In a kindergarten classroom in Des Moines, a small boy begins to shiver uncontrollably. In a nursing home in Phoenix, a pneumonic grandmother fights for her life from a hospital bed. On a crowded metro car in Washington, DC, in the miniscule droplets of saliva from a man's kind "Hello" to a stranger, it attacks. The flu. It comes every year as the months begin to shift into winter, returning slightly different than before, exploding and thriving, determined to wreak havoc. It descends upon the nation, preys upon us in our most vulnerable moments, and says, "This is my year."
In public health, every emerging threat—the flu, E. coli, Legionnaires' disease, Ebola, Zika—is a race against time. What can scientists learn from these deadly pathogens, and more importantly, how fast? Lives depend on this data, on laboratories' ability to track patterns, decipher mutations and to share, compare and build upon those findings—crowdsourcing at its finest and most critical.
Only a few years ago, a lab would manually enter its test results and fax them to CDC and other reference centers. Someone would receive the paper transmission and manually re-enter it. The process would take days. In that time, an outbreak could have spread. Lives could have been lost.
Time matters. But thanks to an APHL-CDC initiative, what used to take days can now take minutes. In 2008, public health labs recognized the need to share their data electronically. APHL worked hand in hand with informatics specialists at state labs and CDC to develop what was then known as the Route not Read (RnR) hub. This seemingly simple, but powerful approach sent public health data through a service that read the outside envelope of the electronic message and delivered it to the intended recipient without opening its contents.
Four years later, the increasing complexity and demands for public health data led to the development of the AIMS platform. Now in a cloud-based environment, AIMS has burgeoned over the years. The new environment accelerates the transmission of data and provides shared services, such as message validation translation, to labs and trading partners. Today, more than 80 organizations and institutions exchange data over AIMS, with more than 250,000 messages exchanged each month and more than 2 million messages transported to date.
The vital data exchanged on AIMS includes aggregated influenza test results from public health laboratories to CDC, vaccine-preventable disease reports, biological threat data, immunization data exchange among several public health jurisdictions, electronic laboratory reporting between hospitals and their jurisdictions, and whole genome sequencing through the Advanced Molecular Detection initiative. And AIMS is expanding again to offer electronic case reporting to connect laboratories and health agencies with CDC and with other data recipients nationwide.
Since its launch in 2012, the AIMS platform has equipped public health officials to monitor and respond rapidly to health threats, strengthened labs with shared resources and expedited delivery of time-sensitive health information to consumers. As the platform continues to gain traction, its contributions to the nation's health infrastructure will be tremendous.