At a glance
Goal 1: Strengthen the core of public health data
Ensure that core data sources are more complete, timely, rapidly exchanged and available to support the integrated ability to detect, monitor, investigate and respond to public health threats.
Core data:
- Is essential for multiple purposes, every day and during emergencies.
- Covers multiple, if not all, diseases and conditions.
- Is critical for detecting and forecasting threats, understanding burden and monitoring trends.
- Combines easily with other data to provide new insights for informing action.
The current PHDS identifies the following as core data sources: case, laboratory, emergency department (ED) visits, vital statistics, immunization, healthcare capacity and wastewater data. The list of core data sources will continue to evolve as new sources become available.
In 2025-26, Goal 1 focuses on these key priorities:
- Expand breadth of data shared from health care while decreasing the burden of exchange.
- Improve the efficiency of data submissions from state, tribal, local and territorial (STLT) senders.
1.01 — Expand real-time access to ED visit data.
Expands the geographic coverage and enables more comprehensive situational awareness and early detection of emerging and ongoing public health threats. Learn more about the National Syndromic Surveillance Program (NSSP).
2025: CDC is receiving data on at least 90% of ED visits from 41 states and the District of Columbia (D.C.) and at least two territories. For the rest of the states, CDC is receiving 50% of the ED visits.
2026: CDC is receiving data on at least 90% of ED visits from 45 states and D.C. and at least four territories. For the rest of the states, CDC is receiving 65% of ED visits.
1.02 — Faster access to in-patient hospitalization data.
Automated hospitalization data feeds enable faster situational awareness and improved understanding of severity of disease burden across the nation. Learn more about NSSP.
2025: CDC is receiving data on at least 60% of in-patient hospitalizations from six states and D.C.
2026: CDC is receiving data on at least 60% of in-patient hospitalizations from ten states and D.C.
1.03 — Automated hospital bed capacity reporting.
Reduces reporting burden on hospitals and STLT partners and enables more accurate and timely tracking of hospital bed capacity. Learn more about the National Healthcare Safety Network (NHSN).
2025: At least 40% of Epidemiology and Laboratory Capacity (ELC)-funded jurisdictions have established an automated data feed and are submitting near-real time hospital bed capacity data to CDC (with goal of 100% by end of 2027).
2026: At least 60% of ELC-funded jurisdictions have established an automated data feed and are submitting near-real time hospital bed capacity data to CDC (with goal of 100% by end of 2027).
1.04 — Electronic case reporting (eCR) reduces manual reporting from health care.
Increases timeliness and efficiency of receiving critical reports and enables STLTs to phase out requiring manual reports from health care.
2025: Facilitate improved integration of eCR into STLT systems through tools, standards and guidance, enabling phasing out manual reporting from health care. 60% of public health authorities that are processing eCR data into their surveillance systems share a plan to each year turn off manual reporting for at least one condition from at least 10% of jurisdiction healthcare facilities submitting eCR.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
1.05 — Expand the use of eCR for chronic conditions.
Enables faster detection of chronic conditions at STLT and national levels to enhance situational awareness.
2025: Pilot at least one use case for the existing data exchange between health care and public health to enhance situational awareness for non-infectious, occupational or chronic conditions.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
1.06 — eCR for tribal nations.
Improves completeness and timeliness of case data available to tribal nations and Tribal Epidemiology Centers (TECs) for situational awareness.
2025: At least six tribal nations are receiving eCR data directly or through TECs.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
1.07 — eCR rural expansion.
Enables faster detection of anomalies in health status among rural communities at the STLT and national levels.
2025: Critical Access Hospitals (CAHs) in production with eCR increased to 50%.
2026: CAHs in production with eCR increased to 65%.
1.08 — Shut down outdated case data exchange methods.
Enables STLT data senders to discontinue using cumbersome data exchange methods and switch to streamlined, preferred methods instead.
2025: Publish alternative, improved submission methods for all data submissions currently sent to CDC in outdated formats and transports, such as NETSS (National Electronic Telecommunications System for Surveillance ) and PHINMS (Public Health Information Network Messaging System). This will enable any STLT interested in switching data submission methods to do so.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
1.09 — Sustainable and flexible case data transmission methods.
Reduces burden and increases timeliness and use of data. This milestone builds on 2024 advancements defining Minimal Data Necessary (MDN) for response (2024 Milestone 4.03).
2025: Consolidate existing case data standards into a singular case data standard for both routine and response. Pilot the new case data standard end-to-end with at least five STLTs and two CDC programs.
2026: Expand adoption of improved data transmission methods. Targets to be updated in 2026 based on pilot results, partner feedback and funding levels.
1.10 — Expanded and timely collection of wastewater results.
Enables faster detection of emerging public health threats. Learn more about the National Wastewater Surveillance System (NWSS).
2025: Out of all states and D.C., at least 35% are submitting SARS-CoV-2 wastewater results to CDC. The results are for at least 80% of samples and are submitted within 7 days of collection.
2026: Out of all states and D.C., at least 45% are submitting SARC-CoV-2 wastewater results to CDC for at least 80% of samples and are submitted within 7 days of collection.
1.11 — Expanded exchange of mortality data using FHIR®.A
Supports faster sharing of mortality data, which can enable more robust national-level situational awareness. Learn more about the National Vital Statistics System (NVSS) and Fast Healthcare Interoperability Resources (FHIR).
2025: Implement FHIR-based exchange of mortality data between CDC and 12 additional jurisdictions, up from 12 jurisdictions in 2024.
2026: Implement FHIR-based exchange of mortality data between CDC and 33% of remaining jurisdictions.
1.12 — Expanded public health laboratory data exchange.
Enables laboratories to share test results faster with facilities and public health authorities.
2025: All CDC infectious disease laboratories are sending laboratory test results to state public health laboratories and health departments via electronic laboratory reporting (ELR). 75% of state public health laboratories and health departments are able to accept ELR from CDC infectious disease laboratories.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
Goal 2: Accelerate access to analytic and automated solutions to support public health investigations and advance opportunities for all people to attain their highest level of health
Provide tools for STLTs and other decision-makers that enable better use of public health data to address health threats and preventable differences in health outcomes.
At the STLT level, there is a need for tools and systems that are sustainable, secure, scalable, adaptable and interoperable. That requires flexible, modern infrastructure and shared standards. The PHDS milestones showcase CDC tools that directly serve STLTs and provide standards and best practices for the broader ecosystem.
At the national level, the One CDC Data Platform (1CDP) will allow public health experts to make informed decisions and take action without spending hours manually compiling data across siloed systems. The vision is to create an integrated, scalable and secure data ecosystem that enables CDC and STLTs to prepare for, detect and respond to public health threats with unprecedented speed, accuracy and efficiency.
Beyond PHDS milestones, CDC supports STLT capabilities through funding, guidance and collaboration.
In 2025-26, Goal 2 focuses on these key priorities:
- Strengthen STLT capacity to receive, use and share data.
- Advance data use and integration capabilities.
- Appropriately and responsibly leverage artificial intelligence (AI) at scale.
2.01 — Faster time to threat detection by reducing manual burden for end user activities associated with receiving, processing or using healthcare data.
Reduces STLT manual burden to ingest and harmonize disparate data streams for disease surveillance.
2025: By end of 2025, reduce the reliance on manual processes in STLT public health agencies by 30% through the implementation of Data Integration Building Blocks (DIBBs) automated data solutions, as measured against a baseline assessment of current manual processes.
2026: Adoption of at least one DIBBs product by more than 30% of STLTs, increasing national access to high-quality, standardized public health data.
2.02 — Modernized integrated disease surveillance system to better receive, use and share data.
Improves STLT integrated disease surveillance systems. Reduces STLT overhead to coordinate hosting and management of CDC-provided disease surveillance systems.
2025: National Electronic Disease Surveillance System Base System (NBS), an open-source CDC-provided disease surveillance system, will double ELR and eCR processing speed so users will have access to 100% of inbound data in near real time. Additionally, users will have ready access to eight times more case data ensuring STLTs have timely and comprehensive insights to track trends, allocate resources and respond to public health threats. These improvements will be available in an updated, cloud-based version of NBS and five jurisdictions will adopt it. Learn more about the National Electronic Disease Surveillance System.
2026: Adoption of the updated version of NBS by 40% of jurisdictions currently on legacy NBS version. The updated version provides ready access to all case data and supports all data transmission protocols to CDC.
2.03 — Expand the ability for STLTs to receive data from frontlines.
Broadens the scope and completeness of available data by targeting data collection from reporters who are not connected to existing modernization efforts.
2025: Increase the number of top reportable public health conditions supported by SimpleReport to 15.
2026: Availability of SimpleReport nationwide, accepting a wide variety of data elements via multiple data formats for reportable conditions and other types of biosurveillance information.
2.04 — Access to core data sources and core capabilities on a central platform.
Establish a central platform, 1CDP, to support both routine public health surveillance and emergency response needs with speed, efficiency and transparency. Support core public health missions such as early detection, trend monitoring, outbreak response and information dissemination.
2025: 1CDP users (CDC programs, STLTs and federal partners) have access to at least three core data sources (ED, lab and case) and five reusable tools through the platform.
2026: 1CDP users (CDC programs, STLTs and federal partners) have access to at least five core data sources and 10 reusable tools through the platform.
2.05 — 1CDP Partner Workspace.
Enables state, tribal, local, territorial and federal partners to benefit from data assets, core capabilities and cutting-edge innovation developed at CDC.
2025: CDC will launch a shared workspace for authorized users from STLTs, federal and other partners to securely collaborate and access data, tools, services and insights, increasing data access, quality and trust. In 2025, CDC will launch a Minimum Viable Product version with key partners.
2026: In 2026, CDC will expand access to more partners and continue to iteratively expand and improve available functionality.
2.06 — Expand use of comprehensive healthcare data.
Expanding the use of CDC's robust portfolio of electronic health record and administrative healthcare data can inform timely and effective public health action, including for emergency response.
2025: Release at least five new analytic capabilities or automated data products for identifying, monitoring or characterizing public health threats using CDC's healthcare data portfolio.
2026: Make available in the 1CDP Partner Workspace at least two data products derived from CDC's healthcare data portfolio to provide timely and localized situational awareness to STLT partners.
2.07 — Combine core data sources to improve integrated surveillance.
Leverages foundational infrastructure improvements on 1CDP that enable easy data access, integration and reusability and ultimately lead to simplified data exchange.
2025: Deploy at least three CDC operational dashboards combining multiple core data sources, such as case and wastewater, and leverage reusable analytical components.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
2.08 — Expand non-medical data elements in data products
Enables STLTs and CDC programs to better identify barriers that may impede individuals from the opportunity to attain their highest level of health and address these through more tailored and cost-efficient public health action.
2025: 50% of CDC centers will have expanded the number of data elements related to non-medical factors that influence health outcomes in reports/visualizations they release.
2026: 75% of CDC centers will have expanded the number of data elements related to non-medical factors that influence health outcomes in reports/visualizations they release.
2.09 — Scale AI services.
CDC appropriately and responsibly uses AI to improve public health efficiency, response readiness and outcomes.
2025: Define and scale shared AI capabilities within 1CDP by building off learnings and successes of the 2024 AI use cases.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
Goal 3: Visualize and share insights to inform public health action
Serve as a trusted source for near real-time visualizations and offer situational awareness for the public and decision-makers to understand risks, make decisions and direct resources.
The PHDS advances open and effective data dissemination by promoting accessible, repeatable and scalable technical capabilities across CDC and STLTs. Through 1CDP, CDC will enable transparent nationwide sharing of actionable public health insights with partners and the public. This approach is intended to transform data accessibility, empowering stakeholders with timely, comprehensive information.
In 2025-26, Goal 3 focuses on these key priorities:
- Improve ability for CDC, STLT and federal partners to visualize data for shared situational awareness and decision-making.
- Enhance CDC's ability to deliver timely, actionable data to the public.
3.01 — Streamline CDC agency-level communication with STLTs on data dissemination
Increases consistency of data shared by CDC and STLTs by enabling partners to see a common operating picture before data are disseminated. Improves transparency and speed of communication.
2025: Develop a mechanism using 1CDP to share pre-dissemination data with partners systematically, leading to decreased time or labor needed to publish new visualizations.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
3.02 — Sophisticated outbreak analytical tools available to STLT partners.
Allows partners to apply sophisticated analytical tools to their private data in a secure environment without needing specialized computing resources.
2025: Make at least one CDC-developed forecasting or outbreak analytical tool available for pilot STLT use through 1CDP.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
3.03 — Tribal data sharing.
Enhances tribal and TECs access to public health and epidemiological data from CDC.
2025: Develop agency-level governance for data sharing with federally recognized tribes and TECs.
2026: Follow-on milestone to be specified during 2026 PHDS revision process based on progress measurements.
3.04 — Disseminate integrated data and visualizations.
Supports public health decision-making through actionable insights on public health threats and disease burden.
2025: Building upon the success of the Respiratory Illnesses Data Channel, expand public access to dashboards for five of the nation's most urgent public health threats.
2026: Empower public action by developing three external partnerships for disseminating data, visualizations and data-driven insights through STLTs or private information providers.
Goal 4: Advance more open and interoperable public health data
Enable exchange of interoperable data so that health care, STLTs, federal agency partners and CDC programs can access and use data they need, when they need it.
The consistent use of standards and policies for data exchange is crucial to ensure interoperability, reduce the burden of data management and exchange, and increase the quality and utility of data for public health action. The PHDS advances the development, implementation and adoption of common standards and data use agreements for data exchange across the public health ecosystem. These efforts are aligned with the HHS Federal Health IT Strategic Plan. Additionally, investments in workforce development initiatives to improve data science literacy and promote a culture of data sharing are critical.
In 2025-26, Goal 4 focuses on these key priorities:
- Make exchange of data easier through adoption of common standards.
- Grow adoption of common legal agreements that ease the burden of data sharing.
- Understand the potential of Trusted Exchange Framework and Common Agreement (TEFCA™) and other healthcare exchanges for public health use cases.
4.01 — Minimal data necessary (MDN) definitions for public health response.
Reduces data reporting burden on CDC's partners, including STLTs and laboratories, particularly during public health emergencies.
2025: Define data elements for three core data sources (case notification, immunization, death records), aligning with USCDI (United States Core Data for Interoperability) where possible. The minimal data elements will also serve as a starting point for Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology to use for USCDI+ public health domain use cases.
2026: Follow-on milestone efforts to be assessed during 2026 PHDS revision process.
4.02 — FHIR adoption for National Healthcare Safety Network (NHSN).
Reduces reporting burden on hospitals and enables faster sharing of critical healthcare data. Learn more about NHSN.
2025: At least 10 healthcare facilities are submitting critical hospital data to CDC through the use of automated FHIR-based exchange.
2026: Facilities submitting critical hospital data to CDC through the use of automated FHIR-based exchange increased by 200%.
4.03 — FHIR adoption for birth data.
Reduces reporting burden on hospitals and enables faster sharing of critical healthcare data.
2025: Test FHIR-based exchange of birth data with 15 jurisdictions cumulatively during quarterly CDC-hosted interoperability testing events.
2026: Implement FHIR-based exchange of birth data between CDC and five jurisdictions in production.
4.04 — FHIR adoption for fetal death data.
Reduces reporting burden on hospitals and enables faster sharing of critical healthcare data.
2025: Test FHIR-based exchange of fetal death data with three jurisdictions cumulatively during quarterly CDC-hosted interoperability testing events.
2026: Implement FHIR-based exchange of fetal death data between CDC and three jurisdictions in production.
4.05 — Reportable Conditions Knowledge Management System (RCKMS) for lab data.
Enables public health data recipients to publish requirements that enable laboratories to send required data more easily.
2025: Plan and design the expansion of RCKMS to support the exchange of lab data.
2026: Leverage RCKMS to build a public health data exchange rules engine that supports case, lab and other data types.
4.06 — Establish common data use agreement for core data sources.
Facilitates faster and more seamless sharing of critical public health data and insights and reduces variation in data usage and sharing.
2025: Sign data access and use agreement under common, established terms for core data sources across at least 20% of ELC-funded jurisdictions.
2026: Sign data access and use agreement under common, established terms for core data sources across at least 30% of ELC-funded jurisdictions.
4.07 — Launch and support implementation for TEFCA use cases.
Lays the foundations for faster exchange of more interoperable data between health care and public health while reducing the complexity of point-to-point connections.
2025: Launch at least one additional, new use case for TEFCA and support implementation of existing use cases launched in 2024.
2026: Support two additional use cases for TEFCA and other exchanges including exchange using FHIR standards.