1066: Smarter Data Infrastructure for Public Health

JOHN SHEEHAN:

This is Public Health Review Morning Edition for Tuesday, February 10, 2026. I’m John Sheehan with news from the Association of State and Territorial Health Officials.  

Today: how new technologies like telehealth, wearables, and AI, are transforming how health data is created, shared, and used.  We’ll speak with Deloitte Consulting Managing Director in Government and Public Services, Digital Health Practices, John Stinn, about building systems that are flexible, trustworthy, and sustainable. Deloitte is a founding member of ASTHO’s Innovation Advisory Council – a multisector collaborative of industry partners helping keep ASTHO’s membership and leadership informed and nimble on emerging topics affecting public health. 

 John Stinn, welcome to the show. 

JOHN STINN:

Thank you, glad to be here. 

SHEEHAN:

So, John, new technologies, new trends are having a big impact on healthcare delivery and the way that agencies use their data. Can you talk us through some of the developments? 

STINN:

Sure. I think it's safe to say that the way people are accessing health care is constantly changing. You know, we think of telehealth, we think of new provider networks, and even the advent of personable wearable technology. Each of these changes can bring on new types of data, new formats, new sources for public health agencies to possibly use information to help in disease surveillance or other public health operations. These agencies can access data that are richer, that allow them to analyze trends faster and collaborate with others more than ever before. So, with all that potential, there's also some more complexities and the responsibilities and the expectations, including how to respond to outbreaks, even the logistics of how to respond to outbreaks, to supporting new initiatives around rural health programs and meeting new compliance and quality expectations. So, public health agencies have to keep up with these changes, but they also have to consider how those data are collected, they're verified and trustworthy, and then how they're integrated and analyzed. And of course, the challenge is designing the information systems and ecosystems and partnerships that can adapt to all this constant change. Change that's only going to be accelerated with AI without getting locked into rigid and outdated ways of work. 

SHEEHAN:

Yeah, the range of options I'm sure is mind boggling. Are there best practices for organizations that want to implement maybe a big infrastructure, data infrastructure change? 

STINN:

To know about best practices, but better practices that I've seen along the way is really starting with the fundamentals. It sounds cliche, but identifying the problem that you're actually trying to solve before looking to the technical solutions. So, you need to map out the questions you're trying to answer, the issues you're trying to get a handle on. Could be optimizing case management and a disease surveillance program. Could be identifying populations at risk. From a technical and financial perspective, getting a handle on cost, performance, user scales, number of people that need to access the information. Focusing on the issues that need to be resolved is really kind of the essential question. And then we can identify the data that exists that might answer those questions, how those data are collected, who owns them, what the governance policies are, what the governance policies that need to be filled in, and then the workflows and partners that are needed to be involved to get to the right answers. We often see that jumping ahead and picking a platform or someone's favorite standard or interface protocol presents a lot of risk to the success of a public health initiative or information system. For example, in our disease surveillance and intermediary work, and we'll talk about intermediaries a little bit later. We can assist public health agencies in exchanging data with hundreds of partner organizations. And there's a huge mix of structured and unstructured data, a lot of different workflows and many different needs to be addressed, whether it's data integrity, cybersecurity, performance, record-leading, linking across multiple data streams. So, when we start these engagements, we help clients concentrate on the basics. What are the clear goals for the data providers, the users, the administrators? What are the well-defined governance things that we can adhere to? Again, what do we need to fill in? And even the basic and critical descriptions of what the data flows are. I want to emphasize data flows are really the essential part of public health information initiatives. And that upfront work is really what enables us to build systems that are stable and responsive and supportive of the jurisdictions and their goals. 

SHEEHAN:

Sure, it seems like there's probably a temptation to get the newest, shiniest, flashiest system, but you're suggesting starting with the question of: what problem are you trying to solve first? 

STINN:

Absolutely, and I like new and shiny and flashiest as probably more than most, but I find that I get in less trouble if we concentrate on what we're actually trying to do. 

SHEEHAN:

That strategy comes into play when you're trying to rein in costs for rolling out one of these systems? 

STINN:

Yes, definitely. I think what we see about managing costs across with our clients or even within what we're providing to our clients, you know, starting with the entire picture, whether it's the hardware, the cloud compute, the software licenses, the people that need to be involved in technical support, onboarding, things that are really nerdy, like reference data management, but also things that are absolutely essential like cybersecurity and privacy. These are things that all need to be accounted for when we're thinking of the big picture of costs. I think when we start to go into managing costs, what we've seen from agencies and some successes, agencies working with open-source platforms like EpiTrax where states collaborate to customize their systems, share lessons, and accelerate implementation of features that they think are critical for their public health operations. These open-source projects and shared platforms also foster a continual improvement. Agencies learn from one another, they co-develop features, they scale solutions quickly and more quickly than when they work alone in the open-source world. It also allows each jurisdiction to tailor to their unique needs, whether they are doing it on their own or collaborating with a vendor like Deloitte or anyone else. 

SHEEHAN:

An advantage of using open source is that organizations don't have to necessarily reinvent the wheel or ask for some custom-made platform or system. 

STINN:

Definitely. What we've seen working with states that have implemented EpiTrax is that these states have been able to collaborate with each other, develop common features, and even choose to develop features that build upon each other. So, one state may have one feature that is styled a certain way, but another state wants to build from that and elaborate it just a little bit more. And the open process and code base allows them to do that to their needs. 

SHEEHAN:

When an agency or an organization is trying to make the case to secure funding for one of these big initiatives, are there sort of universal points that they should be making? I guess I'm getting at it: what is the big selling point in really building a strong data management system? 

STINN:

Well, since the funding landscape is continuously evolving for many different reasons, agencies that are building smart partnerships, whether it's within their own departments of health or across other public agencies or with private partners within their jurisdiction or even across jurisdictions, these groups are better able to garner funding and amplify their specific services and impact. So, moving the, away from working in silos and embracing transparent collaboration. We see that as key to success for ensuring the sustainability and the resilience of public health agencies overall. 

SHEEHAN:

And you touched on this a little bit, but could you explain a little more the role of intermediaries? And, as I understand it, loosely like third party organizations that exchange data, How can these organizations play a role? 

STINN:

Yeah, I think intermediaries are really key to the future of how public health, how the public health data ecosystem will evolve. So, intermediaries like the like health information exchanges and health data utilities, and also the APHL AIMS platform can help public health agencies and laboratories, clinical health care providers and others exchange information in a secure, standardized, scalable way. That helps lower the technical burdens and the financial burdens for each individual trading partner. I think intermediaries are also good examples of what we just discussed of how government and private partnerships can gain funding and accelerate adoption of new standards, new technologies, and also enable from a public health perspective the proactive interventions that are, that we're all trying to foster. In the last few years, I think it's important to note that AIMS has proven essential for scaling some core data flows for public health, electronic case reporting, electronic lab reporting, immunization information exchange. And that's been essential to move from zero to thousands of trading partners over the last few years. And even more exciting looking to the future, AIMS and other HIEs and HGUs can make it much easier for agencies to quickly tap into genomic data for emerging pathogens and other data such as social determinants of health. And so, with the broader and longer data sets that intermediaries can handle, agencies and partners will be able to unlock new insights for interventions that can anticipate future public health challenges, and support routine public health and even emergency responses in a much more cohesive and efficient way. I mean, for me, ultimately the intermediaries can help public health data move at the speed of trust and collaboration. And that's probably one of the most exciting developments in public health since I've been involved for the last 25 years or so. 

SHEEHAN: 

John Stinn is managing director in government and public services, digital health practices, for Deloitte Consulting. I’m John Sheehan and this has been Public Health Review Morning Edition from the Association of State and Territorial Health Officials.