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Building the Bridge from Data to Knowledge Management

State: NE Type: Model Practice Year: 2004

Information is an essential tool for the department to carry out the core functions and the essential public health services in Lincoln and Lancaster County. Available, accessible, reliable data with a high degree of integrity are critical at all levels and for every activity. The department’s goal is to develop and maintain an integrated data management of all department data systems and databases. In addition, the department staff will become skilled at collecting data accurately, managing information effectively, and using the information to have the right knowledge in the right place at the right time to make better informed and faster decisions. This is a model for effectively integrating all data and information sources regarding population, individual health and environmental risk factors, and interventions and outcomes.A critical component of this development was a design that will allow replication of the project in part or in whole. A future activity will be to document the design and identify methods that can be used to replicate the project on a smaller scale. A critical component of this development was a design that will allow replication of the project in part or in whole. A future activity will be to document the design and identify methods that can be used to replicate the project on a smaller scale.
Information is an essential tool for the Health Department to carry out the core functions and the essential public health services in Lincoln and Lancaster County. Improving the infrastructure for managing information was identified as one of the county’s primary goals. The initial plan for the Integrated Data Management project included an analysis of the current problems and barriers to achieving this goal. This included a review of:All current information technology resources.  National and state initiatives that will impact the local health department. Current and future demands for information. The ability to support knowledge management for department managers and program areas. The Integrated Information Management Project is a creative, innovative, and practical approach to building a sustainable infrastructure to support knowledge management. The design took into consideration the national developments in public health informatics including PHIN, NEDSS, HIPAA, data standards development, and surveillance, as well as state initiatives such as the NEDSS Base System and the PH Laboratory System. The project was designed to be flexible and allow for changes in technology as well as for growth and changes as the needs of the public and the department change. The health department developed a model for effectively integrating all data and information sources regarding population, individual health and environmental risk factors and interventions and outcomes. Many integration efforts attempt to combine everything into one software development. This model is designed to bring together information from multiple sources so that managers can use the information to assess, plan, and evaluate. The model included elements to improve availability, accessibility, reliability and integrity of the data at all levels and for every activity.
Agency Community RolesStaff at every level of the department have been involved in developing and implementing the Integrated Information Management Project.. As the project continues, it will involve every single user. Every user has some input into design and development of service encounter systems that they will be expected to use. This is accomplished through a disciplined approach to requirements development and product testing. At the same time, the users receive a basic orientation to the broader principles of knowledge management as they work through the specific tools that they will use. Information Management staff lead the development process but always collaborate directly with key staff members from the division or program who shares the responsibility for assuring that the end product meets the needs of the program staff.  Costs and ExpendituresThe Integrated Information Management Approach was funded through the local public health infrastructure funds allocated by the state from Tobacco Settlement Funds ($150,000 per year). Additional programmatic dollars were available from the first funding cycle and used to purchase the software for the Environmental Health System. Two full-time Information Management staff members were added through this funding. The department server was upgraded, and SQL and ARC IMS servers were purchased. The health department is currently in the fifth year of funding.  ImplementationThe initial business plan is still functional, but there have been refinements throughout the implementation process. Key elements of the Integrated Information Management Project are: Standards of practice for staff to follow for all information management activities. Development and implementation of an internal Web site that is accessible to every staff person. Underlying hardware and software structures such as SQL server, ARC IMS, and Crystal Enterprise. An online query system for reference data that is accessible through the internal Web site. Data warehouse; data dictionary; mapping tools that can be used by any staff person through the internal Web site. Knowledge Management Pyramid and components of the Integrated Information Management Approach. Development and implementation of informatics competencies for all department staff.
Each strategy is reviewed as the work plan is developed for implementation by the Information Management Team and key staff from other divisions. Options are identified and research is conducted to determine the most feasible and practical approaches. Prototypes are developed and tested by the Team and key staff. Then, the product is tested by program staff who will use it. The feedback is collected and reviewed, and modifications made as needed. This practice is used for all levels of development and implementation. Tools are evaluated based on whether they meet the needs of the program staff and managers. Overall, the Conceptual Model has been extremely useful to allow the department to identify how everything will fit together and then to work effectively on individual pieces. The interfaces and standards needed can be readily identified and applied to each of these. The biggest challenge is keeping up with the growing demands of the department and the availability of program level staff to invest time in the development of tools that affect them. The support of the Director and the Division Managers has been a key to resolving this problem. The work plan for 2005 includes exploring the feasibility of scaling many of these tools down so they can be used by a small local health department with just basic microcomputers and software (e.g. Microsoft Office).
SustainabilityFunds to sustain the project come from infrastructure funds ($150,000 per year). Future projects are always evaluated for sources of funding. Standards of practice are being sustained through policies, procedures, training and on-going practice. Also, there is significant stakeholder support. The Health Director has allocated resources, created a Division of Information and Management, and provided on-going encouragement. The division managers across the department ranked this infrastructure development as their number one priority when listing the strategic goals in 2002. Staff response continues to be very positive. Lessons LearnedYou cannot communicate too much. Regular project team meetings are critical. Written reports and demonstrations on your progress to stakeholders are very important. A visual conceptual model or approach that presents the development in a way that does not require technical knowledge is critical to engaging and retaining stakeholder interest. Also, take note of the challenges that stakeholders are facing in their work and show them ways to make use of the development to support their work. Remember to document and standardize your development for future staff members’ use.