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Centers for Disease Control and Prevention

Improving public health data infrastructure through flexible, modern approaches to cloud services

Summary

State, tribal, local, and territorial (STLT) public health agencies have struggled to handle the pace and volume of incoming case data when responding to disease outbreaks. We’re working with the Centers for Disease Control and Prevention (CDC) and U.S. Digital Service (USDS) to provide STLTs with flexible cloud hosting infrastructure that enables them to quickly upgrade and scale their data systems with modern, cloud-based software solutions, so they can meet the scope and scale of emerging public health threats.

A woman climbing a step ladder to flip a light switch embedded in a cloud

The challenge

The COVID-19 pandemic exposed significant gaps in our nation’s public health data infrastructure, revealing a widespread need to modernize antiquated, disconnected data systems. In particular, STLT public health agencies weren’t able to reliably process large influxes of COVID-19 case data, leading to issues with downstream disease detection, reporting, and investigation. Emerging public health threats like mpox continue to test the limits of STLT public health data infrastructure, as many legacy systems simply can’t scale fast enough to handle significant volumes of incoming case data.

To efficiently process ever-growing amounts of data, STLTs need to integrate modern digital services — like cloud hosting — into their data environment. With cloud hosting, STLTs can more flexibly acquire the computing infrastructure they need to modernize aging data systems or add new data management capabilities as needs evolve. It can also help them scale their infrastructure to handle the high volumes and intermittent flow of public health data, especially during a public health crisis.

While many STLTs recognize the need for transitioning to a robust and secure cloud environment, they often face obstacles to adoption. For example, they may lack the internal technical capacity to successfully migrate their data infrastructure to the cloud. Not only that, hosting cloud infrastructure isn’t free. Neither is the cost of maintaining these systems. Maintenance requires dedicated IT personnel and consistent funding, which aren’t always available. As a result, STLTs that want to leverage cloud hosting to scale and upgrade their data systems with modern software solutions are often stuck without the means to do so.

The solution

In support of the CDC and USDS Pandemic-Ready Interoperability Modernization Effort (PRIME), Skylight is working to enable STLTs with modern cloud hosting infrastructure. Through CDC’s centrally-hosted Azure cloud environment, STLTs can access our portfolio of cloud-based Data Integration Building Blocks (DIBBs) to modernize their data systems without the cost and maintenance burdens of having to host their own cloud infrastructure locally. CDC’s cloud environment follows the same security and privacy policies as other widely used, externally facing CDC applications like SimpleReport and ReportStream. Onboarding, updates, and scaling are quick and free.

While leveraging cloud infrastructure hosted by CDC offers a range of benefits (e.g., lower costs, fewer maintenance burdens), some jurisdictions face obstacles with regulatory compliance and data security. These STLTs may prefer a hybrid approach, leveraging aspects of a centrally-hosted cloud environment while maintaining other parts of their data infrastructure in a self-hosted environment. With a hybrid approach, STLTs can choose to manage how their data is fed to the centrally-hosted environment for processing — without CDC hosting or retaining the data. To enable these more flexible, hybrid options for hosting DIBBs infrastructure, we’ve leveraged Octopus Deploy, an industry-renowned deployment tool, that allows us to treat each STLT with the individuality it needs. For example, our software can go directly to STLTs with the proper permission and legal agreements, without the need for their IT departments to manually install updates.

For STLTs who would like full control over their infrastructure and to host DIBBs services directly, we’ve also created a series of Terraform templates. These templates, which are available in our open-source repository, allow STLT DevOps personnel to rapidly assemble a fresh cloud infrastructure from prewritten modules. We’ve also provided searchable documentation to make the process even easier.

By meeting STLTs where they’re at from a compliance or data security standpoint, our DIBBs hosting options move them a step closer to adopting cloud technology (either in their own cloud environment or in the centrally-hosted CDC environment). Ultimately, by providing flexible and accessible options for cloud hosting, we hope to enable resource-constrained STLTs with the tools to build modern, scalable disease surveillance infrastructure that can be used for both daily and emergent public health action.

The results

  • Successfully deployed DIBBs infrastructure to a centrally-hosted CDC cloud environment
  • Working with the CDC to make centrally-hosted DIBBs products available to interested STLT pilot partners
  • Onboarding four potential STLTs (Alabama, Idaho, Dallas, and Chicago) to pilot centrally-hosted DIBBs infrastructure
  • Rolled out a proof of concept deployment engine that would facilitate updates and improvements to DIBBs hosted locally by STLTs to cut down effort on IT staff for maintenance

Let’s deliver together.

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to deliver results in weeks, not years.