CDC has worked on several fronts over the past eight years to strengthen the public health information infrastructure. Building on needs identified in the IOM report "The Future of Public Health", CDC WONDER was developed to organize CDC's wide array of scientific and prevention data and information in a manner accessible to public health practitioners. In addition, an array of automated disease surveillance and large population surveys were developed to facilitate the collection, reporting, and analysis of important population-based health information. Finally, CDC INPHO was developed to provide leadership to state and local public health agencies as they began realizing the vision of the NII.
CDC INPHO is a programmatic effort designed to build an information and communications infrastructure linking the nation's state and local health departments to each other, CDC, other PHS agencies, and the academic community (7). Developed in partnership with state and local public health departments, academic centers, and private foundations, the goal of this project is to meet community needs in disease prevention and health promotion through improvements in communication linkages, more efficient and timely exchange of data, and better and more timely access to public health information. Georgia was the first state to come on line; during the recent flood, the e-mail component of the system played an important role in keeping the state capital informed of developments in flooded counties so that necessary supplies, personnel, and equipment could be directed to areas in need. Eleven other states are now involved in the INPHO project.
CDC WONDER is a menu-driven software program designed to help public health professionals rapidly identify and acquire critical public health information, and to share that information with their public health colleagues (8). CDC WONDER is accessed via a toll-free telephone number using a microcomputer and modem. Without the user's needing to know the location of data or communication pathways, it provides access to: people at CDC (via e-mail and the Resource Index Database); reports prepared by CDC scientists, such as MMWR articles and prevention guidelines; and over 40 scientific datasets on CDC computers, such as national public use datasets on mortality, cancer incidence, hospital discharges, AIDS, behavioral risk factors, and diabetes. The requested data can be summarized and analyzed using tools built into WONDER.
The National Telecommunications System for Surveillance (NETSS) was developed by CDC and the Council of State and Territorial Epidemiologists to collect, transmit, analyze, and disseminate weekly and annual reports of notifiable diseases. NETSS includes both core surveillance data and some additional disease-specific programmatic data, replacing paper case-report forms. The system is also used to transmit to CDC information on injuries and certain non-notifiable diseases. Surveillance data from this system are made available through CDC WONDER after publication in the MMWR Summary of Notifiable Diseases, United States. Software is provided to state health departments to analyze information and to transfer data electronically in standard format to CDC. Epi Info and Epi Map are microcomputer software packages developed by CDC and the World Health Organization. Epi Info is an epidemiological tool that can be used to build questionnaires, collect and analyze data, and organize results into text, tables, or graphs. A "Statistics for Surveillance" module that includes advanced statistical techniques has recently been produced. Epi Info is used in the NETSS to collect, analyze, and transmit information on notifiable diseases in 40 states. It is in the public domain in the United States and is used in more than 80 countries.