We have proposed needed information management capabilities for future US health departments predicated on trends in health care reform and health information technology. Regardless of whether health departments provide direct clinical services (and many will), they will manage unprecedented quantities of sensitive information for the public health core functions of assurance and assessment, including population-level health surveillance and metrics. Absent improved capabilities, health departments risk vestigial status, with consequences for vulnerable populations. Developments in electronic health records, interoperability and information exchange, public information sharing, decision support, and cloud technologies can support information management if health departments have appropriate capabilities. The need for national engagement in and consensus on these capabilities and their importance to health department sustainability make them appropriate for consideration in the context of accreditation.