INFORMATICS
AIMS: Keeping Pace with a Changing Digital Health Ecosystem
By Melanie Kourbage, MA, PMP, lead specialist, Informatics
“ What do you think the future of the health technology ecosystem should look like?”
This was the question recently posed by the Centers for Medicare and Medicaid Services( CMS) and the Assistant Secretary for Technology and Policy( ASTP) through a request for information( RFI) released in May. CMS and ASTP sought input from various perspectives on health information technology( IT) and solicited ideas for how to shape the future direction of health technology.
The RFI specifically requested feedback from patients, providers, payers and technology developers, but notably not that of the public health community. This omission of public health voices is telling— and risky. Public health data inform population-level decisions that save lives during crises like pandemics or outbreaks and supports campaigns to combat chronic disease. In many cases, public health laboratory testing plays a key role in individual patient care as well as treatment. A more future-forward health IT ecosystem should make public health not just a recipient of data but a key architect in how systems are built and governed.
Making Public Health a Priority
The omission of public health from the list of parties utilizing health IT underscores a deeper reality: public health data are often not a priority for health IT developers. Their primary focus is, understandably, on enabling clinical care, supporting payer workflows and ensuring patient data flow smoothly across care settings. But public health data play a different yet equally critical role, which is why a dedicated intermediary— one designed specifically to support the interoperable movement of public health data— is needed.
The APHL Informatics Messaging Services( AIMS) Platform has been securely transporting millions of messages daily for use cases that span the full spectrum of public health data exchange for over two decades. But AIMS continues to evolve with the digital health ecosystem and is helping jurisdictions meet new interoperability and data exchange challenges. AIMS is ahead of the curve on the Trusted Exchange Framework and Common Agreement( TEFCA), helping public health agencies become early adopters. While hospitals are still onboarding to qualified health information networks( QHINs), AIMS has already established connections to 70 + state, local and territorial public health agencies and currently supports 55 agencies in receiving electronic case reporting( eCR) via the eHealth Exchange QHIN, one of the first examples of public health data in production through TEFCA. AIMS processes 2.25 million eCR documents via TEFCA each month.
Crucially, through APHL’ s collaboration with eHealth Exchange, as TEFCA finalizes sub-exchange purposes for other use cases, AIMS is positioned to seamlessly transition additional data feeds, such as electronic laboratory report( ELR), syndromic surveillance, electronic laboratory surveillance messages( ELSM), case notification messages, cancer reporting, vital records, immunization data and electronic test orders and results( ETOR) to TEFCA for its data exchange partners.
AIMS is also building its fast healthcare interoperability resources( FHIR) capabilities and has partnered with Deloitte and the Florida Department of Health to conduct a pilot project to run a FHIR query to retrieve missing patient demographic data from an electronic health record.
A Robust Solution with a Strong Foundation
Despite current uncertainties surrounding public health, there is a strong foundation being built for the future. AIMS can support a streamlined public health system with consolidated and centralized services. For example, the CDC Data Integration Building Blocks( DIBBs) team is working with APHL to launch its eCR Refiner tool as a centralized service on AIMS to“ refine” eCR messages and surface the relevant data before they are received by public health. Hosting,
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32 LAB MATTERS Fall 2025 PublicHealthLabs @ APHL. org
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