PRESENTING INFORMATION
PEOPLE UNDERSTAND AND USE
• Kathleen Cook, BSN
• Information & Fiscal Manager
CHALLENGE and STRATEGY
CHALLENGE
 Produce easy to understand and timely information
 Demands from public, decision-makers, political
leaders, program staff and managers, funders and
stakeholders, grantors
 Pressure to show evidence-based practice outcomes
 More data and data sources are available with little
guidance for interpretation
 Limited resources and staff to do the work
GOAL
STRATEGY
Principles to Guide
Investments
• Support work at point of
service
• Use standard, off-the-shelf
technology
• Look for potential
scalability
• Document for future
 Key Elements
 Systematic
 Replicable
 Easy to Use
 Meaningful




Reliable, consistent and ongoing sources of data
Comparable
Bench-marked
Related to Department
mission, goals, objectives
Health Department IT Strategy
• Financial system
• Personnel System
• Document
management
• Network / database
management
•
•
•
•
Staff
Stakeholders
Decision makers
Citizen portal
• Electronic medical /
dental applications
• Permitting and
inspection
applications
City
Enterprise
Support
Department—
Daily
Activities
DASHBOARD
Web-based
hub for
technology
services to
staff
• Report
• Forms / Policies
• Planning
MANAGING THE DATA
PRACTICAL AND STRUCTURED APPROACH
TYPES OF DATA
PRESENTATION
 Static Data
 Measures
 Benchmarks
 Performance indicators
 Population health indicators
 Process indicators
 Periodic updates
 BRFSS / YRBS
 Hospital Discharge
 Vital Statistics
 Dynamic and Calculated Data
 Near real time updates (Dynamic)
 Collection of data, organized and
pre-calculated
 Point of service software
(electronic medical/dental record;
permit & inspection records)
 Syndromic surveillance
 Analytics
 Data / process mining
 Statistical / predictive analysis
 Reporting
 Visualization
 Graphs/charts
 Dashboards
 Alerts
Managing Static Data
Standardize the process
for each data source
Create scripts and
routines that can be run
automatically
Modify only when the
data itself changes
• Raw data
• Analysis and Weighting
– Survey data must be weighted
based on sample size and
demographics
– Event data (e.g. births, deaths)
must be adjusted when used for
rates—particularly if cell size is
less than 30
• After analysis and weighting,
data are stored in SQL data base
• If data change, new fields are
created in the database
From 1-2
datasets per year
to 10 data sets
Managing Dynamic and Calculated Data
Collaboration is critical
Report Developers must work
with
• Front end users who
generate the data
• Managers who determine
what is useful and or
interpret the data
Report Developers must also
collaborate with Users of the
Data
• Public Health leaders
• Stakeholders
• Partners
• Decision-makers
• Managers and Supervisors
 Create a Structured approach
to identifying and testing data to
produce usable information
 Identify routine process for
linking data source to dashboard
 Recognize and follow
requirements from data owners
related to privacy and access
 Produce calculated data through
routines
Dashboard
Development and Deployment
Our Health Department uses Dashboard Reporting Software from
Logi Analytics
REPORT PROCESS
 All work starts with the Users:






Managers and Frontline staff
Identify Division / Program
needs, indicators, benchmarks
and other performance
measures
Collect Data
Extract, Transfer and Load
(ETL) the data to appropriate
database
Build Reports, dashboard and
applications
Verify that reports accurately
represent the indicator or
measure
Publish
Updating Dashboard Applications
 Updating the dashboard usually involves adding new
data to the database
 The dashboard is updated automatically.
 Time spent on the initial design of the rules for
Analysis, Weighting, Selection, Extraction, Transfer,
and Load of data from each type of data source is the
most intensive and important.
 Assuring that the rules can replicated
 Assuring that the rules can be automated
 Assuring the rules can be systematically applied
 Each additional use of the rules th
Using Dashboards
Easy to Use
 Web-based deployment
Improving Public Health
 Assure Quality Service &
Performance
training required
 Promote Healthy Behaviors—Use of
data to support and reinforce
 Users control what
change
information they want
to see, follow or monitor  Monitor Community Health Status
/Risks
 Benchmark performance and
measure outcomes
 No special software or
Assure Quality Service &
Performance
# of survey responses
TRACK-IT SURVEY BY ISSUE: Response by
IT staff showed appropriate priority
March 1, 2013 through February 28, 2014
200
150
100
50
0
Strongly agree
Agree
Disagree
Strongly disagree
Unknown
450
Maintain number of food safety complaints at less than
325 per year and food borne illness reports at less than 50
per year
Environmental Quality Goal 2
405
400
414
393
411
394
350
324
328
319
306
300
250
Complaints
Food Borne Illness Reports
200
150
100
50
84
86
81
61
59
44
65
67
45
0
FY2003
FY2004
FY2005
FY2006
FY2007
FY2008
FY2009
FY2010
FY2011
Promote Healthy Behaviors
Use of data to support and reinforce change
Monitor Health Status
Community Health Status Indicators
Risk Indicators
Benchmark performance Measure
outcomes
Performance Measures and Indicators
Increase pet license sales by 3 percent each year
65,000
7%
Change in percent over previous year
# Licenses Sold
60,000
60,996
6%
5%
58,039
54,942
57,173
4%
55,477
55,000
3%
2%
50,000
1%
1%
4%
6%
0%
-2%
45,000
-1%
-2%
40,000
-3%
FY2006-2007
FY2007-2008
FY2008-2009
FY2009-2010
FY2010-2011
Assure that at least 80% of industries pose minimal risk of illicit discharge
to the storm water system
Environmental Quality Goal 5
88%
90%
80%
75%
71%
70%
60%
50%
40%
30%
20%
10%
0%
FY2009
FY2010
FY2011
Medical Home by 2014
Lessons Learned
Things to Watch Out For….
Helping Users understand information
We keep these points in mind and include explanations:
 Taking care when using “percentage change” and rates
for data sets with small cells.
 When comparing years, the starting and ending years
may not be reflective of the real change in values.
 Know if there are breaks in the data:
 Deaths classified using ICD 9 in 1998; ICD 10 in 1999
 Changes in birth certificates in 2005.
 BRFSS: Changes in sampling as data collection using
cell phone numbers increased led us to make a break
between 2010 and 2011 data. We don’t display 2011 and
2012 data in direct comparison with 2010 and earlier data
Including confidence intervals
and meta data
 Age adjusted data can’t be compared if different
standard populations are used (2000 is the usual
standard, but sometimes a different year—say 1946 or
1970, is used).
 Racial and ethnic definitions have changed in Census
data for races and persons of Hispanic origin.
 Don’t be overly precise—survey data have confidence
intervals to consider.
GIS is powerful but …..
 GIS maps often raise more questions than they answer
(counties next to each other may appear to have widely
differing rates):
 For cancer incidence, be careful, as cancer is age related
and residential care and nursing homes are not located
in all counties
Wrap up
• Best Practices
• Contacts
Best Practices / Model Practice
Best Practices we used:
 Business Process Analysis
 Requirements Gathering
 Strategic Mapping and
Planning
 Business Case
LLCHD Public Health
Informatics Program
Model Practice Program
Award Winner: July 2011
LHDs and Electronic
Health Records
Webinar
Why should your local health department (LHD) adopt
and utilize electronic health records? Webinar that
spotlights Lincoln-Lancaster County Health
Department and Marion County Health Department
use of electronic health records and how it has
improved their public health practice.
Questions ? / More information?
Kathleen Cook
Information & Fiscal Manager
Lincoln-Lancaster County Health
Department
3140 N Street
Lincoln, NE 68510
402-441-8092
kcook@lincoln.ne.gov
Raju Kakarlapudi
Public Health Epidemiologist
Lincoln-Lancaster County Health
Department
3140 N Street
Lincoln, NE 68510
402-441-6270
rkakarlapudi@lincoln.ne.gov
View some of our dashboards:
http://data.publichealthne.org Developed with the Public Health
Association of Nebraska for all Nebraska local health districts
http://lincoln.ne.gov/city Key word: data