A model for regionalizing epidemiologic services across 27 communities

Epidemiologic services are integral to monitoring disease status in a community. In Massachusetts, most epidemiologic services reside at the state level; few local public health agencies have staff epidemiologists, and most lack resources to hire them. In 2005, a regional coalition of 27 communities began working with the Cambridge Public Health Department Advanced Practice Center for Emergency Preparedness to address the gap in epidemiologic services, and to determine whether providing epidemiologic services through a regional structure is viable. An assessment was conducted to identify the epidemiologic needs of the communities. Results underscored the widespread lack of epidemiologic capacity, and identified needs including assistance with communicable disease reporting, and with collecting and reporting on local and regional health data. A limited menu of epidemiologic services is being developed and will be offered to the region through the Regional Epidemiologic Services Center, which has obtained additional resources through an Academic Health Department collaboration between Boston University School of Public Health and the regional coalition. The Regional Epidemiologic Services Center provides an innovative model that centralizes services where local capacity is severely limited, and combines academic and practice resources. By regionalizing epidemiologic services we will enhance the capacity to monitor local and regional health status and disease, and to provide epidemiologic support in an emergency. Streamlining resources at the regional level provides one means to build epidemiologic capacity for local communities. Potential challenges include offering a menu of services that is useful to all communities, sustainability of services within staffing constraints and funding.