Supporting rapid exchange of public health data is urgent, crucial and laden with challenges appeared first on APHL Lab Blog.

APHL: Engaging for change in emergency diagnostics

APHL: Engaging for change in emergency diagnostics | www.APHLblog.org

The process for developing and deploying emergency diagnostics to laboratories nationwide will now be more efficient. A new entity, the Tri-Agency Task Force for Emergency Diagnostics, has brought together representatives from the Centers for Disease Control and Prevention (CDC), the Federal Drug Administration (FDA) and the Centers for Medicare and Medicaid Services (CMS) to coordinate systems for rapid delivery of tests, reagents and guidance to public health and clinical laboratories.

APHL contributed to the development of the Task Force by communicating the potential value of such a mechanism. Beginning in the early months of the 2016 Zika pandemic and continuing long after, the association and its member laboratories engaged federal partners in a dialog around systems for cross-agency coordination of emergency diagnostics.

“The federal partners recognized that instead of relying on APHL to coordinate communications during a crisis, having a more permanent solution in place would be more effective,” explains Peter Kyriacopoulos, senior director of public policy at APHL. “With CDC taking the lead, the Tri-Agency Task Force for Emergency Diagnostics has been established. Whenever the next disease comes along, this group will be ready to get to work.”

Kelly Wroblewski, APHL’s infectious disease director, adds that the Task Force makes communication more routine. “Having communication channels already open will make it easier to get the response going as quickly and efficiently as possible,” she says.

Since 2016, the threat of Zika has subsided. In 2017 and 2018, there wasn’t another outbreak, but Zika will likely come back. But this time, the public health community will be ready.

“With the Tri-Agency Task Force in place, we’re much better off than we were in 2016,” says Kyriacopoulos. “Other improvements, like more efficient ways to send data electronically, are still needed. But the systems we had and the new ones we’ve introduced have strengthened communication and coordination.”

The post APHL: Engaging for change in emergency diagnostics appeared first on APHL Lab Blog.

Urban Forestry In the Schoolyard: New PLOS ONE Research on Trees and Student Performance

0000-0002-8715-2896 Research into how nature impacts our well-being has shown that being outside makes us feel better. Images of nature alone have been shown to lift people’s mood. But is there any connection with how

APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing”

APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing” | www.APHLblog.org

APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing” | www.APHLblog.org

The Association of Public Health Laboratories (APHL) is very concerned about the decline in federal funding for public health functions such as detection, surveillance and response in the administration’s budget for fiscal year 2019. “It is extremely disheartening and disappointing to see such severe cuts to public health programs at CDC, HRSA, USAID and the Department of State at a time when the services they support are most in need,” said Scott Becker, executive director of APHL. “What is more, these cuts to public health funding come after a historic bipartisan agreement between Congress and the White House to increase federal spending overall for the next two years.”

CDC cuts include:

HRSA cuts include:

Global Health Programs:

  • $1.26 billion cut to Department of State Global Health Programs which includes funding provided to CDC for PEPFAR; and
  • $1.11 billion cut to USAID Global Health Programs.

While the majority of the president’s budget proposal is grim for public health, there were a few areas that are not as dark. APHL was pleased to see that the budget request designates $175 million to CDC to address the growing opioid crisis. Additionally, funding for the Global Disease Detection Program would increase by $51 million and funding for the Public Health Emergency Preparedness program would increase by $4.5 million.

As Scott Becker explained, “The director of the president’s Office of Management and Budget said, ‘the budget is a messaging document.’ In that case, the message to the American people seems to be, ‘Good luck if there is an outbreak or other public health emergency because federal early warning and response programs won’t be there to help you through.’”

APHL will continue work with Congress to assure that funding levels continue at the much-higher amounts provided in previous years. Adequate levels of federal support for state and local laboratory contributions are critical to the nation’s public health security.

The post APHL: President Trump’s FY 2019 budget request is “disheartening and disappointing” appeared first on APHL Lab Blog.

APHL responds to “banned words,” remains focused on CDC’s budget

APHL responds to “banned words,” remains focused on CDC’s budget | www.APHLblog.org

By Scott J. Becker, executive director, APHL

Recent news concerning limits on language permissible in CDC budgetary communications has drawn considerable attention in the media. As a longstanding partner of CDC, APHL shares its commitment to science-based work to protect the public’s health and improve its health status. We are heartened by CDC Director Fitzgerald’s statement that CDC remains committed to evidence-based work described using all appropriate language, and we are confident that CDC will continue to serve all communities, including those most vulnerable and diverse.

Our primary focus is on ensuring that CDC receives funding that will enable APHL members – local, state and territorial public health laboratories – to do the vital work necessary to detect and respond to public health threats. We feel strongly that, while the words CDC uses in their budget submission are extremely important, the funding levels are at least equally deserving of our attention.

We look forward to working with the Administration and Congress to ensure the best scientific evidence is used in all public health decision making and that all public health professionals are able to use language that appropriately conveys the public health policies and programs that allow for improvement for the health of our nation.

You can also read Scott Becker’s letter to the editor of The Washington Post on this matter.

 

The post APHL responds to “banned words,” remains focused on CDC’s budget appeared first on APHL Lab Blog.

CDC Cuts Threaten our Health and our Economy

CDC Cuts Threaten our Health and our Economy | www.APHLblog.org

By Scott J. Becker, executive director, APHL

CDC Cuts Threaten our Health and our Economy  | www.APHLblog.orgThe president’s proposed 2018 budget and repeal of the Affordable Care Act threaten to slash $2.3 billion from the Centers for Disease Control and Prevention. A defense agency in all but name, CDC protects us from a horde of infectious, foodborne and chronic killers—everything from asthma to Zika. Cutting the agency’s funding by 33% would be counterproductive in all the worst ways, costing far more—in dollars and lives—than any imagined savings.

As a taxpayer, I’m all in favor of smartly trimming any fat in our national bureaucracy, but instead of a wisely wielded scalpel, the president’s proposals have all the finesse of a sledge hammer lobbed toward our public health system’s heart. The proposed cuts would drop CDC funding to its lowest levels in 14 years, critically impairing a variety of life-saving programs.

As we’re now entering mosquito season, the resurgence of Zika virus is at the forefront of my mind. Budget cuts would severely impair CDC’s ability to respond to this unpredictable disease and limit its devastating consequences. Among the assets that would be lost: the US Zika Pregnancy Registry, which helps ensure that infants born to infected mothers receive essential care. In 2016, the registry recorded 1,297 such pregnancies.

Meanwhile, CDC must maintain constant vigilance to protect us from an ever-mutating world of unknowns. A new contagious disease has emerged every year for the past 30. In the last seven years, CDC’s emergency operations center has been in operation more than 91% of the time.

Already, a new strain of avian flu in China has killed more people this season than in any season since it was discovered four years ago. It’s just one of many potential dangers on the radar of CDC’s infectious disease experts. Deep budget cuts would impede CDC’s work to develop the tests necessary for detecting and responding to new and emerging infectious diseases.

But that’s not all. The president’s budget would hobble or kill a long list of other programs that help prevent Americans from getting cancers, diabetes, heart attacks, strokes and other deadly conditions.

And if all the threats to people’s health weren’t bad enough, these funding cuts will also threaten our economy. Investing in public health, without question, leads to the greatest economic savings. For example, research shows that every dollar invested in evidence-based prevention programs—like CDC’s smoking cessation efforts—yields $5.60 in savings.

Every year, seasonal influenza causes more than 200,000 hospitalizations and over $10 billion in direct medical costs in the U.S. It also costs $7 billion in workplace productivity. Expect these numbers to skyrocket if CDC loses influenza resources. However, if we invested in detection and prevention of influenza, those numbers would decrease.

Looking ahead to the next five years, CDC predicts that optimal infection control and antibiotic stewardship can prevent over 600,000 antibiotic-resistant infections, averting $7.7 billion in healthcare spending. That alone is quite a return on simply leaving the $2.3 billion in place and letting CDC continue doing its good work. However, the president has not only proposed reducing antibiotic resistance funding, he has moved it to the Prevention and Public Health Fund (PPHF), a section of the Affordable Care Act (ACA), which he hopes to repeal. That is, antibiotic resistance funding would be eliminated by FY18.

Additionally, CDC provides vital workforce and training programs to ensure a strong and sustainable public health workforce. With an over $7 million proposed cut, CDC would be forced to slash the number of trained disease detectives and rapid outbreak responders working on the frontlines to protect my family and yours.

America’s public health professionals have already been stretching every precious tax dollar, doing as much as humanly possible with too little for too long.  I’ve seen this in my daily work with public health laboratories: chronically understaffed teams working with outdated equipment and pre-recession funding under intense pressure to hunt down invisible killers.

Public health work transcends partisan politics, saving and improving lives in red states, blue states, purple states, flyover states and beyond. Rather than recklessly undermining our nation’s health defenses, we should be investing in a stronger America by ensuring we have the best detection, prevention and response systems possible.

Follow Scott J. Becker on Twitter.

 

The post CDC Cuts Threaten our Health and our Economy appeared first on APHL Lab Blog.