Health Information Technology: More Detailed Plans Needed for the Centers for Disease Control and Prevention's Redesigned BioSense Program

In January 2013, CDC provided updated cost estimates for the redesigned BioSense program. These estimates were well documented and comprehensive and accurate, and met the cost estimation guide's best practice criteria for credibility. For example, for each cost element, a description of the element, the data source, and the estimating methodology was identified. Additionally, a risk analysis was conducted that quantified the risks, and costs were estimated by an independent group outside the acquiring organization to determine whether other estimating methods produced similar results. By developing well-documented, comprehensive and accurate, and credible cost data, CDC has taken steps that should improve its ability to estimate and more effectively track the cost of implementing BioSense, and to more effectively manage the development and implementation of the redesigned program and its related systems.

In September 2012, CDC provided GAO updated timeline estimates for the redesigned BioSense program that were complete and met GAO's cost estimation best practice criteria for reliability. Specifically, the estimates identified the resources needed to accomplish strategic activities and the schedule's critical path, and included an analysis of risks to the schedule. By taking steps to establish complete and reliable timeline estimates, CDC officials better defined plans to help effectively manage the development and implementation of the redesigned BioSense program and its related systems.

In August 2012, CDC released an evaluation plan for the program that contained outcome-based performance measures for BioSense that were developed with input from stakeholders. Specifically, the plan described measures related to user diversity, system usage, and the number of jurisdictions providing data for analysis by the system, among others. These measures are intended to be used to assess the extent to which the implementation of the system supports the program's progress toward meeting its goals. For example, program officials intend to measure progress toward the program's goal of regional collaboration by monitoring the number of jurisdictions electing to provide data to CDC for analysis by BioSense. Additionally, officials intend to gauge progress toward the goal of promoting a workforce competency to use public health surveillance tools by monitoring the diversity of the users and the number of jurisdictions using the system during public health events. Further, program officials engaged BioSense stakeholders when defining these measures and milestones for meeting them. Specifically, representatives from entities such as hospitals, state and local public health jurisdictions, and other federal agencies that play a role in delivering health care and public health provided input by participating in an expert panel and periodic collaboration meetings. BioSense program officials considered and incorporated their input while developing the program's evaluation plan and performance measures. For example, in expert panel meetings, stakeholders expressed the need for emergency department data, and program officials included in the performance measures a metric to indicate the percentage of emergency departments participating in the program. By engaging stakeholders in defining outcome-based performance measures that reflect the goals of the program, program officials should be better positioned to effectively gauge the success of the system's performance toward meeting CDC's and its federal, state, and local partners' goals and needs for improving abilities to respond to public health events.