Many of the information systems supported or used by HHS agencies are not national surveys, but surveillance and reporting systems designed to identify individual cases for public health intervention, track occurrence of infectious diseases in order to identify patterns, or provide accountability for Federal grant programs. Although there are many of these systems, the cost to the Federal government is not significant, since surveillance activities are typically based on voluntary reporting by State health departments.
There is wide consensus in the public health community that fundamental change is needed in the current patchwork of independent, uncoordinated, categorical disease surveillance and grant reporting systems. The report "Integrating Public Health Surveillance and Information Systems," drafted by the Centers for Disease Control and Prevention (CDC), outlines how this fragmentation has hindered public health efforts.
Efforts by CDC and PHS to foster the development of integrated information systems will accelerate, including:
• removal of unnecessary Federal requirements for States to maintain distinct, non- integrated data collection mechanisms, in order to allow States to develop integrated systems that satisfy both State and national needs;
• support of streamlined, integrated data systems at the State level that can satisfy disease surveillance objectives; and
• consolidation of categorical grants into performance partnership grants, with streamlined reporting requirements.
Efforts to streamline and integrate these multiple, distributed data systems will depend on strong Federal leadership in the development of consensus standards, definitions, and approaches to recording and sharing of data.