Many activities currently under way in preparation for and response to public health emergencies, including bioterrorism, are supported by information technology (IT) which enables public health agencies to identify naturally occurring or intentionally caused disease outbreaks and support communications related to public health. The U.S. General Accounting Office (GAO) was asked to review Federal agencies’ IT efforts to support bioterrorism preparedness and response. GAO’s objectives included: (1) compile an inventory of Federal agencies’ current and planned IT systems and initiatives related to bioterrorism and identify the range of coordination activities; (2) identify and describe the development and use of health care IT standards for bioterrorism-related systems; and (3) review the potential use of emerging information technologies to support bioterrorism preparedness and response. The review focused on six key Federal agencies responsible for supporting the response to bioterrorism and other public health emergencies using IT. Federal agencies identified about 70 planned and operational information systems in several IT categories, such as detection, surveillance, communications, and supporting technology associated with supporting a public health emergency. Although a number of efforts are under way, no comprehensive set of standards has been implemented sufficiently to fully support the public health infrastructure. Leadership and overall IT strategy are imperative for ensuring that standards development organizations and Federal agencies address remaining implementation challenges. Several recommendations are presented to enhance American preparedness for public health emergencies, especially bioterrorism. It is recommended that the Secretary of Health and Human Services, in coordination with other agencies, develop a strategy entailing the setting of priorities for initiatives and coordinating the development of an IT standard for the health care industry. Appendices I-XVI, tables and figures