Best Practices for Data Modernization Across the United States Public Health System: Scoping Review

The adoption of new technologies and data modernization approaches in public health aims to enhance the use of health data to inform decision-making and improve population health. However, public health departments struggle with legacy systems, siloed data, and privacy concerns, which hamper the adoption of new technology and data sharing with stakeholders. This paper maps how to address these shortcomings by identifying data modernization challenges, initiatives, and progress.

This study aims to characterize evidence for data modernization-associated gaps and best practices in public health.

This scoping review was conducted using the 5-stage framework developed by Arksey and O'Malley and was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A structured search was performed in databases PubMed, Scopus, CINAHL, and PsycINFO, and was complemented by a further search in the Google Scholar search engine, covering publications from January 1, 2019, to April 30, 2024. Eligible studies were peer-reviewed, published in English, and focused on data modernization initiatives within US public health system and reported on best practices, challenges, and outcomes. Search terms combined concepts such as "Data Modernization," "Interoperability," and "Public Health" using Boolean operators. Two reviewers independently screened titles, abstracts, and full texts using Rayyan QCRI, with conflicts resolved through consultation with a third reviewer. Data were extracted into Microsoft Excel and thematically analyzed.

This review analyzed 21 studies focused on public health data modernization. Across the literature, common components included transitioning to cloud-based systems, consolidating fragmented data into unified platforms, applying governance frameworks, and implementing analytics tools to support decision-making. Primary data sources were electronic health records, insurance claims, and disease surveillance registries. Key challenges identified across studies involved data quality issues, lack of interoperability, and limited resources, particularly in underfunded settings. Notable benefits included more timely and accessible data, improved integration across systems, and enhanced analytical capabilities, which collectively support more responsive and effective public health interventions when guided by clear standards and policy alignment.

Progress hinges on balancing local adaptability with national coordination, improving data governance practices, and enhancing collaboration across institutions. These steps are vital to ensure that public health systems can deliver timely, accurate, and actionable information to support effective public health efforts.