Modernizing CDC's information technology to meet growing public health needs

The Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) is a cornerstone of patient safety and healthcare delivery in the United States. As the nation’s leading infection surveillance system, NHSN provides critical data helping healthcare facilities prevent infections among millions of Americans while tracking emerging health threats. More than 167,000 users across 38,800 healthcare facilities depend on the system daily.

NHSN has evolved significantly since its introduction in 2005, expanding well beyond its original focus on healthcare-associated infections to become an essential tool for monitoring healthcare system capacity, tracking vaccination coverage, and responding to public health emergencies.

Recently, Leidos, which was instrumental in creating the system, completed a major milestone in its modernization by migrating it to the cloud. The migration lays the groundwork for enhanced capabilities to come.

“The migration to the cloud is step one in our broader modernization journey,” explains Brian Fitzgerald, program director for the CDC NHSN program at Leidos. “This positions us to take advantage of new cloud-based tools and enables the capabilities we need to better serve our user community.”

Expanding capabilities

The modernization of NHSN is critical as healthcare facilities face increasing demands for rapid, accurate data reporting.

For example, regulations require over 15,000 nursing homes and 5,300 hospitals nationwide to provide data on COVID-19 cases. The facilities fulfill the reporting requirements via forms submitted through NHSN. The system then feeds these critical data to agencies such as the Centers for Medicare & Medicaid Services (CMS), which rely on the information to fulfill their own public health functions.

Related reading: A strategy for transitioning hospital covid data

In addition to expanding reporting and other capabilities, NHSN’s modernization efforts are also geared toward making it easier for end users to perform their daily work.

“We talk a lot about end user burden,” Fitzgerald says. “With the NHSN now in the cloud, we can leverage more powerful tools and technologies to help with automation and scaling.”

The Leidos team is also embracing human-centered design principles to reshape the end-user experience. “The new version is a reimagined version of what the NHSN user experience should look like,” Fitzgerald says.

The new cloud-based backend also supports NHSN’s shift to a microservices application architecture. NHSN is being deconstructed into smaller, independent, software components that can be added and updated more quickly than larger, monolithic systems. Microservices enable faster response to changing requirements and evolving situations.

Improved rapid development capabilities powered by the cloud enabled the Leidos team to build a new hospital respiratory data reporting system within NHSN that lets facilities report on flu and RSV in addition to COVID-19 data.

Engaging strategic partnerships

After 15 months of preparation, the team completed NHSN’s migration to Microsoft Azure cloud over a single weekend of intense work in February 2024. The smooth changeover from on-premises servers, invisible to users, was the result of careful coordination across multiple stakeholders and technical teams, according to Shannon Woodis, CDC portfolio director at Leidos. She notes that the CDC’s largest program migration to date demanded extensive planning and collaboration.

“The foundation of all of this, first and foremost, is this team’s understanding of the dynamic mission,” Woodis says. “There are a lot of nuances in this: the CMS connection, the internal CDC ecosystem, our technical partnerships.”

Related Reading: A weekend race to keep CMS email flowing

The migration required working with multiple groups within CDC, including managed service hosting contractors and the enterprise data analytics and visualization group, while maintaining seamless service for thousands of healthcare facilities. The project’s success relied heavily on Leidos’ long-standing relationships with key technology partners, including Microsoft and SAS, as well as its deep understanding of CDC’s operations, according to Woodis.

The future of health IT

Looking ahead, the healthcare modernization initiative encompasses several key components beyond the cloud migration. The team continues to work on transforming the system’s architecture from large, monolithic macro-services to more flexible micro-services that can be updated independently. It is also implementing DevSecOps practices—a modern approach that integrates security into software development and deployment. And the team is building data analysis capabilities using innovative technology from Databricks to enable more efficient processing of large-scale health data.

It’s all in service of CDC’s ongoing Data Modernization Initiative, aimed at giving public health decision-makers faster access to data and insights through IT modernization. In the near term, “the future is FHIR,” says Fitzgerald, referring to the healthcare data interoperability standard, Fast Healthcare Interoperability Resources. “That’s going to enable facilities and hospitals to submit data via a standard format versus the manual data options we have today.”

These modernization efforts support NHSN’s expanding role in public health response. Coming soon: a new capability to monitor hospital bed capacity during emergencies, including hurricanes. The system will locate beds where and when they’re needed most, saving time that could make all the difference for patients who need care fast.

NHSN’s modernization starts with a shared vision, according to Woodis.

“People believe in the mission,” Fitzgerald says of the modernization teams and their partners. “They believe in public health. They believe in what they do and why they do it. That’s part of what makes this program special.”

learn more about our healthcare technologies