CDC’s Futures Initiative
Heath Protection for the 21st Century
Creating the Future of CDC
for the 21st Century
Input
Ideas
Implementation
Dixie Snider, Jr., MD, MPH
Deputy Director of Public Health Science
Centers for Disease Control and Prevention
•• Outside-in
Outside
Outside-in
•• Interactive
Interactive
•• Driven
by
Driven bydata
data
•• Focused
Focusedon
oncustomers
customers
•• Strategic
Strategicdirection
directionfirst,
first,
then
structure
then structure&&processes
processes
AcademyHealth CDC Research Agenda Session
San Diego, CA
June 7, 2004
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
CDC’s Futures Initiative
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Creating the Future of CDC for the 21st Century
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CDC’s Futures Initiative
Ideas…New Strategies!
Why Change?
• Achieve health impact and reduce health
disparities for customers (people whose health we
protect)
– alignment (strategy, goals, & action)
– performance measurement and improvement
– integration across organizational units
– marketing
• Lead the Nation’s public health system
• Expand public health research as the foundation
for all our work
• Expand global health impact
• Support the world’s best workforce and maximize
our effectiveness & accountability
Emerging Public Health Threats
Globalization
Human
Genome
Aging Society
Rising Health
Care Costs
Changing
Demographics
Aging Workforce
Public Health
Infrastructure
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
Impact
Information Technology
CDC’s Futures Initiative
TM
Increase in Health Expenditures
Creating the Future of CDC for the 21st Century
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Health Status
• U.S. life expectancy is 2.5 years shorter
than in Western Europe and Canada, and
more than 3 years shorter than in Japan
• Obesity and obesity
- related health risks
cost the U.S. an estimated $125B per
year
• The U.S. ranks 28th in the world in infant
mortality
• Health expenditures as percent of GDP
projected to increase from 14.9% (2002)
to 18.4% (2013)
• Per capita health spending in the US is
highest in the world, yet we still rank
behind 47 countries in life expectancy
Source: The New York Times Magazine
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
CDC’s Futures Initiative
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Creating the Future of CDC for the 21st Century
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1
Where are people looking?
CDC as a source of health information
CDC Has a Perception of High
Trust/ Reliability . . .
. . . But Few People Turn to CDC
for Health Information
70%
64%
% of Internet Users Who Have Searched for Information
from:
60%
56%
54%
60%
50%
50%
40%
40%
30%
30%
20%
20%
50%
43%
40%
31%
30%
24%
23%
21%
20%
10%
10%
0%
6%
15%
13%
10%
10%
5%
0%
“CDC is one of the
first places I would
turn to for reliable
health information”
“One of the health
information
sources I trust the
most is the CDC”
“I do not remember
hearing about health
or disease info that
came from the CDC in
the past year”
“I tried to get info
about health or
disease from the CDC
in the past year”
0%
Health
Portals
Govt.
Agencies
Doctors’
Offices/
Hospital
Sites/
Health
Centers
NonProfit
Orgs.
Source: Harris Poll (2003)
Source: Porter Novelli
CDC’s Futures Initiative
Pharmaceutical
Websites
Scientific
Retrieval
Systems
Online
Universities
Newsletters
Chat
Rooms
CDC’s Futures Initiative
21st
Creating the Future of CDC for the 21
Century
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NIH vs CDC Budget
Creating the Future of CDC for the 21st Century
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Strategic Imperatives
• Health Impact
• Customers
30
NIH
25
• Public health system
20
$Billion
% of respondents saying “Yes”
60%
• Public health research
15
10
CDC
• Global health
5
0
1960
1970
1980
1990
2000
• Efficiency, effectiveness & accountability
2004
Source: CDC, NIH
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
CDC’s Futures Initiative
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Health Protection Goals
Creating the Future of CDC for the 21st Century
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Preparedness Goals
People will benefit from statestate-ofof-the art detection, investigation, and
containment of infectious, terrorism, and environmental threats.
• Health Promotion & Prevention of Disease, Injury,
and Disability:
The government public health, health care delivery, business,
educational sectors and other sectors of the health system will be
integrated to protect people from infectious, environmental, and terrorist
threats.
All people will achieve their optimal lifespan with the
best possible quality of health in every stage of life.
• Preparedness:
Preparedness:
People in all communities will be protected from
infectious, environmental, and terrorist threats.
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
CDC’s Futures Initiative
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Creating the Future of CDC for the 21st Century
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2
LifeLife-stage Goals [Draft]
Health promotion and prevention of disease,
injury, and disability by lifelife-stage
Infant: By 2015, the United States is one of five countries with the
highest rates of infant survival (Baseline 28th, 1999)
Children: By 2015, mortality is reduced 20%, saving an additional
additional 800
lives per year (NCHS Baseline).
Adolescents: By 2015, at least 95% of adolescents practice
behaviors which protect them from illness and injury now and in the
future. (NHIS baseline)
Infant
Child
Teen
Adult
Senior
Adults: By 2015, at least 90% of adults have a healthy weight
(NHANES baseline)
Seniors: By 2015, average lifespan of older Americans is increased
increased
by 2 years
CDC’s Futures Initiative
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
Creating the Future of CDC for the 21st Century
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Organizational Design Principles
TM
CDC’s History
• Strategy and goals derive from population
health assessments (“customers’ health”)
to achieve health impact
• Strategy and goals drive agency’s priorities
and allocations
• Emphasis on research and innovation
• Health protection “marketing”
• Consolidation of business & other cross
cutting services
CDC’s Futures Initiative
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
Creating the Future of CDC for the 21st Century
TM
Customers
Department of Health and Human Services
People whose health we want to improve
Centers for Disease Control and Prevention (CDC)
Office of the Chief
Operating Officer
CDC Washington Office
Partn
Alliances
ers
Public Health
Systems
Office of Global Health
Office of Women’s Health
Office of Program Planning
and Evaluation
Office of Health and Safety
Channels
Business
Education
Stake
holders
Health Care
Delivery
Federal
Agencies
Coordinating Center for Health Information and Services
Office of the Director
Office of Executive Secretariat
National
Center for Health
Marketing
Office of Equal Employment
Opportunity
Office of Minority Health
Coordinating Center
for Infectious Diseases
Office of Communication
NCID, NCHSTP, NIP
Office of Genomics and
Disease Prevention
Office of Science Policy and
Technology Transfer
Coordinating
Center for
Health Promotion
National Center
for Chronic
Disease
Prevention &
Health Promotion
National Center for
Environmental
Health
Epidemiology
Program
Office
National Center
for Health
Statistics
National Center
for Infectious
Diseases
National
Immunizations
Program
National Center
for Injury
Prevention and
Control
National Center
for HIV, STD, and
TB Prevention
National Institute
for Occupational
Safety and Health
Strategy and
Innovation
National Center for
Health Statistics
Office
of Global Health
NCEH/ATSDR
NCIPC, NIOSH
Executive Leadership Team
Executive Board
Human Capital
Management
Chief of Public
Health Improvement
Director
CDC Washington
CDC’s Futures Initiative
Office for Terrorism
Preparedness &
Emergency Response
Chief of
Science
Office of the
Chief of Staff
Public Health
Practice
Program Office
Creating the Future of CDC for the 21st Century
National Center
for
Public Health
Informatics
Coordinating
Center for EIO
NCCDPHP, NCBDDD,
Genomics
Management Council
National Center
on Birth Defects &
Developmental
Disabilities
TM
Office of the Chief
Operating Officer
CDC’s Futures Initiative
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Creating the Future of CDC for the 21st Century
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3
Changing CDC
CDC’s Futures Initiative
FROM
TO
• No overall measure of success
• Lack of customer
segmentation
Strategic
imperatives
Internal and
External
Communications
Health Impact
Goals
Recognition
& Rewards
Business
Process
Redesign
Leader
Accountability
Employee
Education
CDC’s Futures Initiative
• Strong partner network
• Revitalized state & local
health departments
• Media, business, health
care delivery, schools,
communities
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC’s Futures Initiative
FROM
• Segmented customer
approach
• Limited partner capacity
(state and local health
depts)
Organization
Design
• Clearly articulated and
measured
• Primary focus on Infectious
Disease, Preparedness and
Prevention
• Disease specific, fragmented
approach to global
• Comprehensive integrated
global approach
• Inefficient work processes
• Efficient work processes
• Silos/organization
• Integrated organization
(maintaining specialization)
• Focus on process
• Focus on impact
FROM
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
CDC’s Futures Initiative
TO
• Primary focus on Infectious
Disease and Preparedness
Creating the Future of CDC for the 21st Century
TO
• Minimal applied research
• Strong applied research
• Fragmented approach to
customers/partners
• Integrated approach to
customers/partners
• Difficult to do business with
• Easy to do business with
(standard of good gov’t)
CDC’s Futures Initiative
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Creating the Future of CDC for the 21st Century
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Futures Initiative: Improving Health
Impact
CDC’s Futures Initiative
Creating the Future of CDC for the 21st Century
TM
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