When battling infectious diseases and monitoring for emerging threats, how do public health officials determine their deployment of scarce resources and stay ahead of rapidly changing situations? The answer lies in data — information showing which disease variants are spreading, where cases are spiking, how many people are vaccinated, and many more essential details. However, the exchange of sensitive health data introduces many complexities, requiring specialized solutions to make sure information is shared securely and in consistent formats across organizations.

The Association of Public Health Laboratories (APHL) understands the vital role that data plays in improving public health. APHL works with federal, state, and local agencies across the US to shape national and global health outcomes by strengthening public laboratory systems and building effective laboratory response in public health emergencies. To support the swift exchange of critical health information across public health laboratories, governments, and organizations, APHL teamed up with Ruvos, a consulting firm and Amazon Web Services (AWS) Partner that specializes in health informatics and information technology, to create a secure messaging platform on AWS.

For more than a decade, the cloud-powered APHL Informatics Messaging Service (AIMS) has enabled healthcare leaders and government agencies to visualize and share information efficiently as they work to improve public health outcomes.

Powering fast, secure exchanges of public health data

APHL partnered with Ruvos in 2008 to design and build AIMS, a hub-and-spoke model for national public health data exchange. Originally developed to exchange flu data, AIMS expanded in the following years to enable laboratories, hospitals, government agencies, and public health jurisdictions to trade information about many public health threats.

In 2012, Ruvos saw that advances in cloud computing could take the platform to the next level, helping address challenges such as the resource constraints faced by labs, the sensitive nature of public health data exchanged, the need to rapidly scale data exchange during an outbreak, and the ever-crucial need for timely and accurate data. Ruvos led the migration of AIMS to AWS, unlocking significant benefits for public health decision-makers by delivering essential data in real-time and ultimately posturing the platform to absorb the massive data surge during the COVID-19 pandemic.

Ruvos uses AWS in part because it aligns with the Federal Risk and Authorization Management Program (FedRAMP), National Institute of Standards and Technology (NIST) 800-53 security controls, and the Federal Information Security Management Act (FISMA). and has undergone independent security assessment conducted by a third-party assessment organization (3PAO).

AIMS now uses Amazon Simple Storage Service (Amazon S3) to transmit vast quantities of data with no data clogs. APHL and Ruvos also use various AWS services including Amazon Relational Database Service (Amazon RDS), AWS CloudTrail, Amazon Elastic Compute Cloud (Amazon EC2), Amazon OpenSearch Service, and Amazon CloudWatch. The cloud-based platform reduces technical and maintenance burdens experienced by APHL’s trading partners, and solidifies the durability and availability of this pipeline. With reliable, real-time access to information such as test results and vaccination records, officials can make faster, more informed decisions about how to respond to public health threats.

A new standard for public health data sharing

Because protecting public health requires the collaboration of many organizations — and thus many disparate information technology systems — Ruvos designed AIMS to provide interoperability between a variety of data format standards and transport protocols. The platform enables its many users to send data via multiple data exchange streams, including Public Health Information Network Messaging System (PHINMS), the Direct standard, Integrating the Healthcare Enterprise Cross-Enterprise Document Sharing (IHE XDR), Nationwide Health Information Network (NwHIN), Amazon S3, Secure File Transfer Protocol (SFTP), and virtual private network (VPN). The ability to “talk” to many other systems has made AIMS a widely adopted solution for exchanging public health data across the US, including by the Centers for Disease Control (CDC): AIMS is the CDC’s biggest data-sharing intermediary.

 The AIMS platform now transports millions of messages per month between trading partners, including federal agencies, the United States uniformed services, regional commercial laboratories and hospitals, state health information exchanges, and 58 state and territorial public health jurisdictions. Every US state trades information via the AIMS platform, as well as multiple programs at the CDC. Examples of data supported by the platform include aggregated influenza test results, vaccine-preventable disease reports, biological threat data, immunization data, electronic laboratory reporting (ELR), National Quest ELR data, next-generation genomic sequencing (NGS), and electronic case reporting (eCR).

 AIMS also facilitates data analysis by providing dashboards displaying visualizations about transport and other metrics. Data analysts can quickly create visualizations and analytic reports for public health projects using programs hosted on AIMS such as Tableau, Amazon QuickSight, and Kibana.

AIMS in action: Supporting public health decisions in the COVID-19 pandemic

AIMS’s cloud-based architecture helped it play an important role in responding to the COVID-19 pandemic. Because AIMS was already on AWS, Ruvos and APHL were able to scale the platform to accommodate surging transmissions of COVID-19 ELR lab results and electronic case reporting (eCR). This allowed electronic health record (EHR) systems to automatically report COVID-19 cases in staggering numbers, powering the dashboards that officials and the general public came to rely on for up-to-date COVID-19 reports.

AIMS processed more than 2.25 billion COVID messages during the pandemic. The swift exchange of information supported local healthcare leaders and government agencies as they hastened to effectively allocate resources in combating the virus.

Looking forward: Enhancing public health with timely, accurate data

APHL and Ruvos continue looking for opportunities to improve the flow of real-time public health data that enables officials to see and understand trends, such as implementing data analytics, artificial intelligence, and machine learning solutions. AWS tools remain essential for modernizing and scaling the platform.

Robust, reliable data pipelines like those on the AIMS platform become the foundation for advanced analytic models that give real-time snapshots to public health practitioners and decision-makers. To learn how your organization can harness the power of data to inform decisions and enhance public health outcomes, contact Ruvos.

Public sector healthcare organizations around the world use AWS healthcare solutions to analyze their data, improve patient care in the communities they serve, and empower teams with the tools needed to assess, diagnose, and treat in real time. Using AWS, healthcare organizations can reduce the time and effort required to run existing clinical and non-clinical workloads and provide access to new analytics capabilities and machine learning (ML) technologies that meet both regional and global security and privacy requirements. Learn more at AWS for Health.