The Environmental Health world, like other government domains, is fertile ground for aspirational data projects. Local Health Departments consistently capture records of applications, permits/licenses, inspections, violations, complaints and the time spent providing services. Financial accounting is also key to doing business.
In some ways, our collected data is like a dashboard camera, constantly recording video out the windshield of an Uber car. In most cases, the video is never retrieved and studied…until there’s an accident (or a UFO sighting), in which case, it’s gold! The difference is that dashboard cams are cheap. Data collection is extremely expensive, yet expected without question.
The “Dashboard Cam Effect” can be evident when we hear things like the following:
|Data Collection||Dashboard Cam|
|“Our data is collected, but never used again.”||The dashboard camera is always on, but the video is never viewed.|
|“Our million-dollar system is great at taking in data, but I can never get the reports I need when I need them.”||Dashboard camera records video, but there’s no means for playback or to study the precise recorded events.|
|“We’ve identified a new set of data to collect! Let’s collect it…and figure out what to do with it later.”||Let’s point a dashboard camera out every window and under the hood…just in case.|
Then, all of a sudden, there’s a foodborne illness outbreak or an exposé by the local paper, and that data has instant value – assuming it’s credible. Well, that’s not enough. Placing blame or defending claims is not enough. Local health departments, however, don’t have the resources to review, study and really leverage their locally collected data.
Informatics is all about processing data for storage and retrieval. It’s the name of science underpinning what we all aspire to achieve: to make our collected data (permits, inspection violations, complaints, time studies, etc.) mean more to the profession, to policy and to citizens.
The National Environmental Health Association (NEHA), the professional association of environmental health practitioners and leaders, chose to attack this matter of EH informatics in a January 2016 Environmental Health Informatics Forum. Held in beautiful Denver, Colorado, in the shadow of the snowy Rocky Mountains, the forum included federal, state and local regulators as well as data management experts. Accela was there.
NEHA Executive Director Dr. David Dyjack consistently evangelizes the value of EH informatics. It is his leadership that presses the matter forward. He knows from his own ample experience and intuition that the story above isn’t the final chapter. It can’t be.
Dr. Dyjack asked us, “What must NEHA do next?” With that clear charge, the forum members and facilitators went into a closed session to start their work.
It took about an hour to ferret out all the pat answers we’ve seen before: There’s no money, no standards, local politics undermine our efforts, etc. Once that dust settled, we concentrated our experiences and set a meaningful goal…
Make EH data meaningful to federal, state and local agencies,
consumers and industry in order to promote and protect public health.
How is this done when there’s no money, no standard, local politics, etc.?
I’m optimistic that the answers will come and they will be carried forward by the young leaders of our profession. Also critical to the discussion, technology will catch up with the realities described above.
The solutions worth pursuing, the solutions worthy of our time and budget, will be the solutions that save lives, reduce health costs and improve quality of life. That is the mission of environmental health.
The answers will come in the following categories:
- Policy: I appreciate about the FDA Food Code and the CDC Model Aquatic Health Code the strong foundations in science. Data is the currency of science and, therefore, EH data can (and does) impact policy. And, effective public health policy impacts lives.
- Foodborne Illness/Epidemiology: The investigation, identification and control of disease are also driven by data. Faster and better data means reduced illnesses as the sources and spread are managed more quickly.
- Disclosure: Disclosure means interpreting and conveying the data of the health department to the citizen consumer. Restaurant grades or placards posted near the front door, datasets republished by Yelp alongside customer review sites dedicated to identifying bad actors give consumers the information to pursue their best interests. If they choose NOT to patronize a restaurant with demonstrated behaviors that we know to be contrary to safe food, then that restaurant will not serve as many meals, may go out of business or may clean up its act. The promise of disclosure adds teeth to the health inspector’s otherwise kindly advice and official findings.
The forum’s work is not done. Its own action plan includes 1) a comprehensive inventory of existing federal systems (e.g., National Environmental Public Health Tracking Network, National Environmental Assessment Reporting System (NEARS), Environmental Health Specialists Network (EHS-Net), HealthData.gov, FDA Core Network and others); 2) an accounting of vendor-provided core functions/datasets; and a 3) structure for advocacy.
We are so fortunate to have NEHA’s leadership at this time. The organization is uniquely positioned as there is no other steward whose motives are so directly aligned with the need. Their field of view includes all stakeholders. Thank you for your leadership in this area.