The federal Centers for Disease Control and Prevention (CDC) on Wednesday released a report indicating that, while states have made strides in emergency preparedness in large part because of their work expanding communications networks and health information exchanges, significant challenges remain, Government Health IT reports. Specifically, the report found that all state health departments now can receive and evaluate urgent health threat reports 24 hours per day, up from just 12 state health departments in 1999, while all states also are participating in the Health Alert Network, which links local health departments to hospitals, CDC and state health departments. In addition, the number of users of the Epidemic Information Exchange—a secure communications system to track disease outbreaks—increased from 890 in 2001 to 4,646 in 2006. Despite these gains, however, the report outlined various shortcomings that remain. Regarding disease surveillance, for instance, 16 states reported no plans to electronically exchange data with regional health information organizations. Additionally, the report notes that emergency communication systems lack needed interoperability (McKinney, Government Health IT, 2/21/08; Health Data Management, 2/20/08).