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INFORMATICS
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improvements and identify additional savings opportunities. Every system component came under scrutiny.
One way that APHL has reduced costs and overhead is by leveraging cloud native services where possible. For example, a fully managed, scalable service is now used( AWS Transfer Family) that reduces the maintenance burden, and cloud governance solutions and rules are being implemented to reduce overhead on APHL
Another major milestone was completing the Mirth Resilience project. While the primary goal was improving performance, resource utilization, and scalability within the electronic case reporting architecture, an additional benefit emerged: message processing and storage efficiencies that correlated to significant AWS cost reductions. Even after only one month in production, these cost savings were apparent in the monthly invoices.
The results speak for themselves. Current cost-saving efforts have resulted in approximately $ 258,000 per month in reductions. It is important to note that savings don ' t always show up as a direct one-to-one drop in monthly invoices— sometimes unused resources are removed only to add resources for another workload. But the net effect remains a positive reduction.
Looking Ahead: The Volume Challenge
Cost stabilization doesn ' t mean the work is done. APHL is already exploring the next frontier: reducing the volume of eCR messages themselves. A significant portion of what healthcare organizations currently send to AIMS cannot be used by public health agencies. These non-reportable eICRs still require processing and routing, which drive costs.
Several enhancement strategies are under consideration. One straightforward approach would remove high-volume conditions that produce substantial electronic case reporting loads but have minimal or no Reportable Condition Knowledge Management System( RCKMS) authoring by public health agencies. Malignant neoplastic disease represents one such condition. The impact could be substantial: filtering these non-reportable cases could result in an estimated 25 to 30 percent volume reduction, with corresponding operational savings from reduced ingestion, processing and routing.
A Platform for the Future
This stabilization work positions AIMS to support public health through funding uncertainties while preparing for the platform ' s next evolution. APHL is constantly looking ahead, seeking partners throughout the health IT ecosystem to develop and pilot new use cases for TEFCA, FHIR and the CMS Interoperability Framework. Through this innovation, AIMS will be ready when public health needs reliable data exchange solutions.
The pandemic proved that public health infrastructure can scale rapidly to meet unprecedented challenges. The AIMS stabilization initiative proves something equally important: that careful stewardship and strategic thinking can ensure those systems remain sustainable for the long haul. As public health faces an uncertain funding landscape, this kind of financial discipline will be essential to maintaining the critical services the nation depends on. g
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intelligence( AI) or new data sharing models like the Trusted Exchange Framework and Common Agreement( TEFCA). Without adequate preparation, public health laboratories risk falling behind as these innovations reshape the field.
These challenges and opportunities create an opening for collaborative solutions that the Data Modernization Subcommittee was designed to facilitate. Rather than each laboratory developing solutions in isolation, public health laboratories expressed strong interest in collective approaches, whether through shared software platforms, common data standards or hands-on technical assistance. By fostering this collaboration and promoting innovative technologies, the subcommittee aims to help laboratories leverage advanced analytics to safeguard the public and improve patient outcomes. In an interconnected health ecosystem, no laboratory modernizes alone— and the Data Modernization Subcommittee stands ready to facilitate collective progress.
For more information about APHL ' s Data Modernization Subcommittee or to access resources for your laboratory ' s modernization efforts, visit aphl. org or contact the APHL Informatics team. g
36 LAB MATTERS Spring 2026 PublicHealthLabs @ APHL. org
APHL. org