During the first three years of the Covid-19 pandemic, the United States had more than twice as many deaths per capita as Canada — over 600,000 deaths that could have been avoided. Experts agree that it was approx a hard-won victory Canada’s public health response. While political and demographic realities have played a major role, the unsung hero is the data modernization effort that has helped Canada track and contain the surge in infections and meet demand for public health services.
When it comes to public health emergencies, Canadian authorities have a long-standing commitment to learning from crises, applying technology and transforming systems to ensure state and federal agencies can succeed in the next challenge. Even in imperfect political realities, public health organizations around the world can learn from and emulate Canada’s response through data modernization, potentially saving millions of lives in the next public health emergency.
A proactive approach to the threat of a global health crisis
Following the SARS outbreak in 2003, Canada’s federal and provincial governments recognized that existing health care systems and information technology were inadequate. Canadian authorities actively worked with IBM to develop a solution known as IBM Panoramaa comprehensive public health surveillance and vaccination system. This solution would later prove to be key to Canadian public health agencies’ response to Covid-19.
Meanwhile, across the United States, public health officials continued to utilize paper-based systems that later failed to keep up with the rapid spread of Covid-19.
In the years following the SARS outbreak, the public health sector largely returned to equilibrium. The day-to-day activities of public health agencies consisted primarily of dealing with customary vaccines, diseases and conditions.
During this period, Panorama assisted Canadian authorities in a wide range of public health functions, including case investigation and outbreak management, as well as vaccination and vaccine stock management.
When the Covid-19 pandemic hit, health agencies immediately found themselves in the spotlight. Suddenly, public health agencies had to deal with:
- A novel disease for which no standards (such as case definitions) existed.
- A rapidly developing disease whose variants, signs and symptoms, and interventions are changing rapidly
- High case numbers and extensive contact tracing, which required the hiring of novel public health workers to meet demand (with confined training availability)
- Novel vaccines and evolving protocols, such as mixing and matching doses of different vaccines
- The need to inform the public about health risks based on rapidly evolving data and uncertain interpretations
While both the United States and Canada faced unprecedented challenges during this time, Canadian provinces equipped with Panorama were better prepared to respond to the Covid-19 pandemic. Unlike many U.S. counterparts, they had a powerful enterprise-grade solution designed specifically with public health in mind. This solution enabled the management of large-scale vaccination events and disease monitoring.
Given global travel and climate change, it’s reasonable to predict that another pandemic (and the problems mentioned above) could be just around the corner.
This time, the United States can learn from the experience and preparedness of Canadian public health agencies. An effective public health response to a future pandemic will rely on collecting and managing critical data, investing in sharp, capable and pliant data modernization systems, and preparing people with the right knowledge and skills.
Lesson 1: Utilize a data model built for public health.
Canadian provinces used a disease surveillance solution that included a person-centered public health data model, which meant it captured necessary information needed by public health workers to forecast and identify emerging trends and outbreaks (as well as analyze interventions and report to stakeholders). U.S. public health agencies would benefit by selecting disease surveillance solutions that rely on a proven public health data model that offers appropriate terminology, relationships, and models.
Lesson 2: Make key decisions based on high-quality data.
High-quality data underpins any public health response. U.S. public health agencies should seek solutions that process data in multiple formats and have built-in data cleansing processes to maintain data integrity. Data silos often arise when data is not shared or accessible, leading to workarounds and incomplete information. Having data sharing agreements in place before an emergency occurs is crucial.
Lesson 3: Handling data volumes with system integration.
Both Canadian and U.S. public health agencies have been overwhelmed by massive amounts of data during the Covid-19 pandemic. U.S. agencies have invested COVID-19 emergency funds in novel case management and contact training solutions. However, these were often standalone solutions that did not address the fundamental problems of silos, incomplete or duplicate data.
Canada used integrated public health information systems such as Panorama to seamlessly acquire, cleanse and process import data. By integrating systems through open APIs and other means of integrating data with patient health records, it served as a single source of truth for all exposure information, case investigation, contact tracing, outbreak management, and case management for each resident.
Lesson 4: Adopt a cloud-native architecture for pliant scalability.
Many investments in novel technological solutions resulting from the Covid-19 pandemic are now coming to an end. To ensure sustainable investments, public health agencies need the ability to scale data and information systems to the volumes of data encountered during steady-state operations as well as during emergency response. Investing in a cloud-native solution provides a pliant architecture and a future-proof solution that enables public health agencies to flexibly scale.
Lesson 5: Prioritize pliant configuration to adapt to evolving disease scenarios.
Canadian public health agencies have leveraged the power of IBM Panorama to address all of their 100+ reportable diseases and conditions. When the novel coronavirus began to emerge in laboratory tests, signs and symptoms led epidemiologists to code the data in the Panorama parking lot until LOINC and SNOWMED officially coded the virus as Covid-19. This type of configurability is needed to adapt to emerging diseases and conditions, rather than systems that only support single diseases and conditions.
Lesson 6: Ensure end users can respond quickly with an effortless and customizable system.
The field of public health has seen major changes as people retire or experience burnout. Data modernization initiatives provide public health agencies with the opportunity to attract novel talent by offering solutions that leverage human-centered design. These solutions leverage augmented intelligence, guided workflows, machine learning, and even incorporate generative AI to embed domain expertise in workflows and escalate efficiency and training of novel users.
Lesson 7: Utilize storytelling to engage stakeholders and the public.
While epidemiologists are equipped with the tools to report and analyze data and communicate it to other scientists, accessible storytelling is critical to fostering greater trust and influence when translating science into public communications and public policy. Canada is providing “data storytelling” training for public health professionals that enables public health information officers and state health officers to draw insights from data to maximize public understanding and action.
Create a proactive data modernization plan to prepare for the unexpected
The COVID-19 pandemic has revealed opportunities to change the way public health is managed, as well as the need to invest in technology. Thanks to CDC’s Data Modernization Initiative and Public health infrastructure grantsIt is time for U.S. public health agencies as they modernize to learn from other public health agencies like those in Canada.
By taking a proactive approach to data modernization, U.S. public health agencies can manage steady-state operations and be better prepared to respond to the unknowns of the next public health threat.
Incorporate these lessons into your data modernization journey