INFORMATICS
Behind the Data Curtain
by Rachel Shepherd, specialist, Informatics
Right now, the whole world can see
the power of data. The public has
been scouring headlines for months,
monitoring charts, graphs and statistics
on a daily basis, trying to comprehend the
lay of the land. Leaders are reviewing that
same data to hopefully make informed
decisions about what activities can be
resumed, and how much of life should
stay on hold.
But think for a moment about what must
happen behind the scenes for data to
be so readily available, accessible and
informative. When a public health crisis
like COVID-19 strikes, laboratories not
only have to quickly develop the ability
to test for a new pathogen, but they must
put in place the technical infrastructure
required to send and receive testing
data, and they must develop and use
a common language to communicate
information. Without that, there could
be no comprehensive response or
strategy. Without that, there could be no
understanding.
For the last decade, APHL has been
developing informatics infrastructure,
strategies, and approaches to prepare for
this moment.
The Infrastructure
APHL built the APHL Informatics
Messaging Services (AIMS) Platform in
2008 as a messaging service for public
health laboratories and agencies to
transmit their influenza results to
the US Centers for Disease Control and
Prevention (CDC) for surveillance. Over
time, AIMS went from having a handful
of laboratories signed on to establishing
connections with every state in the
country, ultimately sending data for
dozens of use cases beyond flu.
Today, most of the nation’s public health
network—more than 200 public health
laboratories and agencies, clinical and
commercial labs, hospitals and medical
providers, and federal agencies—uses
AIMS to exchange critical health data.
So when the whole country needed a
standardized way to report and share
data with CDC, nothing had to be built.
The infrastructure has been in place and
growing, connecting all of public health
for more than a decade.
The People
Since 2008, APHL has delivered technical
assistance (TA) to public health
laboratories and agencies to strengthen
technical infrastructure, improve data
management capabilities and implement
new data exchanges. APHL’s TA team is
comprised of APHL staff as well as a team
of up to 30 consultants across several
organizations—from technical architects
to terminologists to business analysts.
To date, APHL has provided assistance in
some capacity to every state public health
laboratory and nearly every state health
agency, as well as many local public
health laboratories and clinical partners.
Today, nearly all of the nation’s
COVID-19 testing data is routed
through AIMS to CDC. These
data are analyzed and visualized
for surveillance to provide a
real-time snapshot of the testing
landscape nationwide.
By design, the TA program functions as an
expandable and contractible unit. It scales
back when there is less need, but there
is a pool of resources to draw from and
dispatch when there is a greater volume
of work. When the TA team had to ramp
up quickly for the COVID-19 response,
they were able to do so at record speed.
Not only was the physical infrastructure
(AIMS) already in place, but the human
infrastructure was ready to deploy.
Terminologists worked with standards
development organizations to determine
a set of vocabulary specific to COVID-19
testing, and then worked with each
laboratory to ensure that everyone was
communicating the same information in
the same way. Technical architects worked
with each laboratory to reconfigure
routes and data feeds. Business analysts
and project managers pulled together
resources and people, set deadlines and
goals, and moved each laboratory through
the onboarding process.
The TA team was able to draw on longstanding
relationships with public health
partners and within one month, worked
directly with 58 public health laboratories
to generate messages and successfully
route data to CDC. Under normal
circumstances, this easily could have
taken well over a year to accomplish.
Today, nearly all of the nation’s COVID-19
testing data is routed through AIMS
to CDC. These data are analyzed and
visualized for surveillance to provide
a real-time snapshot of the testing
landscape nationwide. These data are also
used to inform decisions and to provide
potentially life-saving guidance to the
public. It is because of the people behind
the scenes who make the data fly that we
are able to see what is happening. •
PublicHealthLabs
@APHL
APHL.org
Summer 2020 LAB MATTERS 25