A central finding of this report is that there appears to be a widening gap between the public and private sectors in the area of information technology. Private sector funding appears to be outstripping public funding, and, as a result, the information infrastructure is simply not being built in PHLs. While the CDC does have a number of small grants in this area, they have been insufficient to generate substantial activity. Building information infrastructure is a clear priority of the present Administration, and applications to public health function should be further explored by the CDC or DHHS.
Unfortunately, the locus for leadership in this area has yet to be identified on the federal level. Leadership might come from the Health Information Systems and Surveillance Board (HISSB) within the CDC. However, there are clearly other divisions and agencies that have a strong interest. In addition, commitment would also need to emanate from the states, as most PHL funding continues to come from state governments. Current interest in integrated information systems for public health and knowledge-based systems among SHAs affords an opportunity to strengthen information technology in PHLs, and significant focus on this issue from federal government is needed.