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Danielle Varda has developed a unique — and potent — public health tool: a software program called PARTNER (Program to Analyze, Record and Track Networks to Enhance Relationships), which demonstrates the progress and benefits of collaboration to funders and others involved in public health services and systems (PHSSR) projects.
“Existing tools were insufficient to measure the effectiveness of collaboration,” says Varda, an Assistant Professor at the School of Public Affairs at the University of Colorado Denver and a guest lecturer at the Colorado School of Public Health in the Department of Health Systems, Management & Policy.
Varda says that stakeholders and funders want public health departments to collaborate with partners such as departments of education and the business community.
“So much of what is happening in public health is happening in a systems framework, so it’s important that everything is interconnected,” says Varda.
Working across boundaries by collaborating in social, political and economic domains brings tremendous value to health departments.
“Traditionally the goal in hiring people in health departments was to find staff with lots of knowledge,” says Varda. “Now an additional key goal is to also hire people who know how to find knowledge, because what you need to know will often be beyond your own specific discipline. It’s a key core competency to be able to find resources and to leverage those resources. That brings a new layer of what’s possible in public health.”
The software program, which the Colorado Department of Public Health and Environment recently used for a social network analysis for a coalition of public health teams, works on the assumption that partnerships and collaborations leads to improved outcomes.
At the 2011 Keeneland PHSSR Conference, held recently in Lexington, Ky., Varda presented PARTNER-derived data on twelve communities. The study looked at factors that contribute to successful collaboration — paying specific attention to how trust and the value that a partner might bring to a collaboration affects outcome.
“We showed that health departments are quite trusting of their partners — such as education and police departments — and that may be because public health is accepting of this shift, of needing partners,” Varda says.
As budget cuts continue at health departments across the country, Varda expects collaboration to be even more important — and for the PARTNER software to be a critical tool.
Editor’s Note: Danielle Varda has received a grant from the Robert Wood Johnson Foundation for work on the PARTNER software program.
Thanks for following along with our coverage as we reported from the 2011 Keeneland Conference in Lexington, KY, writing about news from researchers, practitioners and policymakers who are working to improve the public health system. Did you miss some of our posts? Check out our Keeneland Conference roundup below.
Glen P. Mays weighs in on how the economic downturn — combined with a shifting political landscape and changing policy priorities — is forcing state and local public health professionals to confront difficult choices on a daily basis.
Whether you’re in Lexington or anywhere else around the country, you can follow and contribute to the Keeneland Conference conversation by following and using the Twitter hashtag #PHSSRKC11. You can also follow it right here on NewPublicHealth.
Public health systems and services research has a new place to call home.
The new National Coordinating Center for PHSSR was announced Tuesday at the PHSSR Keeneland Conference.
NewPublicHealth.org sat down with Dr. John Lumpkin, M.D., M.P.H., Senior Vice President and Director of the RWJF Health Care Practice, to talk about the intersection of public health and health care.
Nicole Lurie, M.D., MSPH, Health and Human Services Assistant Secretary for Preparedness and Response, brought the message of emergency preparedness to the researchers, students, academics, and public health practitioners on the last day of the 2011 Public Health Systems and Services Research Keeneland Conference.
If a health department outperforms its peers in a crisis situation, what is the best way to draw key lessons from that performance and use them to help other communities respond better the next time a crisis strikes?
Weigh in: If you were at Keeneland, what did you learn from the conference? What public health delivery issues would you like to see addressed through research?
“If you’re not ready every day, you’re not going to be ready for game day.”
That was a key message Nicole Lurie, M.D., MSPH, Health and Human Services Assistant Secretary for Preparedness and Response, brought to the researchers, students, academics, and public health practitioners on the last day of the 2011 Public Health Systems and Services Research Keeneland Conference.
Lurie said that research on key health issues is pivotal to the National Health Security Strategy -- HHS’ “comprehensive blueprint for dealing with the health consequences of a major man-made or natural disaster or a devastating terrorist attack.”
To implement the plan, Lurie said, America needs resilient communities, strong health and emergency response capabilities, measurement and accountability, and coordinated, integrated resources and investments to plan for and respond to a public health crisis.
For example, our nation’s response to the H1N1 crisis made it clear that the US needs research on surveillance, epidemiological investigations, and lab capacity. The Haiti earthquake proved the need for research on how to best allocate scarce resources.
Lurie also highlighted the need for the field to look beyond its research: “Be sure you [also] learn and use the skills to do it—you’ve got to use your non-research skills to make a difference, to take those findings out to the real world to health departments, community organizations, schools, and businesses. We can’t forget the [Public Health Systems and Services] part of this field.”
“I firmly believe the things we do day in, day out are the things we have to do in an emergency,” said Lurie.
NewPublicHealth.org sat down with Dr. John Lumpkin, M.D., M.P.H., Senior Vice President and Director of the RWJF Health Care Practice, to talk about the intersection of public health and health care. Here are some of the questions and answers from that discussion.
NPH: Where do you see the greatest potential for the public health and health care communities to work together?
Dr. Lumpkin: There are some critical areas where public health and health care need to work together. The first is on implementation of the affordable care act, such as primary care extension systems. The systems looks to the public health departments to be the driver for reaching out to individual practices and small groups to better implement primary care and how to do it in a way that yields better quality and better efficiency.
NPH: What research questions most need to be answered now to help health departments perform at a high level and improve the health of their communities?
Dr. Lumpkin: Clearly, the number one research question that state and local health departments have is how they maximize available resources in the faces of budget cuts. More than half have had layoffs and other budget restrictions. So PHSSR, first and foremost, needs to help these agencies figure out how best to use their limited workforce to carry out essential services, and then look further—at what are their priorities if they have limited funds, what are the public health returns on public dollars that are being invested in the public health system.
NPH: How can public health improve on how they showcase the value of their work, particularly when they’re facing budget cuts?
Dr. Lumpkin: In three ways—two are traditional ones, and the third will be a challenge for public health. By having good data, and public health tends to have a lot of good data, and that data has to be converted into information through analysis. Then, make that analysis available and that is what helps create the evidence for what public health is doing.
But what public health has been less good at is in telling the story. Public health has to get better at putting a face upon the issues we deal with. For example, what we did with immunization when I was a state public health director, is that we had very few deaths in any state from lack of immunizations, but we compared the death rates in 1920 with the number of kids we had, we could show that we saved 14,000 lives. Stories have to be based on evidence, but you have to tell a story to get your message across.
NPH: What’s the intersection between public health and health in making electronic health records as valuable as they can be?
Dr. Lumpkin: Chris Gebbie, first HIV czar in the U.S., has said that public health and clinical care both use the same data, they just look at it differently. We have the opportunity with electronic health records, to learn more about what is going on about with such issues as risk factors. Public health has to get better at getting that information back to the clinicians. There is required reporting for infectious diseases, for example, but then the doctor doesn’t hear back. All of it seems to go into a black hole in public health agencies. Public health needs to get better at doing analysis of that information and feeding it back in. That will make doctors more likely to report their data to public health departments, because they would see a utility.
Public health systems and services research has a new place to call home.
The new National Coordinating Center for PHSSR was announced Tuesday at the PHSSR Keeneland Conference by the leadership team at the University of Kentucky College of Public Health and Debra Perez of the Robert Wood Johnson Foundation.
“The ultimate goal of this Center is to provide the evidence needed to improve health in all communities,” said Perez, the Foundation’s interim assistant vice president of research and evaluation. “We’ve been in this work for five years, and we think we’ve made some really important investments, but we’ve never brought them all under one umbrella. This research is really providing the evidence for public health to allocate resources, time and talent in the interest of a healthy community.”
Perez highlighted one research effort in particular — the work of Glen Mays, professor and chair of the department of health policy and management at the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences, on practice based research networks (PBRN). The networks provide real-time data and best practices to inform decision making in public health. (Read Mays' Idea Gallery piece on Economic Shocks and Public Health Decision-making: How Can Research Help?)
“Our work with PBRNs is strong and growing,” said Perez. “It supports the work that we’re doing in public health law in health impact assessments, public health accreditation and in our advocacy work.”
To learn more about the launch, watch the Center's new video on the goals and direction of its work.
NewPublicHealth is in Lexington, Ky., through Thursday for the 2011 Public Health Systems and Services Research (PHSSR) Keeneland Conference. Sessions begin this afternoon.
Professor Douglas Scutchfield, the conference chair and the Peter P. Bosomworth Professor of Health Services Research and Policy at the University of Kentucky College of Public Health, has laid out the key issues for this year’s conference:
- Development of this year’s PHSSR research agenda with the Centers for Disease Control and Prevention
- Real world applications of PHSSR to inform practitioner decisions
- Resource management — with an eye toward the current economic environment — and how best to decide what expenses a public health department might cut.
Check back here for ongoing coverage and posts throughout the conference, including a podcast with Dr. Lumpkin.
Weigh In: Has your health department struggled with how to handle a recent budget cut?
Whether you're in Lexington or anywhere else around the country, you can follow and contribute to the Keeneland Conference conversation by following and using the Twitter hashtag #PHSSRKC11. You can also follow it right here on NewPublicHealth. This post will update dynamically throughout the week, pulling in all the #PHSSRKC11 tweets. As always, follow @RWJF_PubHealth on Twitter for public health information and discussion.
This week, NewPublicHealth will be at the 2011 Keeneland Conference.
The focus of the conference is public health systems and services research – a growing field that is designed to arm public health officials and policy makers with the data they need to make well-informed decisions about how health departments should be financed, staffed and structured.
This research has become especially important as state and local health departments across the country face difficult choices due to budget cuts and reductions in staff, programs and services.
As hundreds of researchers, practitioners and policy makers gather from April 12-14 to share and discuss the latest and most actionable findings in research to protect and improve health, NewPublicHealth wants to hear from you:
- What trends are you seeing in your health department or your community that need greater attention from researchers?
- How can health departments be structured to make sure they're both efficient and effective?
- In the face of budget cuts, how should limited public health resources be used to have the most impact on a community's health?
Please weigh in by clicking “comment” below and sharing your thoughts with other readers.
Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. Today’s contributor is Glen P. Mays, Professor and Chair and director of research for the Department of Health Policy and Management in the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences.
The economic downturn — combined with a shifting political landscape and changing policy priorities — is forcing state and local public health professionals to confront difficult choices on a daily basis.
This raises a series of critical questions:
- As budget cuts are made, how should public health officials make decisions on which activities to reduce and eliminate so as to minimize population health risks and harm?
- Are there alternative ways of organizing, staffing and delivering core public health services, so that officials can better produce efficiencies and reduce resource needs?
- Are there alternative ways of re-allocating the division of labor among state and local agencies, as well as among governmental and private-sector organizations, so as to maximize health protections and minimize costs?
- How much discretion do public health officials have in using evidence and economic imperatives to reconfigure their delivery systems?
The many uncertainties surrounding these issues create an urgent demand for new research to inform policy and practice. Next week in Lexington, Ky., the 2011 Public Health Systems and Services Research (PHSSR) Keeneland Conference will provide a unique forum for research and practice communities to brainstorm, share preliminary findings and identify improved approaches for applying this type of evidence to the real world.
Among other research, the event will showcase the work of RWJF’s Public Health Practice-Based Research Networks (PBRN), which fields real-time and relevant studies to inform public health decision-making in a time of economic shocks and resource constraints:
- A recent study from North Carolina demonstrates how local health departments have responded to reduced Medicaid support for maternity case management services by improving delivery efficiency rather than cutting services or clients.
- Research underway in Colorado demonstrates how public health agencies are utilizing multi-organizational coalitions to deliver chronic disease prevention activities effectively and efficiently.
- New research from Wisconsin shows that the public health activities most vulnerable to economy-related cuts are those financed through local taxes and not mandated by state law.
- Research from Florida finds that cross-cutting, infrastructure-related public health capacities (such as surveillance and health assessment) are least likely to be funded by categorical funding streams — and therefore especially vulnerable to economy-related funding reductions.
Several other PBRN studies to be presented at the conference will address barriers and facilitators to evidence-based public health decision-making in the face of economic constraints.
These Keeneland Conference sessions will likely stimulate considerable discussion and debate concerning the health and economic impacts of changes in public health service delivery across the United States, as well as how research can be used to estimate and learn from these effects. Estimating these effects undoubtedly will require longer time lags and additional analytic horsepower, but studies to accomplish these tasks are already underway.
PBRNs are a relatively new concept within public health, operating “below the radar” in many communities. Nevertheless, they may prove to be the missing ingredient needed to drive science-based improvements in practice and practice-relevant advances in science. Researchers and practitioners who share this vision of an evidence-producing community of practice should be sure to attend the conference sessions and get involved.