1221: How Real-World Data Can Strengthen Public Health

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Thursday, October 8, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials.

 

Real-world data could give public health agencies a more complete and timely picture of the health of their communities. Today, Andrew Kress, CEO of HealthVerity, and Tabitha Offutt-Powell, vice president for Public Health Data Modernization and Informatics at ASTHO, discuss a new public-private consortium designed to expand public health access to real-world data.

 

We'll start with Andrew Kress.

 

ANDREW KRESS: 

Generally, real-world data is understood to mean any data that's generated as a byproduct of individuals' interaction with the health care system. So you can think about it being sort of all of the data that gets recorded. For example, when you go to your doctor and they maybe put information into your chart, there's a bill that might get filed electronically. You might go to your pharmacy, and there's a prescription that's generated. It's all of the sort of artifacts of those interactions with the health-care system that constitute kind of your real-world experience in terms of your public health importance. One of the benefits that we understand to be the case around real-world data is both that it reflects kind of the real experience of individuals in terms of their health-care system exposure, the disease states that they have, the way they get diagnosed in a in a broad scale setting, but also that these data are available at very large scale and across highly representative populations on a near real-time basis in many cases. So, from a public health standpoint, one of the benefits is that it allows you to see very large populations to be able to conduct surveillance, to be able to look at various types of real-world outcomes in a way that is challenging when you're doing this on an individual, case-by-case basis.

 

SHEEHAN: 

Gotcha. And through this new partnership between ASTHO and Veritas Data Research, you're making all this public health data available to health agencies. That's clearly valuable. Why is that important to you and for HealthVerity?

 

KRESS: 

That's a great question. So the work that we're doing to make this data available through this Consortium builds on work that we've done at HealthVerity with some of our other federal partners, for example, at CDC, at FDA, and at NIH. And the reason is that we believe that there is a, kind of, an opportunity now to really strengthen kind of the public-private partnership model, whereby many of these public health partners can benefit from a lot of these data assets and some of the technical know-how around how to use them at a time when you know many of them are challenged with how to think about enhancing their existing capabilities. And so for us, making sure that we can leverage, as a byproduct, much of the data that we produce and use with many of our commercial partners for public health sort of helps us support the mission of our public health partners, as well as basically making sure that the systems that they're thinking about in the future are as robust as possible; when you want to think about disease detection, for example, as one of the use cases.

 

SHEEHAN: 

You mentioned technical know-how. I'm wondering if that's one of the bigger challenges that public health agencies have in accessing this kind of data, and how the Consortium is going to help smooth that friction.

 

KRESS: 

Sure, I think in terms of data access, there's really a couple of challenges. So the role that HealthVerity plays is that we work with many of our data partners that are the ones that contribute the source data, and we make that data available on their behalf for research and analytic applications. In order to do that, there's a number of technical problems that we are solving so that the data is both privacy-compliant and also has the right kind of governance around it in terms of the use cases, so when we work with a data partner, we'll ingest a copy of their data. We are de-identifying their data so that under HIPAA, the data is not re-identifiable. We are using our own privacy-preserving record linkage technology so that we can track events about individuals on a unique but anonymized basis over time. We're managing sort of the holistic view of data privacy across the data in total to make sure that the data doesn't become re-identifiable because of the combination of features, and then we're basically making the data available in kind of a normalized format so that it can be used by whatever the analytic or application is. So there's a lot of technical middleware that has to happen in order to be able to take those source data and to turn them into something which is fit for purpose for analysis. For example, the other challenge that we solve is we act as the the effectively the data governance partner on behalf of the data owners, and the reason that's. Important is because historically, one of the big challenges is that while there's always been this need for public health to be able to get access to these types of data, oftentimes the data itself sat with private entities. It might be a payer, it might be a PBM or a pharmacy chain, but making sure that there's the right governance model in place, so that the data controller feels that the data is being used for something which is fit for purpose, or something that fits with their model, is an important part of this, and that's what we facilitate by being in the middle of this.

 

SHEEHAN: 

And how do you see the project growing in the coming years, and how can other agencies, communities join the Consortium?

 

KRESS: 

So we're starting out with a set of applications where we think there's a common set of needs among many of the public health partners that we're working with to be able to do. For example, program measurement around certain types of programs to be able to do certain types of enhanced surveillance around particular infectious diseases, as an example. And then what we would envision is, as this moves forward, the users themselves will self-identify more use cases, and then we can sort of tailor what data is made available and in what form it's made available to those particular use cases. So one of the benefits here is it gives the jurisdiction the ability to get access and experience working with this type of data at scale, and the ability to do so in a way where candidly they don't have to be sort of the direct party responsible for assembling the data and doing all the work to make it fit for purpose.

 

SHEEHAN: 

And paint us a picture here of what's possible, you know, with this kind of analysis and access to data, and why communities should really be optimistic.

 

KRESS: 

Well, I think if you think about the availability of de-identified real-world data, one of the areas that's been challenging is for public health to figure out both how to get access to that data and how to work with it at scale. So there are programs that have been done using this data on certain more targeted applications. So, for example, there is the FDA Sentinel [Initiative] program that, for a number of years, has actually been very successful in being able to look at drug safety using real-world data. But that's a very specific application with very specific types of analyzes that are being done on top. The typical public health use case might be more around things like disease surveillance, as an example. So rather than using just a traditional case detection methodology, are there other ways to detect disease-related events? Program measurement; so when you think about public health investing in intervention programs, are there mechanisms to be able to use this data to figure out what's working? So, which programs are having the most effect in terms of changing the curve, whether it's around disease outcome or cost or whatever it may be? And so, as you think about kind of the pivot, it's kind of the move from the traditional case reporting methods to limited surveillance, to, in some cases, now being able to overlay very large-scale data to be able to do kind of real-time detection of events, in addition to some of the more traditional methodologies.

 

SHEEHAN: 

And Andrew, this all seems like very practical and a good use of data and data that public health agencies across the country can use. Why hasn't this happened sooner?

 

KRESS: 

I think one of the reasons it hasn't happened sooner is that historically, the data itself was not really available at scale to most of the entities at the level that we're talking about. So some of the federal partners might be able to get access, but many of the state and local jurisdictions had a challenge getting access to this type of data. I think that's one part of it. The second part, I think, is really a little bit cultural, which is the idea that there can be these types of public-private partnerships with public health agencies. You know, to be candid, it is a bit of a newer idea for many of these agencies, and so I think some of this has been both, you know, the data owners becoming more comfortable with this model, but also the public health agencies recognizing that there was value here and that they could benefit from this in a public-private way that didn't necessarily compromise their public health mission, but effectively could be additive to that. And so, you know, what we see now is this idea of data sharing between entities becoming much more top of mind. And if you look at sort of the work that's being done to really think through kind of modernizing the public health infrastructure. You know, a lot of this is around not just the sort of the technical modernization, but it's also sort of the policy and the process modernization of how public health is going to work with other entities in health care to sort of better the mission of what their core mission is around sort of you know disease detection and prevention and so forth.

 

SHEEHAN: 

Andrew Kress is CEO of HealthVerity.

 

Now let's hear from ASTHO's Tabitha Offutt-Powell, vice president for Public Health Data Modernization and Informatics.

 

TABITHA OFFUTT-POWELL: 

With real-world data, there's so many opportunities. Public health has faced many challenges over the years, and it's an exciting time because we have an opportunity to change the landscape of data availability for public health decision-making; we've had limited access to the broader real-world data ecosystem. Those include things like lab test results, data from electronic medical records, electronic health records, consumer data, many other types of data that public health has. You know, we have access to some of these, but not all of them, and it helps us to complete that picture of what's happening in our community. And it's really important for that reason because public health is really responsible for protecting and improving the health of their communities. So it's really important for them to have a seat at the table when decisions are made about how data are used. Having access to real-world data opens up so many doors and so many possibilities for us to truly understand the health of our populations and the communities for which we public health serves.

 

SHEEHAN: 

And for ASTHO, what is the value of the Public Health Data Consortium, especially in reference to the broader health landscape?

 

OFFUTT-POWELL: 

The value really is truly that this is an opportunity. It's it's a first of its kind public private partnership. For ASTHO, we have some amazing partners in terms of HealthVerity and Veritas data research. They understand the power of real-world data. They've worked with real-world data for a very long time, and so they are really also invested in public health having access to these data, so through that partnership, we're able to provide the real-world data to public health at no cost. We're able to link those data, allow public health to continue to govern those data, provide them with analytics and dashboards and technical support, and it's all contained in basically one model. So, really, they're able. Jurisdictions that are interested in participating can do that early on. They can start to learn more about real-world data, how they benefit public health, and really start to explore those possibilities.

 

SHEEHAN: 

Yeah, and you sort of alluded to this earlier, but how do you see real-world data complementing traditional public health surveillance?

 

OFFUTT-POWELL: 

Yeah, this is a great question. You know, some of the questions I received is: Does having access to these real-world data do they replace traditional public health surveillance systems? And the question is really no, they don't. The real-world data are not intended to replace. They are intended to complement the existing surveillance systems that we have; it helps us to answer some of those questions that public health wouldn't be able to answer otherwise. It gives us the chance to fill in some of the gaps that we've had before and provide some insights into questions that public health has in terms of the health of their community by filling in those gaps with data that help to answer those questions. So it really just gives us a better picture of health care utilization, treatment patterns, and outcomes across the health-care ecosystem, and really opens the doors in that way to be able to have access to the data that inform better decision-making supported by timely and complete information.

 

SHEEHAN: 

Can you give us some examples of the kinds of questions or gaps that this data is going to fill in?

 

OFFUTT-POWELL: 

So, as we were looking at and exploring the real-world data, we focused on what the key public health priority areas right now, and those really focus on some broad areas of maternal health, child and infant health, substance use and overdose, rural health, and chronic conditions. And just a few examples of where that can really help us move forward is in the maternal health areas, understanding postpartum health-care utilization and outcomes. As you know, mom is continuing, you know, progressing with her baby, and how is she doing, right? And a lot of that's in the health-care data, identifying gaps in preventive care, better understanding overdose treatment and recovery pathways that may not be viewable through our existing data streams, monitoring chronic disease management. There are data that public health has access to, but in the chronic disease realm, you know, we're looking for more timely data to understand conditions that may not necessarily be reportable, but that help us to understand what are the the the chronic care cascade in those areas that are really important for public health to intervene and to promote health and those types of things. And also helps us to understand some of the differences across geographic areas and communities for which they serve.

 

SHEEHAN: 

And what should public health agencies know about participating in the Consortium? You know, and what should they understand about that opportunity?

 

OFFUTT-POWELL: 

So the Consortium is designed to be able to allow public health agencies to access real-world data early on. They can become an emerging participant, gain access to the real-world data dashboards that are internal to them, so they can start to see that data. They can also then link their data, and you know that that progresses them along that pathway to participation as they're exploring the value of that, and really, it's to understand and support those use cases that they defined that is informing the structure of the supports that help public health decision-making and data stewardship. So, early participation really helps jurisdictions shape the Consortium and the future of the Consortium. So, it's really for them and with them that public health can begin to engage with the real-world data.

 

SHEEHAN: 

And Tabitha, lastly, it strikes me that this presents a real opportunity for maybe some public health agencies that wouldn't otherwise have access to this kind of information. What other kinds of access are they getting?

 

OFFUTT-POWELL: 

So really, the Consortium, what it's designed to do is reduce those barriers to access to real-world data, because otherwise those would be cost-prohibitive to purchase real-world data, and so it could be 1,000s to millions of dollars annually. So what this Consortium does is provide that real-world data at no cost. We are going to be launching a public-facing dashboard that just gives a few examples to public health jurisdictions about what's available when participating in the Consortium. Some of those, just to give you a few examples, are severe obstetric complication data. There are there's information on alcohol use disorder, and then also things like heart attack and stroke risk are also included as really key data that will be made available. We also have over 130 other types of data that we're going to make available initially through the Consortium. But really, the key takeaway is we want to build the dashboards and the data in the Consortium informed by our public health partners and agencies, and by participating early on, they can do that and really help to shape what those public health priorities are. And we've already really been responsive to the feedback we've received so far to, you know, allow jurisdictions to be able to join early to access the real-world data and then go through processes so that they can see how they can evolve that participation into contributing data and explore what that looks like for them.

 

SHEEHAN: 

Tabitha Offutt-Powell is vice president for Public Health Data Modernization and Informatics at ASTHO. Earlier, we heard from Andrew Kress, CEO of HealthVerity.

 

Public health agencies do not lack mission; they lack time. Every hour a disease investigator spends chasing incomplete reports, reconciling duplicate records, re-keying vaccination history, or manually reviewing electronic messages is an hour not spent on investigation, prevention, outreach, provider engagement, or community trust building. Find a link to the new blog post, "Let Epidemiologists Be Epidemiologists: How Data Modernization Frees Up Staff Time," in the show notes.

 

Public health systems remain under significant strain due to workforce shortages, categorical and insufficient funding, declining public trust, and increasingly complex and intersectional health challenges. Although community partnership development is recognized as a foundational public health capability, it is frequently funded indirectly or through categorical grants, resulting in fragmented community engagement. As a result, partnerships often remain programmatic rather than structural, limiting the ability to support system-wide decision-making, shared accountability, and effective support of public health. Read more about strengthening public health infrastructure through cross-sector partnerships at the link in the show notes.

 

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.