A Path Forward to Build Back Better for Public Health Infrastructure

This entry is part 1 of 2 in the series Innovations in Informatics

This series explores the world of public health informatics and the emerging innovations in this rapidly evolving discipline. These stories and perspectives from the Public Health Informatics Institute (PHII) will delve into leveraging data and technology to equip the public health workforce to use data effectively to solve community health problems. PHII, a program of The Task Force for Global Health, guides public health organizations to effectively access, use and share information to advance health outcomes worldwide.

Our public health data infrastructure in the U.S. already felt strains before COVID-19, but the pandemic pushed it to its limits. This pressure highlights the urgent need to rethink a national vision for public health data and infrastructure.

At the height of the pandemic, in partnership with the Robert Wood Johnson Foundation (RWJF), PHII wanted to better understand how to go about transforming U.S. data and infrastructure to protect public health and achieve health equity. PHII did an environmental scan, hosted an interview series with public and private sector thought leaders, and convened an advisory group to help create what became the Building Back Better report. I’d like to share some of the challenges and recommendations gathered in the report.

The importance of a strategic vision

To start building back better, state and local jurisdictions need help to develop their visions. They require guidance to make informatics plans for building their infrastructure and their future workforce. Building Back Better calls for developing a nationwide strategy to transform ways to gather and use public health data.

What’s missing is a larger vision of where public health needs to go. Bringing together experts from various jurisdictions, public health associations, private industry and healthcare can provide direction for that vision. Their suggestions can serve as a guiding light for jurisdictions that need help to figure out where they’re at, where they want to go and what they need to do to strengthen their data and infrastructure. Then, jurisdictions can make informatics plans to fill their infrastructure gaps and build their workforce for the future.

One way to create a shared vision is by agreeing upon a definition for data modernization. This phrase seems to be everything to everyone. Moving forward, I think we in public health need to define data modernization so we’re better prepared for the next emergency.

New opportunities to transform public health

Before the COVID-19 pandemic entered our lives, the Centers for Disease Control and Prevention (CDC), began the multi-year Data Modernization Initiative (DMI). This initiative aims to improve the data systems for public health surveillance across federal and state, tribal, local and territorial (STLT) agencies. As part of this initiative, PHII collaborated with CDC to provide resources for jurisdictions on developing data modernization plans. We’re also supporting them to improve their informatics infrastructure and workforce capacity.

Now, there’s increased federal funding available for jurisdictions to strengthen their infrastructure. I mentioned in my previous blog post the exciting news about the $73 million offered towards strengthening IT through the Public Health Informatics & Technology Workforce Development Program (PHIT Workforce Program). While having more money to improve is a great start, there needs to be coordination across public health agencies and membership organizations so everyone knows what’s going on across data modernization. We can leverage all that knowledge to move efforts forward. And, jurisdictions can learn where to use their funds to make the most impact.

What it will take to move forward

The coming nationwide vision and data modernization effort must focus on promoting health equity. We’ve got to make equity the lens that we use for all public health activities, including data collection and interpretation; if we do not bake equity in from the very beginning, modernization efforts cannot succeed. Achieving health equity isn’t ever fully complete. It has to be tended to over and over again.

I know public health is a science. We like to be objective, and we should. But there’s more to data collection than just the numbers. To ensure equity, we need to pay close attention to the way we gather data and interpret those results. Every time we’re looking to collect more data, we as public health professionals should ask ourselves, what are we missing? Respecting and including underrepresented communities helps ensure we’re collecting the right data and interpreting it in a way that connects with communities.

Investing in a public health workforce that also reflects national diversity strengthens our commitment to health equity. A diverse workforce—especially one highly trained in informatics and technology—can provide a unique narrative that transforms data into information to inform decision making. Their skills can move forward plans to make transformative changes in our data infrastructure.

Building out a highly trained technical workforce is going to take time. While local and state jurisdictions may have the capabilities, their capacity may not be at the level yet to make the immediate impact they want. Public health professionals have to be realistic about what can get done and how long it will take. After all, we’re talking about truly transforming our public health data and infrastructure.

It’s going to take time, but we can start building back better. Let’s go!

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