CDC: Modernizing Disease Surveillance for Faster Outbreak Response

The CDC’s National Electronic Disease Surveillance System Base System (NBS) helps state, tribal, local, and territorial health departments track, investigate, and manage infectious disease cases across the country. During high-volume outbreaks like COVID-19, epidemiologists struggled to find, triage, and update cases quickly enough to keep up with real-time reporting demands.

CDC partnered with our team to modernize NBS in a secure, cloud-based environment built for rapid case triage and collaboration between public health workers during outbreak response. As UX Design Lead, I guided the human-centered design process from discovery through validation and created a reusable design system aligned with USWDS and Section 508 standards.

During high-volume outbreaks, epidemiologists rely on NBS to quickly identify, triage, and act on incoming case reports. As caseloads surged, the system’s core case-management workflows became a bottleneck, slowing review and increasing the risk of delayed or missed follow-up during critical response windows.

NBS uses multiple queues to support different stages of case review, including automated lab reports, active investigations, and cases missing jurisdictional data. These queues are the primary decision surfaces for public health users, determining what gets reviewed, when, and by whom.

• DRR queue for reviewing lab or case reports that were not auto-processed by the rules engine
• Open Investigations queue for cases still in progress
• DRSA queue for reports missing jurisdiction data

Research identified several compounding issues that increased cognitive load and slowed decision-making:

• Epidemiologists often had to open individual records to understand urgency, delaying triage during peak caseloads
• Large queues of 100+ records made it difficult to prioritize work and track progress
• Filters resetting between views forced repeated setup and rework
• SSlow load times interrupted review during time-sensitive response periods

Every delay in navigation or rework translated directly into time not spent confirming cases, coordinating follow-up, or containing outbreaks. Improving speed and clarity in these workflows was not just a usability concern, but a public health imperative.

We partnered closely with epidemiologists and public health staff, shadowing them as they worked through daily lab reports and case queues during both routine operations and outbreak response. This firsthand observation revealed how much of their time was spent navigating spreadsheets, sticky notes, and multiple browser tabs just to keep track of what needed attention next.

Rather than redesigning workflows wholesale, we focused on reducing friction at the point of decision. We prioritized surfacing the most critical information directly within queue views so users could assess urgency without opening individual records.

This led to several targeted design decisions:

• Elevating key data points such as notification status and associated investigations to support faster triage
• Introducing configurable queue views to reflect how different disease programs prioritize work
• Improving performance and search indexing so large queues remained usable at scale

We translated these patterns into reusable queue templates and filtering behaviors within the design system, allowing other teams modernizing NBS features to adopt the same approach without reworking core workflows.

When a system gets out of the way, public health professionals can focus on stopping outbreaks, not clicking through screens. The biggest win for me was hearing users say they were finally keeping up with their caseload. Faster review means faster action, and that keeps people safer.