Overview 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 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 AcademyHealth June 25, 2006 Rationale Research Objectives Public Health Agencies • complex information processing entities Pilot study • specialized information and knowledge networks • 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 • 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 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 1 METHOD: ORGANIZATIONAL NETWORK ANALYSIS An empirical, descriptive technique for modeling organizational systems as interlocking networks people, knowledge, resources, tasks ORA: Organizational Risk Analyzer Carnegie Mellon University ORA uses relational datasets organized into adjacency matrices analyzed as a metamatrix People 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 Premise Organization as information processing entity Network measures use graph theory to describe structural features Knowledge 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 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 Resources Precedence Dependencies Tasks related to tasks Tasks 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. 2. 3. 4. 5. Agent by Agent 156 x 156 Communication network questions Agent by Task 156 x 190 Job level, relevance resources, job functions, job title, communication w/ other orgs Agent by Knowledge 156 x 39 Education, experience, self rated skills 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 2 Communication Network by Division Department of Health Formal Hierarchy Public Health Nursing Commissioner Health Information Administration Environmental Communicable Dx Control Health Planning & Education Administration Environ Water Lab Commissioner Clinical Physician Environmental Health Public Health Nursing Medical Examiner Public Information Office Clinical Physician Water Lab Health Information Comm Dx Control Medical Examiner Communication Network by Division Use of electronic resources by front line staff Environmental staff Public Health Nursing Environmental Communicable Dx Control Administration All other staff Commissioner Clinical Physician Public Information Office Water Lab Health Information 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 PH N* Pr ev Se rv Ho m eH lth Cl in ic al Sp Ne ed s C En vE ng En vH ea lth IN Pl O CD DC DO H 0 AD M Medical Examiner 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 3 Findings Findings Complexity and Task Environment 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 Context – public health tasks = well understood, but considerable instability in the public health environment – unplanned events like outbreaks, water main breaks, extreme weather Strengths that contribute to effective processes •efficient communication paths •good social density in the programs 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 Significance Proposed Application of Findings Health department • Use findings to inform the agency’s ongoing strategic management initiative •Strategic planning •Managerial value: process, resources • Identify appropriate redundancies Public health organizations • Connect more programs and people internally (mentoring and pairing staff) to improve redundancy and communication •Private sector method--case study for public sector •Evaluation metric outside incentive-based market logic Public health informatics • Provide more) communication tools and infrastructure (mobile devices) •Collaborative PH/informatics knowledge building •Refine information management • Apply knowledge of network to preparedness Public health system •Establish baselines, compare, identify preferred structures THANK YOU 4