The public health informatics infrastructure: anticipating its role in cancer.

Cancer information and surveillance, historically conducted with manual data collection and submission, are viewed increasingly as inherently dependent on the effective application of information science. One challenge is to use information technology (IT) in a manner that improves cancer-related decision-making and ultimately the quality of care that is offered to patients with cancer. In this article we begin by envisioning a future view of IT-supported surveillance and care that can be made available for application in cancer and its management. We then ask what barriers need to be overcome and what forces are at work that may help us in our efforts to effect the necessary changes. Our future vision for surveillance and information, although appealing and widely shared, requires major cultural change, financial investment, and logistical planning. Competition in the medical marketplace, coupled with fiscal pressures affecting providers and health systems, suggests that leadership for regional and national coordination will need to come from elsewhere-and likely from governments.