1005: Scalable Data Surveillance For PH

JANSON SILVERS: 

This is the award-winning Public Health Review Morning Edition for Monday, October 6, 2025. I'm Janson Silvers. Now, today's news from the Association of State and Territorial Health Officials.

This morning, we have a special episode all about disease surveillance. We are joined by Eric Whitworth, CEO of InductiveHealth, a public health software and services company. InductiveHealth is a member of ASTHO's Innovation Advisory Council, a new collaborative of private sector partners to help inform ASTHO's membership on emerging topics that affect public health.

Eric, your team has been at this a long time. Can you tell me the changes you've seen in the world of data surveillance?

ERIC WHITWORTH: 

Yeah, it's the question everyone looks at. And we have- the big thing, right, we have a very recent data point to go off of that highlighted a lot of the weaknesses and gaps and areas for improvement in public health technology and processes. And that's, that's COVID. You know, there was a long-standing pandemic, and a lot of lessons were learned very fast. And so kind of the shift from COVID until now has been an ongoing kind of back and forth between local public health departments, states, and federal agencies to kind of shore these gaps up in preparation for what one day will probably be the next pandemic. And so you've seen a different relationship between state public health departments and locals, as well as federal agencies. You've seen it, and procurement and public health have- have a different relationship internally, trying to figure out what systems to buy and how, and how does these public health departments scale together? And you're kind of planning for a future that is more real, right? You never want these things to happen, but you know that it can, you see the impact of it. And so, kind of the planning and scalability and- and funding of these systems is more important than ever, because you can see the outcome of what can't happen. And so it's kind of changed the needs. You want systems that can scale up and down faster, right, that are less reliant on- on big pushes of funding. So, because, you know, grants, and funding and- and the ability to spend, you know, broad dollars isn't there forever, you're looking at the introduction of more cloud-based systems, right? So, you can scale up and down without internal hardware and- and the maintenance to support internal infrastructure and, kind of, legacy mainframe technology. And you're, kind of, looking at systems that can do more than one thing, kind of historically, in public health, you've got kind of siloed systems, one system for disease surveillance, and one system for vital statistics, and one system for syndromic, and now, kind of, coming in and being able to scale and do more with less, and kind of the rollback of COVID funds and lower budgets, you have states wanting to do and public health wanting to do more with less, and systems that can meet more of those use cases. So, it's kind of a constantly, now evolving spectrum of public health jurisdictional needs.

SILVERS: 

Your team has specifically been supporting North Dakota on setting up a new disease surveillance system. Can you tell me about some of the barriers your team has faced?

WHITWORTH: 

Transitioning systems is hard, you know, no matter- no matter how you're doing it, no matter how good the new system is, or how legacy an old system is, or why you're making the change. And you know, rather than just getting new functionality, you know, which is a lot of times, why you make changes. You want to scale and upgrade. Kind of states and local jurisdictions are wanting to change processes, get more people involved, protect data differently, all coming out of COVID, you're introducing new interoperability functions, trying to collate data in different ways, and some before link systems in ways that haven't been done before. And you're kind of doing that with new state mandates, new IT mandates, and new federal mandates, and a little bit of- as a moving target, right? Because the end goal is not- not exactly there. You know, there's new methods of data transformation and and there's ideas on what's coming next. You're kind of planning for a little bit of everything and nothing at the same time. And so, trying to put a new system in place and get- get locked down to what you want to commit to in the future, because these systems, you want them to last a long time. It's tough. You've also got the introduction of a lot of new technology. AI, it's new to public health, newer and then, some other, kind of, commercial markets, and so, trying to figure out what a state wants to do, how they're willing to get involved in it, how vendors are willing to invest in it, where data is, and how it's protected.

SILVERS: 

A lot of these projects are long-term, but is there anything that can be done now or in the more immediate future to help a health department modernize its disease surveillance?

WHITWORTH: 

Just start taking a broader approach to data and system modernization. Don't consider one system at a time or one need at a time. If you're going to change a syndromic system, or an immunization process, or evolve a team, think about how you want to integrate with your other teams, and other technologies, and other data sets now. Because in the past, that wasn't necessarily the case. So, start taking a broader approach to public health technology at a state and local level, how these teams and systems will work together, how you can drive down cost across these teams over time, and scale together make a big difference. Realize the right balance between internal resources at your jurisdiction or at a jurisdiction, vendor partners and support you need, your relationships with federal agencies. You know, nobody can do all of these things themselves, but everyone needs different levels and types of support, depending on what their needs are. And so, not trying to force everything into 'do it yourself,' versus all on a vendor, versus all federal or agency support; finding the balance now.

SILVERS: 

Lastly, technology is advancing so rapidly. Knowing that, what are you currently telling health agencies or jurisdictions that are looking for a new system or technology partner in today's environment?

WHITWORTH: 

It's a key question. A couple things I'd mention. First, just kind of focus on configurability over customization. You know, when a system or a group of systems need custom development, you know, investment in R&D dollars to scale, it can be tough. It can be time-consuming. It can be expensive. Some more commercialized, modern systems allow for configuration, deep configuration, to help evolve and scale the system. And then they put that in the hands of the jurisdiction systems that have more front-end administration tools, and allow jurisdictions and their users to have more control over the evolution of the system. It's going to be key to a jurisdiction being able to, one, control their cost, and two, scale systems, and evolve as they need to, and then take a different approach to what you're looking for, and why a lot of RFPs and proposals that are put out there look for qualifications that are a bit antiquated at this point. You know, you want something to have been in place across five jurisdictions, or be in place for three years, and a lot of new technology hasn't, but it doesn't mean it's not ready, or it doesn't mean it's not good. So, kind of, making sure that you have a balance between, you know, the historical evidence you have that something will work for you, versus looking to the future and taking a chance on a new technology may be worth it, because a lot of times, you know, jurisdictions are kind of cutting out options right off the bat, because they're not even- not even considering them. So, you've got to be open to that a little bit to know what's coming. Because a lot of new vendors and a lot of new technologies are on the market that haven't been around for a while, but doesn't mean they're not ready.

SILVERS: 

Thank you so much for your time, Eric.

You can find more information on InductiveHealth's work in this area and the resources our guest was referring to in the show notes.

That'll do it for today. We're back tomorrow morning with more ASTHO news and information. I'm Janson Silvers. You're listening to the award-winning Public Health Review Morning Edition. Have a great day.