Partner Spotlight: Q&A with Lilly Kan, Project Director, The Pew Charitable Trusts

July 15, 2024 | ASTHO Staff

State and territorial health agencies need access to timely, standardized, and high-quality health information, which healthcare providers can report seamlessly through automated data sharing using modern scalable response-ready systems. As ASTHO’s Public Health Data Modernization Policy Statement notes, this core capacity requires not only technological and workforce investments but also strong policies that facilitate the exchange and governance of public health data.

We speak with Lilly Kan, project director of Public Health Data Improvement at The Pew Charitable Trusts, who asserts that data sharing between the healthcare system and public health forms the basis for timely public health action. She explains how staff in state health departments have informed Pew’s efforts, including an upcoming 50-state report, and can support the drive to modernize public health data exchange.

Tell us about Pew’s work to improve public health data sharing.

The public health data improvement project follows our previous work around the interoperability and usability of electronic health record systems and focuses on leveraging those technologies to improve data sharing with public health departments. Our aim is to identify strategies that facilitate more seamless sharing of timely and complete data from those who collect it (e.g., doctors, labs, and other providers or care settings) with those who need it in our public health agencies, reducing provider burden and helping to protect their communities. Some of our work is at the federal level, as we are engaging with agencies like CMS, CDC, and the Office of the National Coordinator for Health Information Technology on rules governing topics such as incentives for data sharing.

In addition, we’re developing a 50-state report that reviews data sharing policies throughout the country, discusses how data between healthcare and public health gets shared in practice, and includes interviews with public health officials that provide deeper context on their needs and challenges. We’re aiming to release the report this fall and look forward to showcasing steps state health agencies are taking that may be useful for their peers as well as highlighting some of the most common trends we’ve seen throughout the country.

What role does the healthcare system play in the public health data infrastructure?

The billions of data points generated by doctors’ offices and hospitals every year could yield a dynamic, high-definition picture of the nation’s health and provide insight into potential threats, but only if public health agencies have timely access to it.

What we’ve heard in conversations with providers is that they see public health data as a potential benefit for them as well. The data state health agencies compile and analyze could be a boon for patient care if providers receive bidirectional access to it. Building connections with partners in the healthcare system could make it easier for everyone to work together and support healthier communities.

Which partners are important to this project and how can they help to support it?

Since our project is focused on supporting health departments, public health officials in states, counties, and cities are critical—they know their operating environment and what policy changes would be best for them. We’ve been speaking with officials throughout the country as well as organizations supporting public health departments, such as ASTHO, from the start, but we’re also thinking of the groups that collect data (e.g., hospitals, individual practitioners, and labs). Additionally, elected officials at the state level may be responsible for shepherding policy changes into law. Every one of those groups has important perspectives to offer and different questions they’ll need answered.

How have your conversations with public health officials shaped Pew’s approach?

At its core, our work needs public health practitioners’ experiences, perspectives, and voices. We have heard from public health officials that having quality data isn’t enough; having the people and systems in place to analyze it and harness it is equally important. Sorting through reams of faxes when every hour counts for contact tracing is not a good position for health agencies to be in, especially if they are understaffed. As such, resources are a frequent concern for people we speak to—as anyone who works in public health will understand, making improvements without further financial and staff support is an immensely difficult task.

We also recognize the importance of understanding a state’s specific challenges. What if a state has less access to high-speed broadband internet, and faxes or phone calls are the best way for some providers to contact patients? What if new systems or connections would be an undue financial or staff burden? That’s why, again, the biggest takeaway in our conversations is that we need to understand states’ specific situations before we provide guidance. That is critical for our work going forward.

Finally, we know that there is no one-size-fits-all solution to advance data sharing between healthcare and public health. Every state comes at this from a different starting point and with different needs and challenges, and public health officials are working heroically in their own specific environments every day. But we also know that there are common themes or aspects across different states’ policies and practices that peers could adopt in their own settings. As we work to better understand where states are in this process and what policy changes might get us closer to seamless electronic data sharing, we know a single top-down strategy will not work; collaborating with people who face these issues every day is key to finding the solutions that will work for them.

What do you have planned for the continuation and/or expansion of this work?

We’re also conducting research into states that have implemented successful data sharing practices between their public health agencies, other state agencies, and even external partners beyond the government—all of which could help other states take steps of their own, based on the experiences of their peers. We’ll aim to highlight some of those in case studies to come over the next year.

Ultimately, our goal is to help better prepare our country for the next public health challenge before it arises. The best time to make these changes is when we aren’t facing a health crisis—so we can take the time to ensure we’re ready for the next one and better able to deal with existing issues in our communities that may need extra intervention. Health departments are essential for that, and we’re looking forward to working with them further.