In a report that found states are showing the highest scores ever for health emergency preparedness, health IT is seen as a major indicator. Experts, however, caution that in order for states to close the gap on existing vulnerabilities an "ongoing investment to rebuild and modernize our public health system" is required.

The eighth annual study, Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism, was released by the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation. States received one point for achieving an indicator or zero points if they did not achieve the indicator. The data for the indicators are from publicly available sources or were provided from public officials.

State preparedness scores:

• Ten out of 10: Arkansas, North Dakota Washington state,
• Nine out of 10: Alabama, California, Kentucky, Louisiana, Maryland, Mississippi, Ohio, Utah, Virginia, West Virginia, Wisconsin
• Eight out of 10: Alaska, Arizona, Colorado, Connecticut, Delaware, Florida, Indiana, Michigan, Minnesota, Nebraska, New Hampshire, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, Vermont, Wyoming
• Seven out of 10: Washington, D.C., Georgia, Hawaii, Maine, Missouri, Oregon, Tennessee, Texas
• Six out of 10: Idaho, Illinois, Kansas, Massachusetts, Nevada, New Mexico, Rhode Island, South Carolina, South Dakota
• Five out of 10: Iowa, Montana

Officials said the scores reflect nearly 10 years of progress to improve how the nation prevents, identifies, and contains new disease outbreaks and bioterrorism threats and responds to the aftermath of natural disasters.

The report provides the public and policymakers with an independent analysis of the progress and vulnerabilities including. Key findings of two IT indicators show that gaps still exist:

• Seven states cannot currently share data electronically with healthcare providers.
• Ten states do not have an electronic syndromic surveillance system that can report and exchange information to rapidly detect disease outbreaks.

"There is an emergency for emergency health preparedness in the United States," said Jeff Levi, PhD, executive director of TFAH. "This year, the Great Recession is taking its toll on emergency health preparedness. Unfortunately, the recent and continued budget cuts will exacerbate the vulnerable areas in U.S. crisis response capabilities and have the potential to reverse the progress we have made over the last decade."

According to the report, while states have made progress, there are still a series of major ongoing gaps in preparedness, including in basic infrastructure and funding, biosurveillance, maintaining an adequate and expertly trained workforce, developing and manufacturing vaccines and medicines, surge capacity for providing care in major emergencies and helping communities cope with and recover from emergencies.

The report provides a series of recommendations that address the ongoing major gaps in emergency health preparedness, including:

• Gaps in funding and infrastructure: The resources required to truly modernize public heath systems must be made available to bring public health into 21st century and improve preparedness.
• A surveillance gap: The United States lacks an integrated, national approach to biosurveillance, and there are major variations in how quickly states collect and report data which hamper bioterrorism and disease outbreak response capabilities.

According to James Marks, senior vice president and director of the Health Group at the Robert Wood Johnson Foundation, the gaps that remain and the risks of loss of our nation's ability to respond during emergencies call out for an ongoing investment to rebuild and modernize our public health system.

"This report makes it clear that not enough Americans are protected against health emergencies," said Marks. "And those whose health departments have done a good job preparing are at great risk of losing ground. The American public needs to know if their state and local health agency has the resources and expertise to respond to any health crisis. Detecting weaknesses and identifying how to fix those are why independent accreditation with specific, measurable standards of quality and performance are so critical to helping the public and their leaders know what more is needed to protect their families and communities."

A full list of all of the indicators and scores and the full report are available here.