Redefining health: Navigating to avoid future data catastrophes

Anne Zink, MD, has a vision for an interconnected, resilient and patient-centric future for public health, using insights from the pandemic.

I recently attended the Civitas Network's annual conference in National Harbor, Md. There’s been a lot of talk that health information exchanges (HIEs) world are a dying breed, with many of these prophecies made before the COVID pandemic.

But in an industry still recovering from the interoperability crisis that was the pandemic, the future of the health information exchange seems assured. And as Civitas’ keynote speaker highlighted, whatever market forces were supposed to be the end of the HIE now are seeking their help in the new world of data exchange.

A frontline perspective

In her keynote address, Anne Zink, MD, the chief medical officer of Alaska, offered a unique blend of personal narratives, facts and a forward-looking vision – including her own experiences with the challenges of the public health system during COVID-19.

She began her address by emphasizing the inherent value of data in the realm of public health. Reminding the audience of the chaos of March 2020, she lamented the state of data management and transfer during the crisis. At one point, she shared a photo of herself mid-clinical shift, stopping to fax results back and forth across the care continuum.

At one point, she recalled that they had to bring in the National Guard to assist in putting the same data points into three distinct systems at the same time, painting a vivid picture of a system under duress. There was an urgent need, she emphasized, to evolve, innovate and reimagine the public health infrastructure.

Zink also touched on the emotional toll of the pandemic on public health professionals. The strain of manually entering data, instead of performing crucial epidemiological tasks, was palpable. Epidemiologists found themselves buried under heaps of paperwork, unable to provide communities with actionable intelligence or insights. This administrative quagmire, according to Zink, was largely the result of a lack of investment in modern public health data systems. The tools to remedy the situation existed, she argued, but implementation was lacking.

To make matters worse, COVID burnout compounded the already hectic situation. “We lost 46 percent of the public health workforce,” she said. “Just look around the room and imagine that half of the people here are missing, and the workload is increasing.” Zink recalled. “And at the same time, we lost 20 percent of the healthcare workforce.”

They left, she surmised, in part because of the inefficiencies of data collection. She would watch a nurse collect nine data points in the emergency department, and then later watch as a public health worker would call patients to get those exact same data. Then, the data would be asked for a third time upon submission to the CDC. It’s the mindless, repetitive work that directly sets the stage for staffing shortages.

Redirecting the river of healthcare

Blessedly, Zink's address wasn't just a recitation of healthcare’s well-known problems. She also advocated for a refocusing of energies and resources toward more effective solutions.

Wearing two hats as a public health expert and active clinician gives Zink unique insight into gaps that others might not identify.

“Chicago used to have the dirtiest river in the country. It also used to have the highest rates of respiratory diseases and infectious diseases,” she explained. This was because the sewage water was constantly intermingling with the river, creating a public health crisis. After a massive, ineffective effort to use conventional wisdom — try burying the sewer pipes deeper — the city was forced to innovate. They reversed the flow of the river, a project completed in 1900, and solved the cross-contamination problem.

This story, Zink explained, paralleled the need within healthcare for robust, reliable and innovative systems. By leveraging existing infrastructures, fostering innovation and enhancing workforce capabilities, a brighter future for healthcare and public health becomes conceivable.

With the rise of artificial intelligence, machine learning and digital health platforms, she argued, the potential to overhaul traditional healthcare systems and “redirect the river” has never been more profound. Such technologies not only promise streamlined operations but also more personalized and effective patient care.

From HIE to HDU

Moreover, Zink emphasized the importance of multi-sectoral collaboration. The silos separating public health, private healthcare, tech companies and community organizations need to be broken down. This is where the future exists for HIEs.

As exchanges accept the call to grow into health data utilities (HDU), they must partner with organizations outside the healthcare silo, becoming champions of data that presents a holistic view of the patient, from their community centers, to the acute setting, to the public health agencies and back. Such partnerships, as she highlighted, will generate cross-pollination of ideas, efficient resource utilization and the creation of systems that are truly patient-centric and future-proof.

However, this vision requires more than just a shiny new tech toy. As Zink highlighted, addressing healthcare challenges isn't just about technology or processes – it necessitates understanding and partnering with community-based organizations, focusing on home-based care, and appreciating the cultural nuances of care delivery in both urban and rural settings.

A call to collaborate

The keynote concluded with a call for greater partnership among different stakeholders – underscoring the importance of a unified front that comprises patients, providers, policymakers, the public and the press.

By fostering a culture of mutual trust and collaboration, and by leveraging each group's unique strengths, the public health system can build a resilient ecosystem, one that does not require the National Guard to be called in to be data entry specialists in a crisis.

In sum, Zink's keynote was a clarion call for transformative change in the public health landscape. Her insights, borne out of personal experiences and professional expertise, offered a roadmap for the future — a future where public health systems are efficient, resilient and, above all, patient-centered.

Jared Jeffery is an HDM contributor.

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