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US Virgin Islands Launches Modernized NBS 7 Disease Surveillance System to Transform Public Health: Implementation
Hannah M Cranford1, Terri Pietka1,2, Leah de Wilde1,2
1Epidemiology Division, United States Virgin Islands Department of Health, Charles Harwood Complex, 3500 Estate Richmond, Christiansted, United States Virgin Islands, 00820, United States, 1 340 514 7583.
JMIR Medical Informatics
|June 23, 2026
Summary
The US Virgin Islands upgraded its disease surveillance system to NBS 7 on Amazon Web Services (AWS), achieving significant cost savings and improving data management. This modernization enhances public health infrastructure for better disease threat monitoring and response.
Area of Science:
- Public Health Informatics
- Health IT Modernization
- Cloud Computing in Healthcare
Background:
- US Virgin Islands Department of Health (VIDOH) faced challenges maintaining its cloud-hosted National Electronic Disease Surveillance System Base System (NBS).
- A critical need existed to support local data modernization initiatives and ensure system functionality.
- Consultation with federal partners and experts guided the decision for system migration and upgrade.
Purpose of the Study:
- To modernize the USVI disease surveillance system for enhanced functionality and cost-efficiency.
- To migrate the VIDOH NBS instance from a vendor-managed environment to a jurisdiction-managed AWS cloud infrastructure.
- To upgrade the NBS instance to the latest version, NBS 7.
Main Methods:
- Implementation of a phased migration strategy.
- Deployment of NBS 7 within Amazon Web Services (AWS) cloud environment.
- Database migration, validation, optimization, and staged re-onboarding of electronic reporting facilities.
Main Results:
- USVI became the first US jurisdiction to implement NBS 7 on AWS, going live May 6, 2025.
- Achieved preliminary cost savings of approximately 80-90% and increased bandwidth.
- Successfully reonboarded 97% of previous electronic reporting facilities and onboarded one new laboratory.
- Enhanced real-time data ingestion, updates, and local informatics capacity.
Conclusions:
- The migration to NBS 7 on AWS has significantly improved USVI's disease surveillance capabilities.
- Benefits include enhanced timeliness of reporting, greater provider flexibility, and direct control over data and workflow.
- This public health infrastructure investment enables quicker monitoring and response to disease threats.
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