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Tabatha Offutt-Powell:
Good afternoon, everyone. Sorry, we’re gonna get started in just a minute. If you all want to get, we’ll get settled down and get started. Okay, good afternoon, everyone. And welcome to the 2025 Public Health Infrastructure Grant Annual Recipient Convening: Data Modernization In Motion, pre-conference. I’m Tabitha Powell, the Vice President of Public Health Data Modernization Informatics at ASTHO, and it’s truly an honor to open this important gathering. Before we get started this afternoon, I wanted to take a moment to acknowledge the horrific events that occurred at CDC on August 8. The public health community supports our CDC colleagues during this difficult time, and we recognize the commitment of those in public health, public safety, and first responders. We extend our deepest condolences to the family of Officer David Rose, who lost his life during this shooting.

So as we head into this week, it’s powerful to see so many of you here joining us for the data modernization pre-conference, leaders, innovators, and change makers united by a shared commitment to strengthening public health infrastructure. This convening provides us with a moment to reflect, recharge, and reimagine what’s possible. You will have an opportunity to interact, engage, and learn from your colleagues. We are here to celebrate progress, share challenges, learn, and explore solutions with each other, as you have an opportunity to connect and interact with each other throughout the sessions today, tomorrow, in our data modernization focus sessions, and as part of the whole PHIG convening.

So who’s joining us today? We have over 80 public health agencies participating in person, representing states, local, territories, and freely associated states from across the country. We were also able to provide a virtual option and extend participation to those public health professionals in 50 public health agencies, and there are over 30 partner organizations represented here today with us. We also appreciate the support of our sponsors during this event. At this time, I would also wanted to extend and express our gratitude to you for being here with us today to the PHIG national partners, ASTHO, PHAB, and NNPHI, CDC, and who are there? Many representatives are here, and we have two sitting with us today, and then all of our public health agency colleagues for contributing to the design and development of the PHIG convening.

I just want to share with you all a few housekeeping items for everyone. So for any assistance at any time during the event, please contact any of the ASTHO staff people with a teal ribbon, please see the staff registration and support desk on the second floor, if you need assistance in case of an emergency, please use any phone to call 911, there’s an automated emergency defibrillator ad placed on the fourth floor outside of the ballroom near the coat check. And just for a reminder, we are on the second floor, so that would be upstairs. If you hear a fire alarm, we will evacuate through the nearest Emergency Exit. The closest stairwells are out of these back doors, front of the FedEx Office, leading to the lobby, and to the left, which will lead to the street access. So do not use elevators or escalators. And then, in the event of a Shelter In Place situation, active shooter, we will secure the doors and stay in this room. There is an on site hotel security and a PA system for announcements. Bathrooms are located to the right down the hall. The women’s room is at the end of the walkway. The men’s room is, you know, make a right out of this room and head towards the women’s room, and then make a left.

The Cvent app is a great resource, so definitely, please be sure to use that. Our pre-conference sessions are located here on the second floor today and tomorrow in Regency, C and AB, that’s right next to us. And then we are scheduled for today’s opening plenary until two o’clock, at which time we will take a 15-minute break and return to the same room for our second plenary session, where perspectives on wave one of the Implementation Center program will be shared. We will have another short break from three, 345 to four, and then followed by two concurrent sessions. And as we close out today, I wanted to extend a thank you to Matopia for sponsoring this evening’s data modernization, networking reception from five to six this evening, which will be located on the fourth floor of the park for you. After tonight’s session, we will see you back here at 8:30 in the morning to 9:30 for a peer networking breakfast. We are followed by concurrent sessions from 9:45 to 10:45, followed by a short break, at which time we will hold the closing plenary from 11 o’clock to noon.

So now we are getting ready to get started. Our main PHIG plenary sessions will be held starting tomorrow afternoon, on the fourth floor. So let’s get started today to talk more about data modernization. So I’m pleased to introduce our opening session objectives, and those are right here in front of you. We will reflect on the successes and challenges, recognize current CDC data modernization priorities and goals, and acknowledge the evolving landscape in data modernization. Our two CDC speakers this afternoon will be Sarah Patterson and Dr Jennifer Layden. Following their presentations, we will have them join us for the director’s corner and a moderated discussion with JT Lane.

Just a little bit of background about Sarah, Jen, and Dr Layden. Sarah Patterson is the Acting Director of the CDC Public Health Infrastructure Center. In this role, she leads the public health infrastructure, which drives strategic initiatives to strengthen the systems, services, and workforce that safeguard health across US communities. Prior to taking on her current position, Sarah served as an Acting Chief Operating Officer at CDC. She served in a variety of leadership roles within CDC, the immediate Office of the Director during the most recent administration transition, including serving as CDC Acting Chief of Staff and as Acting Deputy Director for Policy, communications and Legislation. Sarah’s permanent position is serving as the fixed Deputy Director for Management, Operations, Communications, and Policy.

In this role, she leads the center’s programmatic partnerships and science to advance its priorities and mission. Dr. Jennifer Layden is the Director of the Office of Public Health Data Surveillance and Technology at the Centers for Disease Control and Prevention. In this position, she is responsible for leading, coordinating, and executing a comprehensive public health data strategy and approving the availability and use of public health data to inform decision-making and action. Prior to this position, she served as the deputy director in the CDC Office of Science, where she provided strategic leadership in releasing the expanded COVID-19 public-use dataset and led efforts to expand and support open data across the agency. And before coming to CDC, Dr. Layden served as the Deputy Commissioner and Chief Medical Officer for the Chicago Department of Public Health, and as a state epidemiologist and Chief Medical Officer for the Illinois Department of Public Health.

And then I’ll introduce JT Lane. He brings more than two decades of experience across the public, private, and nonprofit sectors with a deep focus on population health, healthcare transformation, and public-private partnerships. At Premier, he leads efforts to implement and integrate public health programming across the health system. Most recently, he served as senior vice president for population health and Innovation at ASTHO, where he led national initiatives and public health data ecosystem modernization, rural health Medicaid and health plan engagement, and social determinants of health strategies. Please join me in welcoming Sarah Patterson to the podium to share her opening remarks.

Sara Patterson:
Thanks, Tabitha. Thank you all so much for being here, and thank you to Tabitha for the statement about the shootings in Atlanta. I just wanted to take a minute also to address the shootings that happened on August 8. I know the CDC community, but the public health community, really at large, was very affected and has been pretty rocked by the shooting that took place at CDC, and I just want to say that we’ve been really focused on making sure that we’re supporting the recovery of our staff in the midst of this really horrific event and the aftermath of this horrific event, and we’re really focused on the safety and security of all of our staff. I appreciate so much the outpouring of support that we’ve gotten from so many partners across the entire public health spectrum and even in other sectors. It’s been really amazing to see the commentaries, all the emails, all of the outreach. It’s really been helpful in kind of bolstering us and getting us through this.

And then, as Tabitha mentioned, I also just want to take a moment to acknowledge Dr. Officer, sorry, David Rose, who was killed during the shooting. He put his life on the line to protect CDC staff and all the people on the street outside. So did all the law enforcement officers, the security guards, and other staff who were really helping to keep us safe during that time, and we just are so grateful to the entire law enforcement and security community for everything they’ve done, and really mourn the loss of Officer Rose. So I just wanted to take a minute and thank you, Tabatha, for also saying that, and thank you to all of you who have been so supportive. Of us during this time, I know we’ve all been through a lot, and it’s so nice to sort of have an opportunity to come together.

And I want to pivot to something a little bit more positive and hopefully impactful, which is this week. I’m very excited to be here with you all to celebrate our successes, to hear about our challenges, and to really just be in each other’s company this week at the recipient convening. First, I want to welcome all of you to St Louis, or St Louis, Missouri. I have to say my number one memory of St Louis growing up was obviously the arch. But most recently, my son has been really into Percy Jackson, and there’s a big battle scene in Percy Jackson on the arch. So he told me what to look out for to make sure there are no demigods or whatever out there trying to get me, so I’m feeling pretty prepared. So this theme is the theme for this meeting is “a gateway to growth,” and this is really an opportunity for us to reflect on our commitment to build and sustain improvements in our public health infrastructure. And I’m very excited to be here today for this opening session on St Louis strategy, and a side of toasted ravioli, which I did taste because I knew I was going to get asked about it, and it was delicious.

So we’re going to talk a lot today and tomorrow about highlighting upgrades to our public health data infrastructure and how we’re all working together to modernize our data systems. This week is going to be an exciting and enriching experience. I think for us all, we have an incredible group of national partners, ASTHO, NNPHI, and PHAB, that have really helped to put this entire thing together. And especially ASTHO, I know, organized the event, but the partners have worked so closely together over the past few years, in collaboration with all of our state and local partners. We’re just grateful to everybody for helping to get us here today, but also for working together for these past few years. This was a really innovative and different, I think, program when we undertook the idea of PHIG, and it’s really exciting to see it moving forward.

Now that we’re in year three, I’m very excited to see what happens with year four. As year three continues, we know that there have been challenges. It’s a complex program. We’ve gotten a lot of feedback about what’s working, what’s not working, and I know we’ll continue to get more feedback. We know you’ve been very persistent, agile, and innovative in all of the work that you’ve done, and we very much see you, and we very much appreciate you, and we want to continue listening to you and hearing about your experiences now. We’re in very uncertain times, and I know that we’ve all been struggling with that, but public health is at work every day. We continue to show up and make a difference in our communities. We continue to make a difference with each other. We continue to be a community, and I really appreciate that, and I appreciate that we’re able to be here today, to learn from each other and just to be together.

A few examples of the public health that have really been at work in the data space. Over the past few years, you’ve streamlined disease case reporting in Arizona. I think many places have streamlined disease case reporting. You participated in a peer-to-peer connection in Iowa to improve how data requests are triaged, and you built a new Office of Violence Prevention in Maine with a centralized data hub. And I don’t know if you all know this, but I worked in the Injury Center at CDC for about 11 years, so Violence and Injury Prevention are very near and dear to my heart, and it’s really exciting to see the data upgrades happening across the spectrum of public health, the resilience and dedication that you have to our public health community is inspiring, and we’re so grateful for you.

Our national partners have published over 100 success stories talking about what you’ve been doing, and those have been really important to all of us to demonstrate the impact and the importance of the Public Health Infrastructure Grant, so we can continue to focus on making sure that it’s supported. In the future, you filled over 6200 positions, which is a lot of positions. This includes staff who are making improvements to public health data systems, including folks who do data evaluation and work on data quality management, among other things. And each of the people who are hired into those positions is a person making a difference in the community. They’re not just numbers, and it’s important that we’re able to make those numbers come to life, which is why those success stories are so important.

The national partners and CDC stood up for public health data modernization implementation centers that are focused on enhancing public health agencies’ ability to do data exchange. This includes providing support to tribes and tribal serving organizations, and one that reports supports tribes and three that support state, local, territorial, and freely associated states. And I think Jen’s going to talk a little bit about that. We have some sessions on that as well. We could not have done any of this without participating in this together. The implementation centers provide technical support and resources to public health agencies to improve the prevention and detection of current and emerging public health threats.

In year three, our national partners supported you by providing over 200 technical assistance requests covering topics including how to assist teams with accountability and buy-in related to data modernization, how to assist in using AI tools and modernizing surveillance, and lots of interesting topics that I think are going to help all of us learn from each other and do public health better. These are just a few examples of how we’ve all been able to innovate among a changing landscape and at times, an uncertain landscape, and we’re looking forward to seeing more successes in year four. I just want to speak on behalf of the infrastructure center right now. We’re really excited about the support for state health departments, State, Tribal, Local, and Territorial Health Departments, with not only PHIG but the other work that we do, and we are committed to continuing to do that.

We’re very encouraged to see that in the 2026 president’s budget, there is ongoing support for the public health infrastructure and capacity line, which is where the Infrastructure Grant is primarily funded, although I know that we’ve got a ways to go in looking at what the long term effects will be of the covid supplemental funds that are ending at the end of this grant period. We’re also really excited to learn about all of the things that y’all are doing and that you’re going to be able to do with the funds in all three of the different components of the Public Health Infrastructure Grant. But I know right now, we’re really focused on the data work, and the data work undergirds everything. It’s a huge part of every part of what we do across public health, and it’s going to help us modernize into the future.

Together, we can support strategies that help us to collaborate, innovate, and problem solve, and I’m very excited to learn from you. Thanks again for being here to learn, to grow, and to connect. It really is so heartwarming to see us all together, to be with you. It’s been a very difficult time, and it’s so nice to just give people a hug and to hear how you’re doing in person. And I’m also very excited to be with my colleagues up on stage. And with that, I’m going to turn it over to Dr. Jen Layden. Thank you.

Jen Layden:
All right, thank you. It’s really It’s great to be here. As mentioned. My name is Jen Layden, and I serve as the director of the data office. I’m short. I realize I can barely look over its interesting. You mentioned your son and Percy Jackson. I actually just sent my son off to college, and it was very easy on Saturday, because I sent him off to St Louis, and so I waved goodbye and told him I would see him in a couple of days. But it’s great to be here and importantly with all of you, as mentioned, I work at CDC, but prior to that, was at the state and local level, so as a chief medical officer and state epidemiologist and really felt and saw firsthand the challenges and the opportunity to improve the data and technology infrastructure and how important that is for the work that you all do at the state and local level. You know, I always happen and talk about the experiences I had and the challenges of accessing data, the need for critical lab results that was going to inform a decision of what we did at a school or with a community, and the importance and the opportunity to make our work easier in public health, especially at the front line, by continuing the efforts to modernize our system.

But I wanted to start with just a little bit to really remind us all, and for those that are new to public health, to just reiterate that, although there’s been acknowledgement of the need and the importance of data modernization. It really didn’t start in 2019, and that really was stimulated by the advocacy of many partners to make, you know, advocate for the importance of the data modernization line. So in 2019, that first legislative line was in place for only $50 million, which sounds like it was a lot at the time, but when we know the full cost of what it’s going to take to modernize our systems, it’s tiny. We saw tremendous progress over the last four to five years, largely driven by covid supplemental funds.

As the pandemic hit, we were able to invest a significant amount of funds to really help fix the most pressing and urgent challenges that we faced during the pandemic. There’s been tremendous progress, which is so exciting to see, but there’s a long way to go on a long road ahead of us. And so when I talk about the data modernization effort, one of the things I really emphasize is that it’s not just a one-time initiative; this is a long-term, sustained investment that is so critical to the work that we all do in public health. Another key point to recognize and emphasize as we’re talking about data modernization is the complexity of it. You have all the state health departments, you have the local health departments, the city, the tribal partners, and the territories. You have the federal agencies, and there’s more than the CDC that relies on public health data. And then you have our health care partners and the health care side, you have the clinicians. You’ve got the vendors that make the healthcare record systems. You’ve got the private companies that are aggregating data in making it available to others, and you have academic partners.

And so when we talk about the work that we do in modernizing, it’s not work that can be done in silos; it’s work that has to be done in really close coordination in providing the input and engagement from all the partners. We have data that’s generated in healthcare. We have data that’s generated from case investigations or in the lab setting, and so having them at the table to help create the solutions we need is so critical. Much of one of the things I’ve come to learn in this effort is that so much of the technology we need is there in some form or another, and oftentimes in the healthcare sector. And so as we’re trying to create solutions, it’s important that we, you know, grounded in the public health use what we need to use the data for, to identify cases, to identify trends in opioid overdose or gun violence, but the technical solutions we can build off of those that are already there or already used or have been successes in other places, and apply them to the public health.

So, reiterating the importance of one complex ecosystem, two engaging our partners who can really help us to create these solutions that will move our work forward. Going back to the successes, and I really think it’s important that we lift these up, because it’s the great work that’s happened across the public health ecosystem that provides us an opportunity to speak to the why and why it’s so impactful and beneficial that we’re investing in data modernization as we’ve gone down this journey for the last several years, one of the things that we did was release a public health data strategy. And we did this because when you look at what needs to be done to modernize our systems, it’s vast, and with the amount of resources that we have, we can never do it all at once or within the first couple of years. And so we defined certain priority areas based on the input of all of you, working with our partners, directly with jurisdictions, to say what’s most important.

And so, just lifting up here a few of those areas where we’ve seen tremendous progress. One is in the access to the emergency room visits. We now have over 89%, actually, of emergency room visits that are coming and hitting the front line of public health state health departments or the cities, in some instances, that they can use within 24 hours. And this is agnostic of condition or disease. And so many jurisdictions use this to look at trends in heat-related illnesses, opioid overdoses, or other things. And so it’s a huge, tremendously available, almost real-time assessment of what’s happening in the jurisdictions and the communities that you are supporting. Commercial lab data and public health lab data at the start of the pandemic, we were still doing manual and vaccine distribution of lab results. We now have that almost all shifted to electronic, automated solutions at CDC, we’re getting commercial lab data twice daily from five of the major labs, and that’s now made available back to states.

So not only does it help with the diagnosis, but it helps us to understand trends and what clinicians are looking for and what they’re seeing in their clinics. Electronic case reporting, tremendous progress, and I’ll show you a figure in a moment. Prior to COVID, again, we were still that most of the cases that were reported to public health were manual, either a phone call of facts or a nurse practitioner or infection control nurse in the hospital, typing that into the state system. We now have all 50 states, plus many cities, territories, and tribes using electronic case reporting. So receiving that data, and that happens instantaneously. Over 55,000 healthcare facilities are as soon as there’s a trigger for a measles case or an Ebola case that is sent automatically to public health using the technology that’s already there in the health IT sector mortality data prior to covid, again, we saw delays being able to speak to trends in deaths and severe outcomes across all conditions, thanks to the data modernization effort, that speed by which the data is coming, as well as the completeness and the quality of it, has improved.

And then last wastewater, wastewater was a tremendous success during COVID as far as a new way to detect situational awareness, and that was in part supported by a data modernization effort. So, just as a couple of examples, I show these figures in various settings. On the left is electronic case reporting, and on the right is national syndromic surveillance of emergency room visits. Thanks to data modernization and the effort that’s happening at the front line, we went from 187 health care facilities to over 55,000 56,000 health care facilities that are sending automatic, real-time, electronic case reports. Our goal is to get to that point where we completely shut down manual reporting of cases, and that is sent electronically from health care to public health for all conditions. What’s exciting to see is that we are seeing this expanded in jurisdictions, not just for nationally notifiable conditions, but for non-infectious conditions as well. We see some great work in the cancer area, where they’re using this technology to support Cancer Surveillance as well.

On the right is a syndromic surveillance. The dark blue is where we have the coverage of the syndrome of the ED visits. Again, to me, this is some having used us at the state level. This is a really great early indicator for early signals and trends of what’s happening in coming in presenting itself to the emergency room visits. I’m not gonna speak too much about this, but just to note that at CDC, one of the decisions that we made that has been really critical, hard from a cultural standpoint and change management standpoint, is to move the agency to an enterprise data platform. Prior to making that decision, we had hundreds of data systems that were siloed, and we know that that placed sucha burden on state health departments to have to report, often having to report the same data to multiple different systems we have. By making this decision, we’ve reduced the number of data systems at CDC. We’ve been able to reduce the number of contracts and to really build enterprise capabilities that multiple programs and our jurisdictional partners can use. So tremendous progress, hard decision, but we’re seeing the impact and success of moving forward in leveraging state-of-the-art technology.

So just to speak to a little bit of where we’re going, we’ve talked about the successes, tremendous successes, in a short amount of time. When you look at, just to put in perspective, the health IT industry in the advancement of electronic health records, that’s been almost a three decade long effort, with $35 billion we’re talking about five years now for public health, with investment about $3 billion so we’ve seen tremendous progress, but again, we’re really at the start of something that should be a long term commitment to public health. This slide just shows the overall funding that’s been provided from the federal level to jurisdictions. You’ll see here, importantly, that we show here the ELC and the PHIG grants. And the reason I show this is just to emphasize that the funding goes through multiple different sources, and so that coordination across these is really critical.

We’ve been able to invest, largely due to COVID supplemental, significant funding, much of which is multi-year, but the importance of working closely with the different funding lines is really important. And then, just to reiterate the point that transformation takes time, I do believe that we’re in this state of transformation to digital transformation, and that impacts our processes and how we work, and the type of skill sets that we need. So as we continually evolve and modernize our data systems, that means we can’t just think about the technology; we need to think about the people who are using the data, who need to access it. How does our workforce evolve as we take on and leverage AI? How do we train individuals with the right skill sets?

And then, as technology changes, our processes are going to change. Many of our processes in surveillance were put in place at a time when we did not have technical advances like we are we see today. So that forces us to say what needs to change, what is an outdated process that we can streamline by leveraging this technology. And then lastly, the technology itself. So the technologies there, in many ways, that’s the easy part. It’s the other parts, the processes, the governance, the workforce that we need to continue to invest in. I’m not going to speak in length about the different mechanisms or different ways that we provide data modernization support to states and locals.

I’ll just highlight a few, and I know throughout today and tomorrow, we’re going to hear some of the successes. Directly from you, which to me is, I’m really excited to hear. But one has been the ongoing technical assistance that comes in different mechanisms through both the PHIG and ELC, but as jurisdictions are investing in electronic case reporting, providing assistance to understand how to use the data. Additionally, with that is the technical solutions. So we have teams that are building, we call building blocks that help with the data ingestion, data quality, and data cleaning. We recognize that oftentimes, if there’s a challenge in using, for example, electronic case reporting in one jurisdiction, that’s the same in another jurisdiction. So we want to build enterprise capabilities and solutions that can be accessed across all jurisdictions.

Implementation Center Program is excited to hear some of the Wave One cohort one success stories. This has been a way to provide multi-year support to enable faster data exchange across public health and between health care and public health. So we’ve had tremendous success in this first cohort, and excited to see what happens with the additional cohorts, as well as the standing up and acceleration in the tribal Implementation Center as well. The Workforce Accelerator Initiative was another effort to provide data scientists and data engineers directly in the field. Early in the data modernization effort, we heard of the challenges to hire, and I know that this can be a challenge. I was excited to hear about the number of individuals that Sarah alluded to as far as hiring, but we do know that some positions are really hard to fill, or there’s no job description at the state level that enables it. So through this project, we’ve been able to, so far, place 120-ish data scientists and engineers directly into jurisdictions to support the data modernization effort.

Lastly, I just want to emphasize the Core Data usage agreement and support. One challenge we see in the data modernization space goes back to that policy and governance. Sometimes, the rate-limiting step in access to data, whether it’s between state and local, local to local, or state and federal, is the policy and governance around access, use, and release of data. So we’ve been working on an effort to standardize that, working with you, creating standard templates to facilitate faster access to data. Lastly, I want to end with just talking about the AI landscape and recognizing the potential it has and the importance of it by also saying that there really hasn’t been a direct investment into it yet. So much of the work that we’ve seen in AI and public health has been just from folks piloting things and innovating and creating and looking for solutions, using and accessing tools that are readily available.

We’ve already seen tremendous impact and success in a short time. We’ve had some listening sessions with jurisdictions to help understand where one how jurisdictions are using AI and other analytic capabilities, but also where there is a need. Where do we see the potential and desire to advance AI? And we’re really hoping that, as you know, there’s more investment in this area. We can support this area even greater. At CDC, just as an example of impact, we launched ChatGPT and made it available to staff across the agency. We’ve seen a 500-fold return on investment. We have a huge number of 1000s of individuals who are using it. And when we look at the cost savings, looking at time and whatnot. It’s over 500,000 ROI, so it’s really huge. Does take thinking through it strategically across multiple different areas, the workforce, the governance, the bias, and all of that. But there is then been great potential.

We’ve seen it speed up threat detection, we’ve seen it improve outbreak response. One great example is in foodborne outbreaks by leveraging AI tools to mine the data that we’re getting for individuals who ate various types of food. We’ve been able to see pick up trends earlier and shut down foodborne or food related illnesses and outbreaks faster an area that I’m really excited about is more how it optimizes our basic processes that we do so the day to day work in how we can use that to streamline our process, reduce the manual burden, to help free up the time of the public health practitioners. So I’m going to end there and just say, end with saying that we have been so excited to see the progress, the work that’s happening directly in the field. We recognize that this is a long, a long process. There’s much work to be done, and we are going to continue to evolve as the technology evolves. And we can’t do that without you. So look forward to hearing from you what’s worked, what’s not working, as well as where you’re excited for future opportunities. Thank you.

J.T. Lane:
All right. Good afternoon. I have the pleasure and honor of sort of, maybe digging deeper into some of the topics you both have brought up. And I can say, for me, personally, it’s an honor too, because the two of you, as public health leaders who have gone through quite a bit over the last few years, are leading key components of CDC that represent a fundamental shift from the way we’ve been doing business. And I think that’s really important in public health, you know, being disease or population-agnostic and providing that foundational infrastructure needed to do our work.

It’s safe to say that over the last five and a half years, most recently, with the attack on CDC headquarters, we seem to public health seems to be getting the ire, and many episodes of a lack of affection for us that keep trying to one-up each other every time something new happens. So what? What inspires you? What gets you up in the morning? What do you see that I think, what examples do you have in the field that you know you’re like, wow, we can really do this. It’s gonna take time and resources, of course, but you know what just keeps you moving?

Sara Patterson:
Thanks. JT, I’m inspired by a lot of things. I mean, it has been a challenging time, but I do think there’s a lot to celebrate and a lot to be hopeful for. Two weeks ago, I went with colleagues to Tulsa to a Tribal Advisory Committee meeting, and we visited with the Muskogee Creek tribe, and then we also visited with the Tulsa Health Department, which showed us how they were using some of their PHIG dollars, and talked to us about so many things that they were doing that were so impactful. One of the visits that we did within the Muscogee site visit was to the health center, where we learned about work that they were doing with pregnant moms, and then the Tulsa Health Department talked to us about how they’ve been able to reduce teen pregnancy rates.

And you just see that these dollars are used to make real impact when we see like with the stuff Jen talked about with, like reducing foodborne illness, the duration of foodborne illnesses, our ability to use technology to both access data and to use data smartly, those are things that we’re going to learn from and that we’re going to build from. And it gives me a lot of hope that we’re not only doing really important work, but that we’re telling the story of what that work can accomplish and how important it is for public health. And then I think the other thing we need to do is talk about what public health is. I think a lot of times people hear the term public health and they don’t know what that means, but when we talk about going to restaurants that are safe, or being able to look up your vaccine history in a system that’s tied to other systems, or having prescription drug monitoring programs, or any of these types of systems and programs that humans actually interface with and benefit from.

I think those are things that resonate, and if we can build on those things and really help to create messengers that support each other in having messages that we know will resonate, I do feel hopeful. I mean, it is challenging, and there’s no doubt that a lot of misinformation has fueled some antipathy toward public health, but I know we can continue to demonstrate impact and show that these investments are worth it and really do make people healthier. Thanks.

Jen Layden:
And maybe just building on that a little bit this past week, one of the things that you know, just building off of it’s been a challenging week at CDC and for public health, one of the things that has inspired me and gotten me through each day is the public health people. As we were, I was doing a lot of listening sessions with my teams, people kept wondering and caring about the police, the police officer, the force, and his family, and how we can support them. And I think that just speaks to the type of people that public health is. We’re always caring and trying to help others. So just knowing what public health does and the people who work in public health is just a constant support system for me. I always try to remind myself of the day-to-day work when I was at the state and city level, seeing, feeling, and hearing the impact of the work that public health does. Whether it’s as simple as getting rabies prophylaxis to an individual who was exposed, or botulism treatment to someone, or helping to prevent maternal-child transmission of a disease, those success stories and the value, the kind of unspoken impact that public health is what inspires me.

And then, having worked in the city, as in the city at the time of COVID, and seeing how challenging our work was because of our antiquated systems, we were having to spend so much time doing manual things that could have happened in a better, faster way, and not to anyone’s fault. It was just that no one had invested in public health infrastructure and didn’t have the resources. But inspires me to know that how we work can be different and it can be better, and make the work that we do, which is so vital to our communities, more effective.

J.T. Lane:
Thank you. I guess to get more tactical, related to PHIG, I think it’s safe to say we are all in this room might agree that public health, at least in the governmental public sector, is a big data enterprise amongst government functions. Yeah, thanks, Evan. So in data and technology, you know, verticals and horizontals are ubiquitous, and A1, A2, and A3. A3 was for DMI. But we also know that the DMI workforce or activities were applied in A1 and A2. What are some of the examples where you see, you’ve seen this work well, you know, do you think that’s a good strategy? Is there a place that you’d highlight that, that left trying to leverage all three work streams to advance that more holistically, that it’s not just a technology problem, but it’s people, it’s foundational capabilities as well.

Jen Layden:
Yeah, and I can just speak to the hiring and bringing in of such diverse, wide range, and new expertise, and I don’t think that would have happened if you’re just looking at the data modernization line, but really helping to support the workforce. When I was at the state level, we didn’t have a chief data officer, we didn’t have a DMI director, we didn’t have a chief informatics officer, to be honest. And now you see that that’s much more consistently seen across all jurisdictions, and that, to me, is so critical that that has now become central and core to the workforce at the jurisdiction level.

Sara Patterson:
I would definitely agree with that. I think the interrelationship between the systems and the people, and making sure we have people either trained or brought in to help support the data modernization efforts and all of the foundational capabilities. I think it’s really important that we’re looking at what the public health system needs to operate effectively. And that’s really what the foundational capabilities are. And then both the workforce and the data systems kind of work across all of that. And I think every health department that we’ve talked to is really thinking about those things in one cohesive way. It’s not like different buckets of work that don’t talk to each other. It’s a real cohesive strategy. And I think there’s also a lot of really good thinking about how to bring in partners from different sectors. I mean, Jen talked in her presentation about working across healthcare and other sectors. If we’re not working with other sectors, we’re really not going to be effective.

And there have been so many great examples of where health departments have been able to use some of these dollars to just come to the table to have a conversation with a sector that maybe they weren’t able to partner with in the past, or they weren’t on the radar. So it kind of offers some leverage in that respect. But I think the data modernization piece, while I think it’s really important that we have that A3 component, because we need that really focused attention on data modernization, it’s really all that work together and that work with the ELC funding, like Jen talked about earlier, to make sure that the system is working and that we’re trying to figure out like how to make it more efficient, how to use data better, how to get data more effectively, and how to make it really a tool for decision making and public health impact.

J.T. Lane:
Sarah, you mentioned in your remarks that we’re going from year three to four, but soon, so I have two years left for both of you for data modernization. What would you like to see? What opportunities do you think are in the hopper for the next two years, in the midst of a highly dynamic and unpredictable environment? Do you have any thoughts on what the next two years might hold, holistically for the nation or individually, for states, locals, and tribes?

Jen Layden:
Sure, I can start well. I tend to set ambitious goals.

I would love to see where we can speak to the interconnected, automated automation between health care and public health. Not all our data is generated from health care, and I think we have to continue to emphasize that, but a lot of it is, whether it’s from the clinical setting, the lab setting, the immunization side, pharmacies, that there’s data there that we use, either primarily or secondarily. And for in we know, in speaking to our healthcare system partners and our private healthcare vendors like Epic and Cerner, they want to shut down manual reporting because it’s a high burden on them. And if we can get to a point that we are really interconnected, I don’t think it’s quite realistic, in two years, I would say five years. But I think we can show significant progress where it is undeniable that that is where we’re going. And so to me, that would be number one, two, and I think this is more a more the change management transformation process across public health is ensuring that we’re continuing to bring together the public, the folks that use the data, and then the technologist that, and then in I would add, actually a third, which is the policy experts. Sometimes our biggest challenges are in policy and governance. If I could hire more legal lawyers, that would be like one of my highest priorities, but that intersect between technology, policy, governance and then the end users of the data, whether it’s your state health official or your epidemiologist or your program director, that tight coordination is so critical, so really continuing to move the needle on the How We work to make the technology work for us?

That was a great answer. I think just building on that, I mean, it really is about how do we kind of make things more efficient and connect dots in ways that allow us to use data better? And thinking about, you know, there’s a lot of transformation going on at the Department of Health and Human Services. Where can we really look at where centralized data might exist, or where we’re going to be working with new potential agencies that will have data that they’re going to need to be collecting in different ways, or they’re going to be, need to, going to need to be using our data. I think there’s an opportunity here for us to think about where all of those connections need to either be maintained or new connections built, and kind of utilize some of the transformation work that’s happening at the Department of Health and Human Services level to really integrate all of that across the health system. And then I also just kind of built on what Jen said. I think the partnerships are so important in this space because we can learn a lot from other industries. AI, I’m I think we’re going to talk about, like, I don’t really understand AI, I keep trying to use it for, like, trip itineraries, but every time I can learn from another sector on how they use AI to actually do their work better, or even within public health, when we learn about examples where data are being used to make faster decisions and better decisions, it really helps us to understand and tell that story even more effectively about why this work is important. Thanks.

J.T. Lane:
So public health, infrastructure, and data modernization are constantly evolving. It’s a takes focused effort, the right workforce, all the right pieces, funding, and the financial model. So sustainability is really important, and maybe we can spend a little time talking about, I feel, and have reflected on lots of individuals that we don’t quite have the right construct that we’re all aligned on in terms of what sustainability looks like. So from that perspective, what tough questions do we need to ask ourselves as a community? What do we need to reflect on that we might need to do differently to make ourselves more sustainable?

Jen Layden:
I can start, yeah, so I think a couple of things are great questions, and we’d love to hear others’ answers. You know, throughout the next couple of days, one big area for me is, is really testing ourselves. Of what we constitute is our funding models, right? We’ve largely leveraged governmental funding. It’s never going to be enough. We know that we have estimates of the costs, but also how we think creatively about different funding models, public-private partnerships, using Medicaid, and Medicare incentives at the federal and state levels to support the work that we do. So that’s one big area in my mind. The other is, I think we have to constantly ask ourselves, what stops right? Processes were created at a point in time where we didn’t have the technology that we do, and we’re pretty process-heavy in public health; many of the processes may not make sense anymore, and so what do we stop to enable ourselves, to free ourselves to use the technology more efficiently?

Sara Patterson:
I completely agree with both of those. And I think the only other thing kind of related on the same lines of, what do we stop? Is, what do we need the data for? Like we have, we collect a lot of data, and sometimes some of it just kind of hangs out because it’s not really useful to us, but it might be someday, or we’re afraid, what if we stop collecting this data, and then we don’t have any more trends, or what if we do it differently, then we can’t look back. And so I think that’s kind of another, along the lines of more process is just, what do we really need to collect data for? And then what are we going to do with the data? How can we use it for decision-making? How can we leverage other partnerships to get the things that we need?

So many of our systems because of the way federal funding comes in. So many systems that are federally funded were created one by one, by one by one. And I mean, Jen talked about the change management effort at the agency, it is. I remember a partner coming in and trying to talk to me at one point while I was in the injury center about one of our data systems and the idea of consolidating. And I was like, Well, that could never happen. Ours is very special, and we all do that. We all get very kind of proprietary, and we love our babies, and a lot of times our data systems are our babies. And so I think being able to sort of step outside of that long-term ownership and think about, like, how has the world evolved? How has what we’ve been kind of working on and where we’ve been evolving needed to go? And are there things we can do that are a little bit more efficient? And I think JT is going to talk about tomorrow’s session too, so that’ll be, we’re going to learn everything tomorrow, right?

J.T. Lane:
Sustainability will be featured at 11 am tomorrow in this very room; mark your calendars. Let’s do a lightning round in AI and open source. How should we be leveraging its advanced data modernization?

Jen Layden:
We all just learned that. I know nothing about AI, but I will say something interesting that happened at CDC. That was one of my first kind of introductions to how efficient it can make work. We undertook this transition management structure shortly after the reorganization of HHS was announced. And many staff, as you know, were placed on administrative leave with the intent to move forward with the reduction in force. And so we suddenly lost a lot of staff, and had things like in midair, just sort of hanging so we created a transition management structure within the agency where we took input from across the entire staff at every level to make sure that we understood, what’s kind of hanging out there that we don’t even know is a risk or something that we’ve lost or something we need to address.

Sara Patterson:
We got something like 700 entries into this process, which, can you imagine a person going through every one of those and trying to figure out what’s duplicative and how the themes are? They threw that thing into AI, and it put out this amazing report that we were able to quickly use for decision-making to figure out exactly how to prioritize, what to put staff on, and what to alert higher-ups that we had a risk in an area. It was incredibly helpful, and that was really one of the first times that I saw a lot of information that probably would have taken somebody many, many days to go through and try to analyze. They did it super quickly, and it was very, very helpful for all of us to really move forward.

Jen Layden:
I tend to break it into two big buckets. One is, I think, a perfect example of what Sarah was talking about, a perfect example of the operations, the day-to-day work that we do, and I think that is where I think there’s the biggest potential for impact. So things that we’ve often done very manually, writing an FAQ, summarizing, and reading through multiple different grant applications, can be done much faster. Obviously. Takes oversight, and, you know, time to set that up. But that area is one big area.

The second is more on the mission side of the house. So how do we use AI to, for example, detect signals or threat detections, so more like the public health, you know, aspect of detecting and responding to public health threats. So I think of those as the two big areas. I constantly ask my teams, when we’re starting something new, does AI have a role? Can it have a role? Should we be testing it? And I think that’s something we have to start to ingrain in our heads. It may not be a solution for everything, but we should at least explore the what, how, and why, and evaluate its impact.

J.T. Lane:
All right, we’re reaching the end of our time for the most important question around St Louis culture. Somebody planted a question in my notes: What do you prefer? Toasted raviolis, or something called Gooey Butter Cake?

Sara Patterson:
I don’t know what. I know we need a sample. I did try toasted ravioli, as I mentioned at the beginning, and it was delicious. I did think it was supposed to be my lunch, and it was definitely not a lunch portion. So now I’m really hungry. So now I get to try Gooey Butter Cake. I don’t know what that is.

Jen Layden:
I have tried neither. So I have a lot of catching up to do next few days.

Speaker 1:
Cardinals or Cubs. White Sox. Cubs. Okay, see you in the hallway.

J.T. Lane:
Well, I’m getting the stop sign, so I want to thank you both so much for taking the time to be here. We are so fortunate to have you both at the helm of the agencies you are running right now, and we hope you do not leave. We need a lot of stability right now, but you all have done a great job, and we want to thank you for that.

For all of you out there, there’s a slide with instructions about the break, right? It’s up here, okay? And just a reminder to return to the same room for the next plenary session at 2:15, central time. The session will highlight jurisdictional experiences on the IC program. Elizabeth does anything else? Have to say? All right, thanks, Hal, thank you so much.