INFORMATICS
The Results Are In! Data Modernization at Public Health Laboratories Is a Work in Progress
By Melanie Kourbage, lead specialist, Informatics
Data modernization has been the key focus of public health departments since the US Centers for Disease Control and Prevention( CDC) launched the Data Modernization Initiative in 2019. But that focus has been on areas of public health outside of the laboratory. Therefore, when the APHL Data Modernization Subcommittee launched in January 2025, its first order of business was to understand where public health laboratories stand in their data modernization journeys. The resulting nationwide survey of chief informatics officers, interoperability coordinators and informatics program managers revealed a landscape of both persistent challenges and emerging opportunities and a clear path forward for collaborative action.
The key finding? You are not alone. Public health laboratories across the nation face similar challenges and share remarkably similar priorities. Top priorities centered on integration and interoperability: developing fully integrated public health data ecosystems connecting sequencing and analytical activities, creating interoperable networks for laboratory instruments and laboratory information management systems( LIMS), and establishing robust electronic test order and results( ETOR) intermediaries.
Similar Priorities … and Challenges
While 73 % of laboratories report being at least somewhat on track to meet their data modernization goals, the roadblocks they face are substantial( Figure 1). Unsurprisingly, laboratories reported that workforce capacity and funding concerns are their main challenges, followed by the limitations of legacy systems. Data modernization isn ' t simply a technical upgrade; it is an evolution requiring sustained investment in both technology and people.
Despite these hurdles, public health laboratories are moving forward with remarkable consistency( Figure 2). The most common data modernization
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No Current DM Projects Unsure Other
Data Governance Strategy Cloud Migration
Data Lake or Data Warehouse System Assessment System Replacement
Data Exchange / Data Sharing Instrument Interfacing
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projects include instrument interfacing, data exchange and interoperability initiatives, and LIMS assessment and replacement, with most laboratories managing multiple projects simultaneously. Instrument interfacing is an ongoing effort, with laboratories interfacing one device at a time and often juggling multiple solutions to integrate the dozens of instruments in
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Figure 2. Data Modernization Projects in Progress at Public Health Laboratories.
17 %
Figure 1. Roadblocks Impeding Data Modernization Goals.
Instrument Interfacing Data Exchange / Data Sharing System Replacement System Assessment Data Lake or Data Warehouse Cloud Migration Data Governance Strategy Other Unsure No Current DM Projects
their networks. Many laboratories are working with LIMS that are outdated and unable to meet the demands of emerging interoperability and data sharing standards. Yet replacing these systems represents a multimillion-dollar investment that can span years, with significant implementation risks if not approached strategically.
Many laboratories are also building new data management architectures in the cloud— data lakes and data warehouses paired with robust data governance frameworks. These initiatives are often enterprise-wide efforts led by and integrated with other programs across the broader public health agency.
Facilitating Solutions
The survey revealed significant commonalities, both in what laboratories are tackling and in what they are not ready to tackle. Few laboratories feel prepared for emerging technologies like the HL7 Fast Healthcare Interoperability Resources specification( FHIR), artificial
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