The Department of Health and Human Services is increasing its focus on social determinants of health to address unmet health needs through a multi-sector, complex approach.
“We’re focusing on how we can look outside the health care setting and hear from multiple programs to improve health outcomes and lives of the American citizens we serve,” said Kristen Honey, chief data scientist and senior advisor at HHS. “Data and interoperability can advance equity and bridge disparities in health.”
One program the department launched to align with its open data priorities is HHS Protect, the agency’s COVID-19 biosurveillance system that has served as a common vantage point for what’s been happening in the U.S. regarding COVID-19 over the past year.
“This is a data-sharing platform that was brought up through the pandemic. It was designed to facilitate COVID-19 data sharing among stakeholders,” said Kevin Duvall, HHS’ acting chief data officer. “More recently, we’ve been looking at school status ... to see what planning we need to do for school districts.”
Duvall said the department is also looking at social vulnerabilities to understand where different communities and areas are experiencing challenges with COVID-19.
“We know that there are areas and challenges that are disproportionately impacted by COVID-19, and so how do we, as HHS, work with our partners across public health take interventions to make it better?” Duvall said.
Not only is HHS working to uncover new data, but also the department and its partner agencies are transforming data to make it understandable to guide decision-making. Honey said that as HHS analyzes data, it derives novel insights and connects different divisions to find innovations at the crosscut.
“Data has to be looked at in context, and it’s all about the people. Everything we’ve been doing in this space is context-specific, human-centered and people-led. Data is only a piece of the story,” Honey said.
HHS launched a collaborative effort with its internal partners to create a whole-of-department approach to its data collection efforts. The team has taken a three-pronged approach: developing a data pipeline, creating an open data ecosystem and building trust.
“Health equity is incredibly complex. It’s what we call a wicked problem, meaning that it’s multi-faceted and may not have a solution. But we can at least work on it and make the issue better, if not a full-out solution,” Honey said.
HHS’ data pipeline helped transform healthdata.gov to make information freely available to federal leaders and the public. This data is machine readable, easily discoverable and accessible.
“Just making the information out there is not sufficient. You then have to transform it into value,” Honey said. “In collaboration with the Office of the National Coordinator for Health Information Technology, we’ve advanced the [social determinants of health] space in many facets.”
By creating an open innovation, data-driven ecosystem with both industry and government, HHS will help create a lasting solution that fosters collaboration.
“We think of ourselves as a short-term catalyst to begin an initiative, solve a problem, connect people, provide resources to move the needle, and then get out of the way,” Honey said. “Thinking outside of the box of not just how we co-create and frame the challenge we want to solve, but bring in outside partners ... and leverage unique strengths.”
Honey emphasized that COVID-19 has outlined the importance of trust in government, solutions and science. Without trust in the data behind governance, it's difficult to have people following guidelines and mandates. HHS has pushed the idea of “radical transparency” to show trustworthiness.
“Trust is really about relationships. Trust is consistency over time,” Honey said. “If people consistently have a positive outcome, and they know they can turn to us ... that builds trust.”
To continue this work, HHS is pioneering a new data effort to get to the root cause of health disparities, not only within the health care setting, but also across the social environment. Honey calls this “drivers of inequity.”
HHS is also looking into an “open government plan” to make government more available and transparent to the American public, Duvall said, adding that HHS will decide which data will be made available as well as build a clear pathway to share it.
“There is no simple answer of how you create real-world value from data, but there are some general principles: listening to the people, co-creating solutions and having data be our guide,” Honey said. “Keep showing up for consistency and trust over time. Change will happen at the speed of trust with all of us working together.”