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.

Of the many challenges during this project, a recent one was related to case management. Public health users rely on a feature for this called Queues as their gateway to records inside NBS. Multiple queues support different workflows:

• 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 critical issues:

• Limited data visibility forced users to open each record before knowing what action to take
• A cap of 100 records meant large parts of their workload were hidden
• Filters reset when navigating back from a record, causing repetitive rework
• Slow load times stalled triage during peak case periods

Every minute lost to navigation and delays was a minute not spent confirming cases or taking action to protect the public.

We shadowed epidemiologists as they worked through daily lab loads and saw them juggling spreadsheets, sticky notes, and multiple browser tabs just to keep track of what to review next.

From this fieldwork, we uncovered key opportunities:

• Make queue data tables show more critical data up front so users could triage faster
• Allow configurable views so each disease program saw what mattered to them
• Use a search index to load queues faster and display the full workload beyond 100 records

Testing showed that missing data elements such as Associated Investigation or Notification Status made or broke triage speed. So we elevated additional data elements like these into queue tables to cut unnecessary clicks.

We built reusable queue data table templates and filtering patterns into the design system so teams modernizing other features could drop them in without redesigning core workflows.

The improvements delivered clear, measurable impact:

• 78 percent faster case management workflows
• Work that once took hours was completed in less than half the time
• User satisfaction improved from 5.6 to 8.4 on a 1–10 scale
• Increased confidence and adoption of the modernized platform across jurisdictions

One epidemiologist told us, “I can finally keep up.”

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.