DMI

SNAPSHOT

BUILDING 

A STRONG 

FOUNDATION

CDC‚S DATA 

MODERNIZATION 

INITIATIVE 

CS319521-AE

 2021
CDC’s Data Modernization Initiative (DMI)

is the first unified, comprehensive effort 

to modernize core data and surveillance 

capabilities across the federal and state 

public health landscape. While it is 

impossible to capture the complete scope 

of our work, the following report delivers 

a snapshot of progress made in 2021. 

Since the start of the pandemic, CDC and 

our partners have been responding in 

ways that will make our data timelier, 

more complete, more accessible, and 

more usable for COVID-19 and beyond. 

Behind these accomplishments are many 

thousands of people who have worked 

tirelessly over these long months to 

modernize public health surveillance and 

data in meaningful and lasting ways. 

“The COVID-19 pandemic has created both the greatest need and the 

greatest opportunity we have ever had to modernize public health.”

- DANIEL JERNIGAN, MD, MPH, DEPUTY DIRECTOR FOR PUBLIC HEALTH SCIENCE AND SURVEILLANCE AT CDC
WHY MODERNIZING 

PUBLIC HEALTH DATA MATTERS

The COVID-19 pandemic has underscored 

the need for a high-speed, modernized public 

health data infrastructure. When people’s lives 

are on the line, connected and integrated data 

help us put the pieces together faster and take 

action to protect health. 

Years of underinvestment in public health 

have led to systems that are siloed, outdated, 

and incompatible, and data that are delayed 

and incomplete. One result is that many places 

in America are underserved by public health. 

We must use the lessons learned in this 

moment to create systems that will help us 

respond to both infectious and non-infectious 

threats—and improve the health of all people. 

WHAT WE’RE DOING

We continue to answer the demands of the 

pandemic while making our data ready for 

whatever comes next. 

At the federal 

level... 

We’re unifying our data 

at CDC and supporting 

policies that make data 

sharing easier.

At the state and 

local level...

We’re building up our 

public health workforce 

and strengthening 

connections for timelier, 

more accurate data.

For the public...

We’re supporting equitable 

health and providing more 

real-time data for decisions.
MODERN

IN 2021, 

DMI MADE STRIDES 

ON FIVE KEY 

PRIORITY ACTIONS
DMI1 Building the right foundation

2 Accelerating data into action

3 Developing a state-of-the-art workforce

4 Supporting and extending partnerships

5 Managing change and governance

Taken from the DMI Strategic Implementation Plan: 

https://www.cdc.gov/surveillance/pdfs/FINAL-DMI-Implementation-Strategic-Plan-12-22-21.pdf
1 BUILDING THE RIGHT FOUNDATION

In 2021, we improved data collection, analysis, and sharing at CDC and 

focused on a set of core public health surveillance systems that are used 

for all diseases and conditions.

REAL-TIME DATA COLLECTION >

We created new pathways for surveillance data to flow seamlessly between 

jurisdictions and CDC, collected more demographic data, and increased the 

number of laboratories and health departments who are connected. 

CLOUD-BASED SERVICES >

We moved more of CDC’s data securely into the cloud to streamline 

the way we process, store, visualize, and share it. 

AUTOMATION > 

We automated more data from critical sources like electronic health 

records and death certificates to allow hospitals and other data 

providers to begin “turning off their fax machines.” 

STATE AND LOCAL CAPABILITIES > 

We answered state, local, tribal, and territorial needs through a mix 

of funding and technical support, and by identifying dedicated data 

modernization leads in every jurisdiction. 

DID YOU KNOW?

Core systems include 

systems that conduct 

surveillance for:

CASES AND 

ILLNESSES

DEATHS

LABORATORY

TEST RESULTS

IMMUNIZATIONS

MOVING THE DIAL

1.5M

Per day

COVID Electronic Laboratory

Reporting (CELR) opened a new 

pathway for test results to flow 

directly from jurisdictions to CDC. 

By late 2021, this system was 

delivering more than 1.5 million 

results per day, alerting public health 

to changing disease levels and the 

areas and populations most affected. 

$6.5M

Saved

In its first year of operation, CDC’s 

new cloud-based enterprise data, analytics, 

and visualization (EDAV) platform saved 

CDC millions by offering a single, reusable 

platform that programs can use instead 

of building individual systems, while 

also allowing our scientists to catalogue, 

analyze, and publish findings faster than 

previously possible. 

187>>10,200

Facilities

Through CDC’s massive expansion 

of electronic case reporting (eCR), 

by the end of 2021, more than 10,200 

healthcare facilities in all 50 states 

were sending case information from 

their electronic health records to state 

and local health departments, up from 

just 187 before the pandemic. 
2 ACCELERATING DATA INTO ACTION

In 2021, we tapped into more data sources, promoted health equity, and increased capacities for scalable 

outbreak response, forecasting, and predictive analytics.

Deeper insights

HEALTH EQUITY > We continued bridging the

gap between the data we have now and the data 

we need to fully understand and address the 

drivers of health disparities.

DATA LINKAGE > We combined traditional 

surveillance data with non-traditional data, such as 

geospatial, social vulnerability, and administrative 

data, to uncover disease impacts.

Fast and secure connections

INTEROPERABILITY > We continued working 

toward shared data standards, such as FHIR, that 

connect previously disconnected data systems and 

created hubs for rapid, bidirectional data exchange.

PRIVACY AND SECURITY > We used 

new Privacy Preserving Record Linkage (PPRL) 

technology to keep personal information protected 

and to safely link and share health data.

Sharing more

OPEN DATA > We provided more data directly 

to the public and to researchers for faster insights 

on COVID-19, health equity and other priorities.

COMMON OPERATING PICTURE > We built 

updated platforms that bring trusted, real-time data 

together in one place for easier analysis during an 

outbreak or other public health emergency.

Flexibility for the future

SCALABLE EMERGENCY RESPONSE >

We increased the use of systems that can be 

rapidly scaled-up when needed, so that the same 

system can be used for 300 or 3 million cases. 

FORECASTING & OUTBREAK ANALYTICS > 

We stood up a new National Center for Forecasting 

and Outbreak Analytics that will allow us to predict, 

inform, and innovate to fight any disease. 

MOVING THE DIAL

1M+

Genome 

Sequences

CDC began expanding its platform 

for multiple respiratory illness 

surveillance in ways that will 

better prepare us for the next big 

outbreak, including new cloud and 

computational capabilities that can 

easily handle millions of unique SARSCoV-2 genome sequences.

509M 

Records

In 2021, CDC’s new immunization data 

lake tracked and enabled analysis

of more types of data, expanded 

vaccine effectiveness data through 

the use of electronic health records, 

and processed more than 509 million 

unique vaccine administration records.

1,444

Data Sets

CDC continued to expand open 

data with 1,444 new data sets created 

and accessed on data.cdc.gov as of 

late 2021 — a 37% increase from the 

middle of 2020.
DID YOU KNOW?

In 2021, CDC worked in close concert 

with state, local, tribal, and territorial 

partners to harmonize how important 

data are captured and shared between 

healthcare and public health. 

One result is that data elements like 

pregnancy status, disability status, 

occupation, tribal status, and date of 

death have been prioritized for inclusion in version three of the U.S. Core 

Data for Interoperability (USCDI) — an 

important first step toward ensuring 

that all levels of public health can 

more easily access and exchange the 

data they need to do their work and 

show the impact of that work. 

Months to Weeks 

CDC has shortened the time to release 

preliminary mortality estimates from months 

to just weeks. For the first time in 2021, these 

estimates were released on CDC WONDER, 

advancing near-real time surveillance while 

expanding access to death data that addresses 

critical public health needs.
3 DEVELOPING A 

STATE-OF-THE-ART WORKFORCE

In 2021, we prioritized building a data-savvy workforce, improving our nation’s ability 

to use next-generation skills for actionable public health insights.

RECRUITMENT >

We worked to attract a diverse, qualified public health science workforce. 

TRAINING >

We continued building the skills of the current and future workforce 

through team-based programs and career entry fellowships. 

FORECASTING FUTURE NEEDS >

We modernized and expanded the use of public health workforce data. 

STATE AND LOCAL SUPPORT >

We supported our state and local partners to build a public health 

workforce that represents the communities in which they work.

MOVING THE DIAL

2,500+ 

Hours

Housed within CDC’s new cloud-based 

platform, CDC’s Data Academy provided 

more than 2,500 hours of training 

designed to help our workforce build 

state-of-the-art data science skills.

20 

Teams

CDC funded the Council of State and 

Territorial Epidemiologists (CSTE) to 

implement Data Science Team Training

in January 2021. The first cohort of 20 

teams (93 learners) represented a mix 

of state, local, tribal, and territorial 

health departments.

$3B

Grant

CDC is making a major investment in 

expanding, training, and sustaining the 

public health workforce of tomorrow 

as part of a new $3 billion American 

Rescue Plan grant to help states 

and territories.
4 SUPPORTING AND 

EXTENDING PARTNERSHIPS 

In 2021, we worked closely with state, local, tribal, and territorial partners, as well as with healthcare 

and private industry, to ensure transparency, address policy challenges, and solve problems together.

POLICIES > We worked across the federal government and with partners on 

policies that support the exchange and use of data between CDC, jurisdictions, 

partners, and data providers.

ACCESS > We increased access to our data modernization plans and progress 

to increase participation and alignment. 

DATA USE AGREEMENTS > We increased the use of standardized data use 

agreements, allowing jurisdictions and partners to seamlessly access more than 

1,300 datasets that enable research and inform decision making nationwide.

COLLABORATION > We worked with research and academic partners on 

innovative projects that streamline information flow, reduce burden on data 

providers, and accelerate data from the local to the federal level.

MOVING THE DIAL

64 

Jurisdictions 

CDC worked closely with 

public health partners 

including ASTHO, CSTE, 

NACCHO, and NAPHSIS

to coordinate efforts and 

support nationwide policies 

for data sharing across 64 

public health jurisdictions. 

$200M 

Support 

In August 2021, CDC 

awarded $200M from 

the CARES Act to eligible 

state, territorial, and local 

public jurisdictions to 

build foundational data 

capabilities, accelerate 

electronic case reporting, 

and modernize vital 

statistics systems. 

25+ 

Launches 

As part of the PandemicReady Interoperability 

Modernization Effort (PRIME), 

CDC and the U.S. Digital 

Service launched innovative 

COVID test reporting 

solutions in more than 25 

states and territories.

29 

Measures 

In December 2021, CDC 

released the first data update 

for PLACES, a collaboration 

between CDC, the Robert 

Wood Johnson Foundation, 

and CDC Foundation that 

uses small area estimates 

to better understand 29 key 

measures of chronic disease 

and social vulnerability at the 

very local level. 
5 MANAGING CHANGE AND GOVERNANCE 

In 2021, we ensured that resources were used wisely, monitored our progress and 

accountability, and supported strategic innovation for new ways of thinking and working.

GOVERNANCE > We enhanced our ability to approve strategic and 

efficient IT and data investments at CDC, aiding adoption of unified 

technology, data, and data products.

MONITORING AND EVALUATION > We measured progress on a 

growing suite of investments that touch nearly every part of the public 

health ecosystem.

PROCUREMENT > We began making acquisition processes more 

efficient and effective to allow CDC and its partners to get timely and 

flexible resources.

CHANGE MANAGEMENT > We encouraged a culture of innovation, 

collaboration, inclusion, and adaptability among CDC and its partners.

DMI is building 

bridges to more 

partners than

ever before. 

MOVING THE DIAL 

$16M 

Saved 

Unified IT and Data Governance has 

saved CDC approximately $16 million 

by preventing the creation of duplicative 

systems and connecting programs to 

existing systems that meet their needs.

2x 

Innovation 

Teams 

CDC and Georgia Tech Research 

Institute (GTRI) applied innovative 

approaches to common public health 

data challenges, more than doubling 

the number of project teams as of 2021.

60 

Projects 

CDC is monitoring 60 DMI projects 

and 232 activities through the Data 

Modernization Initiative Evaluation 

Hub, ensuring accountability for 

our investments and allowing for 

continuous improvement.
Where we’re headed

During the second year of the COVID-19 

response, we showed that modernization 

is possible, that these capabilities are 

within reach, and—importantly—that we 

know how to get there. We must now apply 

the lessons learned in ways that help us 

address longstanding issues like health 

equity and prepare our nation for the next 

infectious or non-infectious threat.

The Data Modernization Initiative Strategic 

Implementation Plan lays out our key priorities 

and objectives for reaching the future state of 

public health data. In 2022, we will focus on 

connecting more formally with our external 

partners and on developing a “north star” data 

architecture that will allow information to flow 

more seamlessly between CDC and our state, 

local, tribal, and territorial partners. 

We will also focus on the policies that guide 

how data are shared across public health. For 

example, we are looking at how we will move 

beyond the public health emergency in ways that 

break down silos, strive for disease-agnostic 

approaches, and apply common standards to 

make more data available across the multitude 

of systems our nation relies on for answers. 

BEYOND OUTBREAKS: 

Modernizing non-infectious disease 

data Modernization is not just for 

outbreaks and pandemics. Better 

data on non-infectious diseases and 

conditions — birth defects, cancer, 

opioids, suicides, and more — are 

critical to our nation’s wellbeing. 

WHAT WE’VE LEARNED FROM

OUR EXPERIENCE IS THAT:

Data modernization is integrative.

Electronic, automated data is an important first step 

toward creating a true and complete picture of health 

in America, but there is much more to be done in 

terms of bringing together information for action. 

Only when the right policies and agreements are in 

place, when data can flow seamlessly through our 

systems, and when many data sources can be brought 

together quickly and easily will we begin to truly have 

the insights we need. We must also bring public health 

and healthcare together so that we are working as one 

public health community. 

Data modernization is iterative.

There is not one single solution or technology that will 

solve the longstanding problems faced by public health. 

What data modernization must offer are building blocks 

that we can improve upon as we go. We need tools 

that are flexible and scalable to handle the multitude 

of challenges we face today and capable of changing in 

response to an uncertain future. We need to recognize 

that modernization is not a one-time event, but a 

willingness to continue taking on the hard problems and 

challenging ourselves to do better. 

Data modernization is innovative. 

Driving all this work forward is a vision of what public 

health can and should be: cutting-edge, high-speed, 

and nimble in the face of change. We will need to 

think beyond fixing gaps and catching up if we are 

to realize the true possibilities of our data. Through 

modernization, we envision a future in which public 

health is not only “response-ready” but also more 

equitable and better at promoting meaningful wellness 

for all people in America.