116: Data Modernization Report Card

Dr. David Adinaro, New Jersey’s Deputy Commissioner for Public Health, evaluates the state of the nation’s public health data and information infrastructure; Dr. Joseph Gaugler, Director of the BOLD Public Health Center of Excellence on Dementia...

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Dr. David Adinaro, New Jersey’s Deputy Commissioner for Public Health, evaluates the state of the nation’s public health data and information infrastructure; Dr. Joseph Gaugler, Director of the BOLD Public Health Center of Excellence on Dementia Caregiving at the University of Minnesota, promotes a new conference on dementia for public health professionals; and Alison Beam, Pennsylvania’s former Acting Secretary of Health, describes a COVID-19 vaccination clinic model her team developed with a Philadelphia hospital partner for people living with intellectual and developmental disabilities.

ASTHO Health Policy Prospectus: Data Modernization and Privacy Protections

Register: The Public Health Opportunities and Challenges of Dementia Caregiving conference

Website: The Public Health Opportunities and Challenges of Dementia Caregiving conference

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This is Public Health Review Morning Edition for Thursday, February 10th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


The COVID-19 pandemic revealed the consequences of decades of under-investment in public health infrastructure. Some of the most glaring deficiencies were discovered in outdated technology and information systems still in use in jurisdictions across the country.

Dr. David Adinaro is New Jersey's deputy commissioner for public health. He grades the infrastructure at the start of the pandemic and today. His evaluation is our morning conversation.

If you were assigning a grade to the nation's public health data systems and information sharing practices today, what grade would you give and why would you give it that grade?


At the beginning of the pandemic, I would have given it a D; mainly around the lack of uniformity, really the under-investment and the almost complete lack of interoperability between the states and particularly the federal government.


What grade would you give it today now that we're two years into the pandemic?


In terms of the tools we need for this pandemic, I would give it a B, B-minus. I think we now all have the tools that we need to operate within our states—certainly New Jersey does.

I think we still have difficulty with the interoperability part. So, if we're going to split that vote, I would make that more of a C-minus; we haven't gotten as far with the interoperability, either between states or the federal government.

Though, to be honest, if we're talking about our data sharing abilities as a whole outside of COVID, I still think it's probably closer to a D. I don't think we've had the time or the ability to make the investments or the direction necessarily to have a resilient system for whatever comes next.


Reflecting, then, on the progress that's been made, would you have expected to see that sort of advancement during an event that is as historic as the pandemic has been?


So, it's hard—we're sitting here right now having this conversation as most of us are at the tail end of our Omicron surge and all having a little bit more time to think about this; so, I think looking at some of the missed opportunities, particularly in that first summer of the pandemic where we may have had more time to talk about the future of public health.

But I think it's hard to say that we should have gotten farther than we are now. But I think it's just an indicator of where we need to get to over the next three or four years if we're going to really be ready for the current and future challenges, the public health challenges, during the rest of the century, to be honest with you.


Is federal investment the reason why we've seen progress, or do you credit other inputs, other factors, for moving the needle?


I think the accessibility of federal dollars has been a major component. I will say that for most states, we still have been on our own to figure out what to do with those dollars and what products, whether they're our own state-developed products or some of the commercial products available, that we were going to use and adapt. So, I think the leadership on the fence has come in on the financial side, not so much from the technology portion of it.


Hopefully we're nearing the end of the pandemic, and sometime this year we'll get to an endemic status. For this whole exercise as it relates to the investment, are you worried that the dollars will start to trail off or that interest in doing this sort of improvement work and our systems will start to wane?


So, both. You know, I think when we see this with the current dollars that are available, most of them that we have available come with an ending around 2024. And I think almost everybody in public health understands that we need to be able to have ongoing funding streams to be able to not only make some of these upgrades, but also then to maintain those systems that we're going to be developing.


Data modernization is one of ASTHO's top 10 policy issues to watch in the new year. You can read the policy briefing using the link in the show notes.


A vast network of unpaid caregivers—most of them family members—spend their days and nights helping people living with dementia; so many that Dr. Joe Gaugler says the needs of this community must be a public health priority. He directs the BOLD Public Health Center of Excellence on Dementia Caregiving at the University of Minnesota, where he's looking to encourage more dialogue around dementia.


I don't think we're always fully aware of what different public health entities are doing in the space of dementia or dementia caregiving. Also, public health traditionally has tended to be somewhat separated due to funding and other structural issues from the aging service networks in many states and communities.

And so, again, getting a better understanding of how can public health contribute to how we best support families and others providing unpaid care for people with dementia is really critical. And a big part of that, I do believe, is offering the opportunity for networking, the opportunity to listen and learn about what other states or communities are doing, and to find ways that we can take advantage of that for our own communities.


Public health professionals will have a chance to connect with others and learn more about dementia caregiving during the first ever national conference on the topic set for June 14th and 15th in Minneapolis.

The conference offers a hybrid of in-person and online workshops and sessions. You can learn more using the link in the show notes.


Finally today, former Pennsylvania acting secretary of health Alison Beam says the pandemic brought many changes to the way the state serves people living with intellectual and developmental disabilities; but one project done in partnership with a Philadelphia hospital made her especially proud. It was a COVID-19 vaccination clinic model designed to serve people in the IDD community.


So, whether it's not having a long wait time, whether it's making sure that there are squeeze balls nearby to be able to distract during the actual vaccination process, whether it's that modified educational material that we spoke to—all of those aspects were brought together to a vaccination clinic where we were able to vaccinate the IDD population in a much more comfortable way.

And while it didn't necessarily conform to that volume-driven influence that I think a lot of us were focused on at the beginning of the vaccination rollout, that's something that we can actually translate into our daily thinking about the vaccination process moving on when it's not such a massive undertaking, but rather how to reach that on a individual nuance level that I think—pretty proud of Pennsylvania, truly, and the partners that we've had to be able to deliver on that.


Hear more of our conversation with former Pennsylvania acting secretary of health Alison Beam in a new episode of the Public Health Review podcast coming soon everywhere you stream audio.


That'll do it for today's report.


Be sure to join us again tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.

Alison Beam JD

Former Acting Secretary of Health, Pennsylvania Department of Health

Joseph Gaugler PhD

Director, BOLD Public Health Center of Excellence on Dementia Caregiving, University of Minnesota

David Adinaro MD FACEP

Deputy Commissioner for Public Health Services, NJ Department of Health