Prepared by: The HIMSS Public Health Digital Transformation Community Advisory Group, Co-Chaired by Dr. Noam H. Arzt (President, HLN Consulting) and Dr. Bryant Thomas Karras (Senior Medical Epidemiologist, Washington State Department of Health), with contributions from Dr. Theresa Cullen (Director, Pima County Health Department; HIMSS Americas Board Member).

HIMSS staff contact: Valerie Rogers – Valerie.Rogers@HIMSS.org

As we observe National Public Health Week from April 6–12, 2026, the American Public Health Association’s theme of "Ready. Set. Action!" serves as both a celebration and an urgent call to action. NPHW highlights the indispensable role of public health in preventing disease, strengthening communities and advancing health equity.

To translate this theme into reality, we must recognize governmental public health infrastructure is currently at a critical juncture. State, tribal, local and territorial (STLT) health systems are navigating a complex web of challenges, including looming funding expirations, strained workforce capacity and massive technological transitions.

In the spirit of taking action, this brief outlines the strategic priorities required to safeguard the future of public health and its digital transformation.

1. Securing sustainable funding: Moving beyond temporary financial fixes to build a resilient, long-term foundation for health surveillance and operations
2. Driving actionable data utilization: Transforming raw data into clear, accessible insights that empower rapid, community-focused health decisions
3. Fostering responsible integration: Ensuring new public health technologies and health care systems operate together seamlessly, securely and ethically

By addressing these priorities, we can ensure public health systems are truly ready and set to take action for the communities they serve.

Fiscal and Infrastructure Pressures: The Legacy of 2025

The previous year marked a challenging turning point for public health modernization, exposing severe vulnerabilities in financial and human resources.

The July 2026 funding "cliff": The imminent expiration of remaining COVID-19 relief funding threatens to create a severe financial squeeze on STLT public health systems.

Budget reductions: Sharp declines in federal funding for modernization programs, combined with budget cuts at the CDC and legislative risks to Medicaid and safety-net services, have severely constrained operating budgets.

Market and workforce strains: The costs of accessing critical datasets, such as All Payer Claims Databases (APCDs), continue to rise. Simultaneously, the sector is experiencing significant workforce reductions in public health informatics, crippling human capacity when it is needed most.

Technical challenges and data roadblocks: The technological landscape of public health data systems revealed several critical gaps that demand immediate policy and operational intervention.

Burdensome reporting: Current Electronic Case Reporting (eCR) mandates remain overly burdensome and prohibitively expensive for many jurisdictions.

Privacy and security concerns: Federal "one-platform" approaches have raised substantial concerns regarding data privacy and the potential for patient re-identification.

Interoperability hurdles: Vague Data Use Agreements (DUAs) actively discourage essential data sharing between agencies. Furthermore, while the Trusted Exchange Framework and Common Agreement (TEFCA) presents new opportunities, its rollout has caused significant disruption to existing workflows.

Emerging Opportunities

Despite these systemic constraints, innovations in public health surveillance offer a clear path forward. The integration of novel data sources, including wastewater surveillance, remote patient monitoring, and broader claims records, demonstrates the potential for highly responsive, modern public health tracking.

Five Strategic Priorities for 2026

To address the public health digital transformation vulnerabilities, HIMSS has identified five core priorities to modernize and protect public health data infrastructure.

1. Data Actionability

Key objectives and policy focus: Shift from reactive reporting to proactive intervention using predictive analytics. Establish scalable Health Data Utilities to ensure secure, equitable data sharing. Systematically publicizeROI case studies to prove the value of digital investments.

2. Interoperability

Key objectives and policy focus: Formalize a sustainably funded "Minimum Viable Surveillance System" using Electronic Case Reporting as the backbone. Standardize Data Use Agreements (DUAs) to protect privacy and respect tribal sovereignty, ensuring federal standards (HL7/FHIR) preserve local control.

3. Artificial Intelligence

Key objectives and policy focus: Accelerate responsible AI adoption. Advocate for federal AI investments specifically earmarked for public health. Establish ethical guidelines and independent oversight to ensure AI systems act as "ethical guardians" for vulnerable populations.

4. Policy & Funding

Key objectives and policy focus: Reframe public health data infrastructure as a critical component of national security and public safety. Push for the release of an updated "Public Health Funding Gap" report to spur legislative action and drive public-private partnerships.

5. Workforce Development

Key objectives and policy focus: Future-proof public health teams through specialized training in data science, cybersecurity, and ethical governance. Secure sustainable funding to retain experts and partner with academia to build a robust talent pipeline.

Immediate Call to Action for Public Health Leaders

The HIMSS Public Health Digital Transformation Community Advisory Group, Co-Chaired by Dr. Noam H. Arzt (President, HLN Consulting) and Dr. Bryant Thomas Karras (Senior Medical Epidemiologist, Washington State Department of Health) , emphasized that strong digital data governance must be rooted in public value.

To build momentum ahead of the funding cliff, Dr. Theresa Cullen (Director, Pima County Health Department; HIMSS Americas Board Member) during the HIMSS26 Public Health Data Modernization Forum urged stakeholders to complete three immediate steps before the end of Q2 2026:

• Endorse a Minimum Viable Surveillance Agenda tailored to your specific jurisdiction.
• Convene a Cross-Sector Working Group to standardize local Data Use Agreements and e-consent practices.
• Nominate Regional Agencies and HIEs for pilot funding to demonstrate privacy-first, AI-enabled predictive surveillance.

For further engagement, Interested parties are encouraged to join the HIMSS Public Health Digital Transformation Community to coordinate advocacy, secure funding, and build the necessary workforce for sustainable modernization.