How One State Overcomes Barriers to Better Share Public Health Data

Comprehensive, timely data helps policymakers and public health officials identify, track, prevent, and treat a variety of health issues, from communicable diseases such as measles to maternal and child health concerns to the opioid epidemic. But throughout the country, this data exists in separate agencies and departments, and numerous barriers prevent connecting the different data sources.

Some states are implementing promising approaches to help agencies better share data. A new brief from The Pew Charitable Trusts examines how Massachusetts is supporting the use of cross-sector data from various agencies or departments that is analyzed holistically to target more effective public health efforts.

Fully understanding these types of health threats—where they’re concentrated, how they’re spreading, and who’s at greatest risk—requires many different types of data. Health care providers, public health scientists, social workers, and insurers can analyze their own data but often cannot easily share, connect, and compare information with each other. This makes it difficult to get a more nuanced understanding of a locality’s health—and the threats it faces.

In 2017, the Massachusetts Department of Public Health (DPH) created the Public Health Data Warehouse. By linking data from multiple sources, including health, housing, family services, and other public agencies, the warehouse allows state and local health departments, colleges and universities, health care providers, foundations, private companies, think tanks, and other interested parties to analyze and address priority health and quality of life issues in a comprehensive way.

“The driving force behind [the warehouse] was realizing that we had all of these disparate data points telling a piece of the story, but not the whole story together,” Dana Bernson, director of the Data Science, Research, and Epidemiology Division in the Office of Population Health, Massachusetts DPH, said in an interview with Pew.

Advance Health & Well-Being State Health Data Reporting Policies and Practices Vary Widely

Report

In the years since its inception, the warehouse has been used successfully to address a wide range of health problems within the state. From analyses done before the warehouse’s creation, DPH knew that individuals were at a substantially higher risk of dying from an opioid overdose immediately after being released from incarceration. Data also showed that access to medication for opioid use disorder (MOUD) severely reduced an individual’s risk of death. This information led to a mandate by the state Legislature for DPH to implement a pilot MOUD program in 2019 in partnership with county jails that led to a 50% reduction in mortality from all causes.

Following this success, DPH continued to expand use of the warehouse to address maternal and child health issues, COVID-19, illnesses and deaths related to climate change, and racial and health inequities. The warehouse now holds more than 6 billion data records that characterize the health and well-being of Massachusetts residents.

Through interviews with current and former Massachusetts officials involved in designing and implementing the data warehouse, Pew has identified several promising practices that other states can look to as they build their own data sharing practices.

• Engage executive leadership for support. Provide leadership with a compelling case for what a data sharing system can help to achieve and engage them in promoting the model among legislative partners and working through structural barriers such as legal restrictions or technical capabilities.
• Show value and build trust quickly. Identify pressing public health concerns that have the attention of departmental and/or state leadership, which can prove especially helpful in garnering an executive champion. Focus on areas where the system can prove its value early and use that to generate further interest and build confidence in the work. This action is especially helpful for policymakers who need to show results in limited time windows.
• Build flexibility into the data system and its funding. Work to creatively combine funding streams to provide support. Don’t get stuck on building a perfect practice up front. Rather, focus on having components in place that can adapt over time—such as flexible data use agreements and data structures—as states learn from these efforts and public health priorities shift.
• Involve a range of internal and external partners. Focus collaboration on generating buy-in for participation from potential data partners and establishing cross-agency trust. Embrace shared decision-making with IT and legal staff from the onset.

The creation and use of Massachusetts’ Public Health Data Warehouse demonstrates that it is possible to quickly and effectively bring together disparate data sources to better understand and address health issues. This model also shows that building a sustainable data sharing practice is feasible through an approach centered on flexibility and engagement with a multitude of partners.

Ian Leavitt is a principal associate and Margaret Arnesen is a senior officer with The Pew Charitable Trusts’ public health data improvement project.