Abstract
PROBLEM: The current coronavirus disease 2019 (COVID-19) pandemic underscores the need for building and sustaining public health data infrastructure to support a rapid local, regional, national, and international response. Despite a historical context of public health crises, data sharing agreements and transactional standards do not uniformly exist between institutions which hamper a foundational infrastructure to meet data sharing and integration needs for the advancement of public health. APPROACH: There is a growing need to apply population health knowledge with technological solutions to data transfer, integration, and reasoning, to improve health in a broader learning health system ecosystem. To achieve this, data must be combined from healthcare provider organizations, public health departments, and other settings. Public health entities are in a unique position to consume these data, however, most do not yet have the infrastructure required to integrate data sources and apply computable knowledge to combat this pandemic. OUTCOMES: Herein, we describe lessons learned and a framework to address these needs, which focus on: (a) identifying and filling technology "gaps"; (b) pursuing collaborative design of data sharing requirements and transmission mechanisms; (c) facilitating cross-domain discussions involving legal and research compliance; and (d) establishing or participating in multi-institutional convening or coordinating activities. NEXT STEPS: While by no means a comprehensive evaluation of such issues, we envision that many of our experiences are universal. We hope those elucidated can serve as the catalyst for a robust community-wide dialogue on what steps can and should be taken to ensure that our regional and national health care systems can truly learn, in a rapid manner, so as to respond to this and future emergent public health crises.