A Network Analysis
of
Information Use
in a
Public Health Organization
Jacqueline Merrill, Suzanne Bakken, Maxine Rockoff, Kristine Gebbie,
Columbia University
Kathleen Carley Carnegie Mellon University
AcademyHealth June 25, 2006
Overview
Organizational Network Analysis is a
research and a management technique
Potential to
• Aid decision making in PH management
• Improve effectiveness agency processes
• Implications for system wide performance
Rationale
Public Health Agencies
• complex information processing entities
• specialized information and knowledge networks
• networks interact dynamically – affect performance
• complex, nonlinear, hard to understand, therefore
unmanaged
• information needs not well met
• need to justify investments to improve information
management
Research Objectives
Pilot study
•
Empirically describe the structure of information flow in
a health department using organizational network
analysis
•
Determine possible links between information flow and
agency performance, as suggested by the network
model
•
Assess the utility of the method for public health
information management
Acknowledgements
Research funding
•
New York Academy of Medicine through a research grant from the National
Library of Medicine, Maxine L. Rockoff, Principal Investigator
Research
•
Columbia University School of Nursing through a grant from the National
Institute of Nursing Research, Suzanne Bakken, Principal Investigator
Supplementary data for secondary analysis
•
New York Medical College through a grant from the National Library of
Medicine, Diana Cunningham, Principal Investigator
Consultation
•
Center for Analysis of Social and Organizational Systems, Carnegie Mellon
University, Kathleen Carley, Director
• Special thanks to Michael Caldwell, Commissioner, Dutchess
County Health Department
Networks & Complexity
Adjacency Matrix
a
b
c
d
a
0
1
1
1
b
1
0
1
0
c
1
1
0
1
Different kind of data
Relationships among
nodes & edges
d
1
0
1
0
METHOD: ORGANIZATIONAL NETWORK
ANALYSIS
An empirical, descriptive technique for modeling organizational
systems as interlocking networks
people, knowledge, resources, tasks
Premise
Organization as information processing entity
Network measures use graph theory to describe structural features
Purpose
Understand the flow
Find patterns, draw inferences from theory--social sciences, complexity, behavioral
Product
Visualizations, statistics
Insight on structure
Implications for decision-making , planning , overall culture
ORA: Organizational Risk Analyzer
Carnegie Mellon University
ORA uses relational datasets organized into adjacency
matrices analyzed as a metamatrix
People
Knowledge
Resources
Tasks
People
Knowledge
Resources
Tasks
Social network
Who talks to who
Knowledge Network
Who knows what
Resources Network
Who has access
Assignment Network
Who does what
Information Network
Connection among
types of knowledge
Resources Usage
Requirements
Knowledge to use
resources
Knowledge
Requirements
Knowledge needed for
tasks
Interoperability
Requirements
Connections among
resources
Resource
Requirements
Resources needed for
tasks
Precedence
Dependencies
Tasks related to tasks
Setting and Sample
•
•
•
•
•
•
•
County health department
Urban, suburban and rural population
156 employees (4 vacant positions)
9 divisions, 19 programs
Representative of PH workforce
Representative range of services
Case study for applying method in public
sector
Network Survey Development
Modified standard network analysis questions
• work-related relationships and communication among workers
• how individuals receive and share info in routine work
To aid response used
• recognition
• two-sided questions allow reconstruction of network position
to who do you give information
from whom do you get information
Finalized with expert consultation, pilot tested
Secondary data from informatics competency survey
Converted to relational variables
Data Tables
1.
Agent by Agent 156 x 156
Communication network questions
2.
Agent by Task 156 x 190
Job level, relevance resources, job functions, job title,
communication w/ other orgs
3.
Agent by Knowledge 156 x 39
Education, experience, self rated skills
4.
5.
Agent by Resource 156 x 52
Info resources used, program, outside network
Agent by Organization 156 x 85
Outside organizations employees communicate with
Data Analysis
Presentation of preliminary results via web conference to:
For collaborative interpretation (essential)
To direct focus of analysis
To stipulate goals for results
Data analysis plan
Overall network description with visualizations
Key actors (6 measures)
Organizational quality comparisons (15 measures)
Report on experienced staff
Analysis of a planned merger between two units
Department of Health
Formal Hierarchy
Commissioner
Health Information
Administration
Health Planning &
Education
Environmental Health
Environ Water Lab
Medical Examiner
Public Health Nursing
Comm Dx Control
Clinical Physician
Communication Network by
Division
Public Health Nursing
Environmental
Communicable Dx Control
Administration
Commissioner
Clinical Physician
Public Information Office
Water Lab
Health Information
Medical Examiner
Communication Network by
Division
Environmental
staff
Public Health Nursing
Environmental
Communicable Dx Control
Administration
Commissioner
Clinical Physician
Public Information Office
Water Lab
Health Information
Medical Examiner
All
other
staff
Use of electronic resources by front line staff
Shows core resources in the
center. Note large number of
unconnected staff
Use of electronic resources by
supervisory/management staff
Comparison of Redundancies
Number of people w/ same Knowledge, Assignment and Access
*PHN includes Preventive, Home Health and Clinical
100
Redundancy/Access
90
80
Redundancy/Assignment
Redundancy/Knowledge
70
60
50
40
30
20
10
Pr
ev
Se
rv
Ho
m
eH
lt h
Cl
in
ic
al
Sp
Ne
ed
s
PH
N*
En
vE
ng
En
vH
ea
lt h
C
CD
IN
O
Pl
AD
M
DC
DO
H
0
Higher the number in relation to total people in each group = greater likelihood
more redundancy than needed for efficient operation
Lower the number = greater likelihood too little redundancy for efficient
operation if anyone is absent
Findings
Problems
•sub-groups control knowledge, resources
•may be overspecialization of knowledge
•potential for significant knowledge loss -retirement
•little back up for personnel turnover
•informational silos
Strengths that contribute to effective processes
•efficient communication paths
•good social density in the programs
Findings
Complexity and Task Environment
Context
– public health tasks = well understood, but considerable
instability in the public health environment
– unplanned events like outbreaks, water main breaks,
extreme weather
Agency needs
– redundancy
– greater cross-program coordination
– regular within and cross-program briefings
• allow personnel to build up transactive memory
(knowledge of who knows who & who knows what) to
cope w/ novel situations
Proposed Application of Findings
• Use findings to inform the agency’s ongoing strategic
management initiative
• Identify appropriate redundancies
• Connect more programs and people internally
(mentoring and pairing staff) to improve redundancy and
communication
• Provide more) communication tools and infrastructure
(mobile devices)
• Apply knowledge of network to preparedness
Significance
Health department
•Strategic planning
•Managerial value: process, resources
Public health organizations
•Private sector method--case study for public sector
•Evaluation metric outside incentive-based market logic
Public health informatics
•Collaborative PH/informatics knowledge building
•Refine information management
Public health system
•Establish baselines, compare, identify preferred structures
THANK YOU