AWS Public Sector Blog

How APHL transforms public health data exchange with AWS to save newborn lives

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The Association of Public Health Laboratories (APHL) works to build effective laboratory systems in the US and globally, representing state and local governmental health labs that monitor and detect public health threats. In 2024, APHL successfully applied for the Amazon Web Services (AWS) invite-only category of the AWS Imagine Grant, the Children’s Health Innovation Award. Working with their healthcare technology partner Ruvos, APHL received grant funding that included both cash and AWS credits to advance Detor, an electronic test order and result (ETOR) solution developed with support from the Centers for Disease Control and Prevention.

Their project addresses a critical gap in public health infrastructure: fast, secure, and reliable transmission of test orders and results between healthcare systems and public health. This is a capability that was virtually nonexistent. By creating a centralized platform that enables seamless data exchange, Detor has already processed over 60,000 newborn screening test orders and results across 25 hospitals and four public health laboratories in six states. Hospitals now receive newborn screening results almost 4 days faster than before, enabling critical early interventions that can save lives and improve health outcomes for the most vulnerable patients.

Overcoming decades of inefficient manual processes

Before Detor, public health laboratories and healthcare partners relied on paper requisition forms, cumbersome PDF result reports and even fax machines to exchange critical test information. These manual methods were error-prone, time-consuming, and created dangerous delays in patient care.

Even when electronic communication existed, it was inefficient and fragmented. Each laboratory had to independently build and maintain unique connections with every healthcare partner, creating dozens of disparate solutions across the public health sector. Every new partnership required custom transformations and translations to accommodate different system requirements, which was a process that strained already limited staff resources at public health laboratories.

This fragmented approach led to slower results, delayed interventions, and less-informed care. This was particularly problematic for time-sensitive testing like newborn screening, where early detection and intervention are critical for infant health outcomes. The urgency became even more apparent during the pandemic, highlighting how inefficient data exchange systems could impact public health response capabilities.

Building a scalable solution on AWS infrastructure

Detor was built on the APHL Informatics Messaging Services (AIMS) platform, a cloud-based system hosted on AWS that has served as a public health data exchange mechanism since 2008. The AIMS platform securely processes millions of individual messages per month between public health laboratories, agencies, CDC programs, and thousands of healthcare organizations.

The Detor solution uses multiple AWS services to create a robust, scalable platform:

Transforming public health outcomes through data efficiency

Since launching in August 2024, Detor has delivered remarkable results that directly advance APHL’s mission to improve public health laboratory systems and practices. Public health laboratories have reduced their time spent processing orders by 70 percent, dropping from 3 minutes to 1 minute per order. Hospitals have achieved even greater efficiency gains, reducing their time spent processing results by 92 percent, from 6 minutes to just 0.5 minutes per result. With over 60,000 orders and results exchanged through the platform, this translates to 137 days of time savings. If Detor were expanded nationally to include all newborn screening (NBS) orders (3.6 million annually) this would mean hundreds of thousands of hours saved for laboratory staff and healthcare providers, time they could then dedicate to what they do best—testing and patient care.

Healthcare providers no longer need to track down results or manually forward information to clinicians for follow-up care. As soon as results are ready at the public health laboratory, they are automatically sent to the healthcare facility and become immediately available in the patient chart. This seamless flow puts critical information directly into the hands of those who can intervene quickly when necessary.

For newborn screening specifically, where timely testing and early interventions are critical, Detor has transformed the care continuum. Orders are submitted to laboratories immediately with complete, intact, and accurate data. Results reach hospitals in near real time instead of taking days, enabling faster diagnosis and treatment for conditions that require immediate attention in newborn patients.

Looking ahead, APHL plans to expand Detor to additional healthcare organizations and public health laboratories while exploring new use cases beyond newborn screening, including clinical test orders and pandemic response capabilities. This expansion will create a truly national solution that allows public health laboratories to plug into existing infrastructure and share resources, expertise, and technology across the entire public health sector.

Key insights for nonprofit technology implementation

When implementing new technology solutions, nonprofits should prepare for challenges beyond technical considerations. The APHL team emphasizes that securing organizational buy-in requires significant time, particularly when coordinating across multiple organizations. Their experience shows that legal agreements can become unexpected bottlenecks, sometimes taking as long as the technical implementation itself. To avoid delays, they strongly recommend initiating legal discussions and agreements at the earliest stages of project planning.

APHL’s success with Detor demonstrates the value of prioritizing reusability and agility in system design. This approach allows efficient scaling because initial configurations can be repurposed across new implementations, significantly reducing the workload for both laboratory and healthcare staff. With the support from the AWS Imagine Grant and the reliability of AWS infrastructure, APHL has shown how thoughtful technology implementation can transform collaboration between public health and healthcare while creating sustainable, scalable solutions for improving community health outcomes.

How you can support APHL

Detor is a fully developed and deployable solution that is bridging the gap between public health and health care. It’s having a meaningful impact on laboratory and healthcare facilities’ operations, efficiency, and data quality. Unfortunately, due to funding cuts, their ability to expand Detor to more laboratories and hospitals is severely limited and APHL has had to drastically scale back operations. If this is something your organization would be interested in supporting or learning more about Detor, contact detor@aphl.org.

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Rachel Shepherd

Rachel Shepherd

Rachel is a senior specialist in Informatics at the Association of Public Health Laboratories. For the last decade, Rachel has been working with public health laboratories to strengthen informatics infrastructure and advance data exchange capabilities. She currently leads the partner engagement efforts for Detor.

Jules Marenghi

Jules Marenghi

Jules is a business development manager at AWS. She contributes to the team managing the Imagine Grant program and its associated conference, supporting nonprofit organizations worldwide in their use of cloud technology.