PRESENTING INFORMATION PEOPLE UNDERSTAND AND USE

• Kathleen Cook, BSN• Information & Fiscal Manager

CHALLENGE and STRATEGY

CHALLENGEProduce easy to understand and timely

informationDemands from public, decision-makers,

political leaders, program staff and managers, funders and stakeholders, grantors

Pressure to show evidence-based practice outcomes

More data and data sources are available with little guidance for interpretation

Limited resources and staff to do the work

GOAL

STRATEGYPrinciples to Guide Investments•Support work at point of service•Use standard, off-the-shelf technology•Look for potential scalability•Document for future

Key Elements SystematicReplicable Easy to UseMeaningful

Reliable, consistent and on-going sources of data

ComparableBench-markedRelated to Department

mission, goals, objectives

Make the time

to develop

strategic guide

for IT

investments

and

development

Health Department IT Strategy

MANAGING THE DATA

PRACTICAL AND STRUCTURED APPROACH

TYPES OF DATA PRESENTATION Static Data

Periodic updates BRFSS / YRBS Hospital Discharge Vital Statistics

Dynamic and Calculated Data Near real time updates

(Dynamic) Collection of data, organized

and pre-calculated Point of service software

(electronic medical/dental record; permit & inspection records)

Syndromic surveillance

Measures Benchmarks Performance indicators Population health indicators Process indicators

Analytics Data / process mining Statistical / predictive

analysisReporting

Visualization Graphs/charts Dashboards Alerts

Managing Static DataStandardize the process for each data source

Create scripts and routines that can be run automatically

Modify only when the data itself changes

We are saving at

least 500 hours

of Epidemiology

staff per data source

• Raw data• Analysis and Weighting

– Survey data must be weighted based on sample size and demographics

– Event data (e.g. births, deaths) must be adjusted when used for rates—particularly if cell size is less than 30

• After analysis and weighting, data are stored in SQL data base• If data change, new fields are

created in the database

Staff gets new

information

in less than two weeks

From 1-2 datasets per year to 10 data sets

Comparabl

e

Managing Dynamic and Calculated Data

Collaboration is criticalReport Developers must work with •Front end users who generate the data•Managers who determine what is useful and or interpret the dataReport Developers must also collaborate with Users of the Data•Public Health leaders•Stakeholders•Partners•Decision-makers•Managers and Supervisors

Create a Structured approach to identifying and testing data to produce usable information

Identify routine process for linking data source to dashboard

Recognize and follow requirements from data owners related to privacy and access

Produce calculated data through routines

Replicable

Reliable

Systemati

c

Dashboard

Development and Deployment

Our Health Department uses Dashboard Reporting Software from Logi Analytics

REPORT PROCESS All work starts with the

Users: Managers and Frontline staff

Identify Division / Program needs, indicators, benchmarks and other performance measures

Collect Data Extract, Transfer and

Load (ETL) the data to appropriate database

Build Reports, dashboard and applications

Verify that reports accurately represent the indicator or measure

Publish

Updating Dashboard ApplicationsUpdating the dashboard usually involves

adding new data to the database The dashboard is updated automatically. Time spent on the initial design of the rules

for Analysis, Weighting, Selection, Extraction, Transfer, and Load of data from each type of data source is the most intensive and important. Assuring that the rules can replicated Assuring that the rules can be automatedAssuring the rules can be systematically applied

Each additional use of the rules th

Using DashboardsEasy to Use Improving Public HealthWeb-based deploymentNo special software or

training requiredUsers control what

information they want to see, follow or monitor

Assure Quality Service & Performance

Promote Healthy Behaviors—Use of data to support and reinforce change

Monitor Community Health Status /Risks

Benchmark performance and measure outcomes

Assure Quality Service & Performance

Promote Healthy Behaviors

Use of data to support and reinforce change

Monitor Health Status

Community Health Status Indicators

Risk Indicators

Benchmark performance Measure outcomes

Performance Measures and Indicators

Medical Home by 2014

Lessons Learned

Things to Watch Out For….

Helping Users understand informationWe keep these points in mind and include explanations:Taking care when using “percentage change” and rates for data sets with small cells.When comparing years, the starting and ending years may not be reflective of the real change in values.Know if there are breaks in the data:

Deaths classified using ICD 9 in 1998; ICD 10 in 1999Changes in birth certificates in 2005.BRFSS: Changes in sampling as data collection using

cell phone numbers increased led us to make a break between 2010 and 2011 data. We don’t display 2011 and 2012 data in direct comparison with 2010 and earlier data

Including confidence intervals and meta dataAge adjusted data can’t be compared if

different standard populations are used (2000 is the usual standard, but sometimes a different year—say 1946 or 1970, is used).

Racial and ethnic definitions have changed in Census data for races and persons of Hispanic origin.

Don’t be overly precise—survey data have confidence intervals to consider.

GIS is powerful but …..GIS maps often raise more questions than

they answer (counties next to each other may appear to have widely differing rates):For cancer incidence, be careful, as cancer is

age related and residential care and nursing homes are not located in all counties

Wrap up

• Best Practices• Contacts

LLCHD Public Health Informatics Program

Model Practice ProgramAward Winner: July 2011

Best Practices / Model PracticeBest Practices we used:Business Process AnalysisRequirements GatheringStrategic Mapping and

PlanningBusiness Case

LHDs and  Electronic Health Records

Webinar Why should your local health department (LHD) adopt and utilize electronic health

records? Webinar that spotlights Lincoln-Lancaster County Health Department and Marion County Health Department use of electronic health records and how it has improved their public health practice.

Questions ? / More information?

View some of our dashboards:http://data.publichealthne.org Developed with the Public Health Association of Nebraska for all Nebraska local health districtshttp://lincoln.ne.gov/city Key word: data

Raju KakarlapudiPublic Health EpidemiologistLincoln-Lancaster County Health Department3140 N StreetLincoln, NE 68510402-441-6270rkakarlapudi@lincoln.ne.gov

Kathleen CookInformation & Fiscal ManagerLincoln-Lancaster County Health Department3140 N StreetLincoln, NE 68510402-441-8092kcook@lincoln.ne.gov