Q

2.0

🔬State & Local Public Health Departments

Detect outbreaks faster. Report cleaner. Defend the answer.

Disease surveillance, real-time outbreak detection, automated CDC reporting, and population health analytics — all on a governed AI data foundation.

xAQUA augments epidemiologists, surveillance teams, and outbreak responders — it does not replace NEDSS, your IIS, or your lab reporting infrastructure. It sits above them, correlates signals across surveillance streams, and turns plain-English questions into reportable, lineage-traceable answers. Built for hard CDC and state reporting cadence.

90%
Faster cluster detection
24/7
Multi-signal surveillance
0
Bytes of PHI leaving your env.
xAQUA · Cezu — Outbreak Detection
👤
Show me unusual respiratory illness clusters in the past 7 days where lab confirmation rate is below 60% — overlay with wastewater and IIS coverage gaps.
🔬
3 clusters detected.
District 7: 156 syndromic, 47% lab confirmed Investigate
Wastewater: Influenza A elevated · concordant with cluster
IIS coverage: 71% (state median 85%)
Generate NNDSS-ready case package and outreach list?
👤
Yes — and route the immunization gap analysis to community health.
Same foundation. Production-validated. The xAQUA UDP runs at a $300B+ public pension fund in fully private deployment. Public Health is the same engine — packaged for surveillance system integration, CDC reporting cadence, and the privacy posture HIPAA and 42 CFR Part 2 require.
The Challenge

Surveillance systems work. Correlating across them at the speed of an outbreak does not.

Public health data is the most fragmented in government — across labs, providers, registries, environmental sources, and wastewater. The systems work. The integration is what slows everything down. xAQUA fixes the integration without replacing the systems.

🔌

Disconnected Surveillance Streams

NEDSS, immunization registries, vital records, ELR, wastewater (NWSS), and environmental data each on their own platform with their own format. Cross-stream questions take days.

Days behind disease velocity
⏱️

Manual Reporting Burden

Epis spend nearly half their time on data entry, case investigations, and report compilation. CDC and state reporting requires manual extraction from multiple systems every cycle.

Reporting eats analytical capacity
🦠

Delayed Cluster Detection

Days or weeks pass before patterns surface from fragmented data. By the time clusters are identified, an outbreak may already be spreading. The cost of slow correlation is measured in cases.

Time-to-detect measured in days
How It Works

One AI data foundation. Sits on top of what you already run.

xAQUA does not replace your systems of record. It does not bulk-copy your data. It federates queries with full authority enforcement — and every request is logged, scoped, and replayable.

DATA SOURCES xAQUA UDP — AI DATA FOUNDATION CONSUMERS NEDSS & SurveillanceNotifiable conditions · casesLab Reporting (ELR)eCR · LIMS · referencelabsImmunization RegistryIIS · VFC · dosesVital RecordsBirth · death · cause-of-deathWastewater (NWSS)Pathogen signal · sitesEnvironmental HealthLead · air · water 🐕 Cezu — Plain-English Concierge Routes intent · Checks authority · Hands off to agents SIX AI DATA AGENTS StewardMember 360° GovernanceCompliance EngineerPipelines AnalystCross-Q&A ScientistRisk · Patterns BIReports Vertical Semantic Layer Case · Specimen · Pathogen · Geography · Cohort · Exposure · Outcome Governance · HIPAA · 42 CFR · CDC PHIN PHI handling · de-identification · NNDSS lineage · full action audit Connectors — sits on your stack NEDSS · IIS · LIMS · NWSS · GovCloud · Snowflake EpidemiologistsCluster & signal analysisSurveillance TeamsReal-time monitoringOutbreak RespondersInvestigation packagesCommunicationsPublic-facing dashboardsHealth Dept LeadershipPopulation health metricsCDC & FederalNNDSS · grant reporting xAQUA stores no PHI. Federates queries across surveillance, lab, registry, and environmental sources at query time.
1
Federate, don't centralizeSurveillance, ELR, IIS, wastewater, vital records — federated at query time. No parallel surveillance warehouse to defend.
2
Multi-signal correlationCezu routes intent. Agents correlate clinical, lab, syndromic, and environmental signals against the same semantic layer at the same time.
3
Privacy-first by defaultPHI handling, 42 CFR Part 2, HL7/FHIR-aware. Defensible to CDC, state oversight, and IRBs reviewing surveillance practice.
Scope of Coverage

Across the full program landscape.

From front-line operations to federal reporting. xAQUA covers the operational, analytical, and oversight workload across the agency.

🦠
Disease Surveillance
NEDSS · syndromic · cases
💉
Immunization Registry
IIS · VFC · doses
📄
Vital Records
Birth · death data
🧪
Lab Reporting
ELR · eCR
🚰
Wastewater (NWSS)
Pathogen surveillance
🌍
Environmental Health
Lead · air · water
👶
Maternal & Child
MCH metrics & outcomes
💊
Chronic Disease
Registries & prevention
🚑
Emergency Prep
Preparedness & response
📊
Epidemiology
ELC · grant analytics
🔬
Outbreak Investigation
Cluster & source ID
🌐
Health Equity
Cohort outcomes
The Solution

Your AI Data Team — six agents, one platform.

Each agent is a specialist. Together they augment your front-line staff, analysts, and oversight team — without replacing the systems they already use.

📚
Disease Intelligence
AI Data Steward · SemantIQ · Entity 360

A unified, governed view across surveillance streams — cases, specimens, immunizations, wastewater signals, vital records — with sub-county geographic resolution and cohort linkage.

Case linkage across surveillance, lab, and registry sources
Sub-county geographic resolution with privacy thresholds
Plain-English epidemiology queries for surge analysts
🛡️
PHI & 42 CFR Governance
AI Data Governance · Qualix · SenseMask

PHI handling, 42 CFR Part 2 enforcement, de-identification thresholds, and small-cell suppression. The compliance posture CDC, IRBs, and state oversight already require.

PHI tagging and access enforcement at query time
Small-cell suppression for public dashboards
42 CFR Part 2 handling for sensitive surveillance
Real-Time Outbreak Detection
AI Data Scientist · ClickML

Anomaly detection across syndromic, lab, and wastewater signals identifies clusters before they spread. Predictive models with explainable feature attribution.

Multi-signal correlation (ELR + syndromic + wastewater)
Automated cluster detection with epi review queue
Explainable predictive outbreak modeling
⚙️
Surveillance Engineering
AI Data Engineer · Composer

HL7/FHIR-aware connectors. Automated NNDSS submissions. Schema-aware ingestion for new conditions, new lab partners, and new federal data calls.

HL7/FHIR/eCR-aware ingestion
Automated NNDSS / state notifiable disease submissions
New-condition rollout in days, not months
💉
Immunization & Equity Analytics
AI Data Analyst · Infera

Identify undervaccinated populations by geography, age, and demographic. Target outreach campaigns. Track health equity metrics with bias monitoring.

Coverage gap analysis with sub-county precision
Outreach targeting with privacy thresholds
Equity dashboards with bias monitoring
📈
Population Health Dashboards
AI BI Specialist · Narratix · DataLens

Real-time dashboards for health department leadership. Disease trends, immunization coverage, equity outcomes — with auto-narrated commentary and full lineage.

Real-time disease trend dashboards
Immunization coverage maps with privacy suppression
Auto-narrated executive summaries with citations
A Day in the Life

From a syndromic anomaly to a CDC-ready case package — in seconds.

A typical surge analyst flow. Same shape holds for outbreak investigation, immunization gap analysis, and federal reporting.

FROM A SYNDROMIC ANOMALY TO A CDC-READY CASE PACKAGE A typical surge analyst flow. Same shape holds for outbreak investigation, immunization gap analysis, and federal reporting. 💬 STEP 1 Plain English Epi asks Cezu a surveillance Q 🐕 STEP 2 Cezu Routes Picks the right agents, checks authority 🛡️ STEP 3 PHI & Threshold RBAC, suppression, 42 CFR enforced 🔬 STEP 4 Multi-Signal ELR + syndromic + wastewater correlated 📋 STEP 5 Case Package NNDSS-ready with lineage trail 🔍 STEP 6 IG & CDC Replay Every step auditable, replayable Total: under 5 seconds for the answer · NNDSS package: under 60 seconds · PHI handling logged on every step
Use Cases

What teams ship on xAQUA.

Concrete workflows scoped at peer agencies. Each one is a single use case the platform unlocks — and the platform unlocks dozens more after the first.

🦠

Outbreak Investigation

Accelerate investigations with AI-powered case linkage, cluster analysis, and source identification across fragmented surveillance, lab, and wastewater data.

💉

Immunization Gap Analysis

Identify undervaccinated populations by geography, age, and demographic with sub-county precision. Target outreach without violating privacy thresholds.

🚰

Wastewater Surveillance

Correlate NWSS signals with clinical surveillance. Early warning for respiratory viruses, enteric diseases, and emerging threats — days ahead of clinical signal.

📄

Vital Statistics Analysis

Analyze birth and death data for population health trends. Track maternal mortality, infant outcomes, and cause-of-death patterns with cohort analytics.

🌍

Environmental Health

Link environmental exposures to health outcomes. Track lead poisoning, air quality impacts, and water contamination incidents across geography and time.

🚨

Emergency Response

Coordinate emergency public health response with real-time situational awareness. Mass-casualty tracking, resource allocation, communications, and federal reporting.

📋

NNDSS & State Reporting

Automate notifiable disease submissions. Generate HL7/FHIR messages, NETSS, and state-specific reportable formats with full data lineage.

🌐

Health Equity Analytics

Cohort outcomes by demographic, geography, and program participation. Bias-aware models with cohort-level explainability for community health planning.

💊

Chronic Disease Registry

Manage cancer, diabetes, hypertension, and asthma registries. Cross-link with social determinants for prevention program design and outcome tracking.

Security · Sovereignty · Compliance

Compliant by default. Defensible by design.

Government data carries statutory privacy, federal reporting, and oversight obligations from day one. xAQUA is built for that posture, not against it.

🔒
Fully Private Deployment
VPC, GovCloud, or on-prem. PHI never leaves your boundary.
🛡️
HIPAA + 42 CFR Part 2
PHI handling. Sensitive surveillance protected by default.
📋
Small-Cell Suppression
Privacy thresholds enforced on public dashboards.
🔐
RBAC & SSO
SAML/OIDC. Authority enforced at every agent step.
📊
Data Lineage
Every figure traceable to source surveillance record.
🌐
HL7 / FHIR / eCR Aware
Standards-native. Plays well with CDC PHIN architecture.
🇺🇸
FedRAMP-Aligned
GovCloud-class posture. CDC-aligned security controls.
🚫
Zero Storage
xAQUA stores no PHI. Sits on top of the surveillance you already run.
Measurable Impact

Detection accelerates. Reporting submits clean. Equity gets quantified.

Reference outcomes from peer-department design conversations and adjacent production deployments on the same platform.

90%
Faster Detection
Earlier cluster identification with multi-signal correlation
50%
Less Manual Work
NNDSS automation + auto-narrated dashboards
3 wks
Implementation
vs. 6–9 months for traditional integration
100%
Defensible
Full lineage and PHI handling on every output

Bring an AI data team into your health department.

A scoped 30–60 day pilot against your specific use cases. Live in your environment. No PHI egress. We work with state and local health departments on outbreak detection, NNDSS automation, immunization equity, and wastewater integration.