A cornerstone for effective emergency response lies in the ability of local health departments to manage and move critical supplies. The National Association of County and City Health Officials (NACCHO), conducted a timely assessment of the current state of Inventory Management Systems (IMS) for disaster response assets at local health departments across the United States. Based on qualitative and quantitative data collected between January and July 2025, the assessment results highlight systemic gaps, barriers, and opportunities for improving IMS implementation and usage. The aim here is to translate the findings of the analysis into actionable strategies for public health leadership and decision-makers. NACCHO underscores the urgency of modernizing IMS infrastructure, advocates for standardization, and outlines recommendations to enhance emergency response capabilities. The following is a summary of the insights gained from the analysis, which revealed a fragmented landscape of IMS adoption and usage, with significant implications about public health readiness. Overview and Major Takeaways NACCHO's assessment gathered responses from 107 local health departments across 36 states, with the majority representing suburban jurisdictions (49.5%), followed by rural (28%) and urban (22.4%) jurisdictions. The survey focused on 3 key areas: system capabilities, funding mechanisms, and barriers encountered. The key informant interviews and focus groups reflected similar demographics to those of the survey, with participants serving in roles ranging from emergency management and medical countermeasures staff to local health department decision-makers. Twelve key informant interviews were conducted, and 20 individuals participated in the focus group, which was held at the NACCHO360 conference in July of 2025. Major findings from these assessments are presented in the sections that follow. Lack of IMS utilization Alarmingly, 3 in 8 local health departments reported having no IMS system in place. This absence of infrastructure severely limits their ability to track, order, and distribute medical countermeasures and other assets during emergencies. Fragmented IMS and varied platforms Among respondents with an IMS, 27 different platforms were mentioned, including state and federal IMSs. The lack of data and process standardization among these various platforms hampers potential for interoperability, slows response times, and complicates coordination across jurisdictions and between response partners. Limited capacity for IMS improvements and adoption Only 2 in 8 local health departments are currently planning or implementing changes to their IMS indicating a slow pace of modernization. Inventory management systems are often complex and require extensive training, leading to abandonment during disasters due to challenging just-in-time training. Data use agreements Five in 8 local health departments lack a signed data use agreement, and only 4% have plans to establish one. This presents the data sharing gaps between local and state entities and other response partners. IMS Landscape at Local Health Departments Throughout the project, an IMS was defined as a comprehensive approach that uses technology, processes, and procedures to track and manage an organization's inventory throughout the supply chain. This system can be a rudimentary or complex data management tool. Indeed, 63.6% of survey respondents use an IMS, whereas 36.4% have no system or only rudimentary tools. Local health departments with an IMS platform use it to track supplies (94%), receive orders (75%), and distribute to partners (66%), but these functions lose effectiveness without broader system integration. Among 107 departments surveyed, 27 different IMS platforms were identified—ranging from basic tools like Excel to advanced systems like Veoci—creating complexity and reducing interoperability. The most tracked assets include personal protective equipment (PPE), vaccines, and medical devices, yet the absence of a standardized language for asset types and quantities complicates resource management, particularly during disasters. Establishing a common language on data elements would significantly improve efficiency across local, state, and regional response agencies. Addressing Sustainability of IMS Approximately 83.1% of agencies with an IMS depend on a single funding source, threatening long-term stability. Funding is nearly equally split between state (29.3%), local (29.3%), and federal (26.7%) levels, with 7.3% of federal recipients specifically using Public Health Emergency Preparedness (PHEP) grant funds. To address this financial vulnerability, NACCHO recommends a regional or statewide framework to facilitate shared resources and a more sustainable, collective approach to IMS acquisition and maintenance. Inventory management systems rely heavily on program sustainability. The following reflect both resource constraints and lack of organizational inertia, which must be addressed at the decision-maker level to advance IMS modernization: lack of funding, competing priorities, system procurement challenges, leadership buy-in, and limited IT/technical expertise (Table 1). Focus group participants underscored that IMS sustainability is a significant concern for local health departments, as they face budgetary and staffing changes. Systems must be user-friendly and quick to onboard staff, be easily adaptable and scalable to differing public health responses and be usable for coordination with other entities within the local jurisdictions, such as emergency management. If systems do not meet these criteria, users reported reverting back to legacy systems such as Microsoft Excel, Microsoft and Google Forms, Google Sheets, or other rudimentary systems in times of response. Without clear policies governing IMS adoption and disaster-response stockpile maintenance, funding is deprioritized, and long-term sustainability becomes increasingly at risk. TABLE 1 - Top barriers to acquiring an IMS experience by local health department survey respondents (n = 107). Barrier Percentage Lack of funding 63 Competing priorities 41 System or product procurement 40 Lack IT/technical expertise 34 Not a priority 29 Other 9 Policies or statutes 15 Abbreviation: IMS, inventory management system. Strategic Recommendations for Local Public Health Leadership The following strategic recommendations outline key actions to enhance interoperability, coordination, and system readiness, ensuring that local health departments are equipped to operate effectively and efficiently and with shared situational awareness during evolving crises. Establish a unified, interoperable system To drive a truly effective emergency response, public health leadership should champion IMS platforms that anchor their operations in real-time and bidirectional data exchange with local, state, and federal partners. The ideal system strikes a balance between standardized processes and the flexibility to adapt to shifting crises, ensuring that interoperability with partners and user-friendliness remain at the forefront for all personnel. Through interoperable IMSs, health departments can transform complex logistics into a streamlined, high-accuracy operation. Provide clear guidance for IMS To help local health departments align their practices and improve data quality, state health departments should offer policies in support of IMS implementation and sustainability, create standardized criteria for asset tracking, and develop methods and tools for consistent data collection. By pairing these resources with ongoing training and technical assistance, states can ensure that local personnel are fully equipped to maintain a cohesive and effective IMS infrastructure. Enhance communication and coordination Health department leadership must build trust, clarity, and responsiveness well before emergencies occur, as effective IMS use relies on strong communication practices. This includes designating clear points of contact for IMS management, organizing regular informational sessions, maintaining consistent reporting protocols, and establishing bidirectional data sharing between state and local entities through formal data use agreements. Ensure real-time resource visibility Local health departments should have access to real-time information on available resources at the state and regional levels, supported by interoperable IMS platforms and strong data use agreements. This visibility enhances emergency response by enabling the rapid deployment of supplies, the efficient allocation of assets based on need, and improved situational awareness throughout evolving public health events. Secure leadership buy-in and technical expertise Public health leadership must prioritize investment into IMSs in order to overcome institutional resistance and advance modernization efforts. This commitment includes promoting systems improvements within their organizations, allocating resources for system procurement and staff training, and recruiting technical expertise to support successful implementation. Applying the Data and Next Steps Leaders and decision-makers for local public health departments should actively engage in policy development surrounding the strategies of IMS readiness to ensure timely disaster response. By supporting the efforts and resources needed to modernize IMS, local health departments can begin to lay the groundwork for operational precision and resilience in future disasters. The findings point to an immediate need for interoperable IMS platforms, sustained by reliable funding, adequate staffing, leadership engagement, aligned policies, and technical expertise. NACCHO serves more than 3300 local health departments across the United States, and it is important to note that the convenience sample from this project is not representative of all local health departments. For future studies, NACCHO recommends completing a representative assessment to determine the full scope of local health department capacity and needs. Implementing the recommendations outlined in previous sections enables local health departments to enhance rapid response capabilities and coordination with partners at all levels of government—directly contributing to lives saved during disasters. A shared purpose, cross-sector collaboration and investment will create a more resilient, responsive, and prepared country for the next disaster.
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