Is this the big chance to modernize public health?

“I used to be indecisive. Now I’m not so sure.”

That line about indecision came to mind when contemplating the mind-numbing rate of change now faced by health organizations: After all, we’re still figuring out the post-Covid cultural shifts; then, the changes brought by AI come bursting in, and, oh yeah, there’s new leadership with the mantra “move fast and break things.” The natural response to such uncertainty is to freeze, to say something like, “Too many unknowns — let’s just hunker down and see how things shake out.”

That, according to those we’ll hear from today, is exactly the WRONG choice.

Time to ride in on a white horse

Mike Popovich, CEO of STChealth, is arguing that it’s time to embrace the chaos, saying to those who work in public health, “You don’t know how good you are. Instead of waiting for the axe to fall, it’s time to ride in on a white horse.”  

He explained: “It’s time to think about what you have to offer. The new emphasis is on having a healthier population – that’s right up your alley. Here is the chance to reenergize programs. Yes, people are challenging old thinking – that’s good. It’s good to revisit assumptions.”

Popovich went on to contend that public health is in position to rapidly expand its contributions, starting by remembering that public health has already built the infrastructure that could lead to what he calls “the new world of public health,” featuring what he summarizes as “a new ecosystem that creates efficiencies.” He added, “Public health has the infrastructure for prevention programs, whether it’s creating programs, like smoking cessation, or with databases, like for vaccinations. If you want to start an initiative for diabetes or for opioid addiction, you just build, not rebuild. You start a decade ahead.”

That sounds promising, uplifting even. But it also sounds expensive coming as it does in an environment of likely budget freezes or cutbacks. However, in the face of that, come three solutions.:

Remember the big lesson of the Gold Rush,

Build on the public-private partnership,

Tell a better story.

AI: THE NEW GOLD RUSH

In addition to Mike Popovich, we talked with Joe Kelly, the lead tech wizard at STChealth, who reported that he’d just returned from a conference where, “Every company was boasting that they had AI, sometimes when that was mostly an exaggeration. And even if they have AI, 90% of those efforts are going to fail.” Pondering that led him to this realization: “It’s the new Gold Rush. And the important lesson of the Gold Rush was that the successful businesses that emerged from that time weren’t the ones mining for gold, they were the ones selling shovels.” The point being, that it’s possible to embrace the energy of the new tech by finding ways to use existing technology and resources to support it.

For Kelly, this means finding better ways to use existing health data: “If there are going to new programs to improve health, that means new demands for data. But when it comes to privacy, the last thing you want to do is to start sending health records to all these new programs. That’s why it’s time to share access, not data. You’ve spent a lot of money and effort to create the data, and safeguards around it, so stop moving it around. Stop the spread! Once you move it, you can’t get it back.”

Meanwhile, he argues that existing health data could benefit from new analytical tools, from “better shovels.” Having worked in IT for marketing efforts, he concludes this: “Marketing companies have spent billions creating systems to know what you need and what you want. Consumer companies have spent billions to figure out how to sell you a dog toy. We can use those systems to figure out how to improve health.”

So, public health has the information to guide better programs and the infrastructure to implement those programs. Sell shovels?

THE BIG PUBLIC-PRIVATE PARTNERSHIP

How can public health think about new programs in a time of fiscal tightening? One way is to tap into a giant resource that just proved itself during Covid: As Joe Kelly put it, “We have public health wanting to increase coverage while at the same time pharmacies are looking for new markets. They can leverage each other.”

Mike Popovich added this prediction: “As public health undertakes initiatives for opioid addiction, diabetes, maybe stem cells, they can partner with pharmacies, who already are face-to-face with patients, and who have the data to identify candidates for new programs.  This partnership will be so effective that I can see pharmacists hiring chronic disease specialists, and at the same time, I see public health hiring pharmacists.”

THE BETTER STORY

If you’re going to turn doubts into certainties, you need to reframe the conversation, which is, in the words of Mike Popovich is, “You need to tell a better story.” He offered this example for when he’s discussing one of his company’s specialties, collecting and analyzing immunization data: “When we look at all the immunization records that flowed through our networks in 2024, for every record reported there were 13 queries. Said another way, for each vaccination reported into a state IIS, there were 13 times when someone was checking on vaccination status. That means a doctor’s office, a pharmacist, school nurse or parent was getting smarter. So, the data is being used to make better decisions, which means that someone isn’t being over-vaccinated, that money isn’t being wasted. That simple number of 13-to-1 is telling an ROI story.”

SUMMARY

In a time when indecision is logical, there’s another option: to embrace the chaos as a rare opportunity for meaningful, rapid change for the better. You “sell the shovels” by “telling a better story” about the existing infrastructure, making the case that you’re starting “a decade ahead,” and have a massive resource to tap into with the “public-private partnership” with pharmacies. That takes us back to where we started, with Mike Popovich offering the advice, “You don’t know how good you are. Instead of waiting for the axe to fall, it’s time to ride in on a white horse.”

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STATS OF THE MONTH

(Bill is off this month. What follows is a repeat of an article that first ran last year.)

Flying Solo!

The Evolving American Family

By Bill Davenhall, Geomedicine Analyst

I was licensed to fly an aircraft long ago but still remember the day I made my first solo flight – both exciting and scary. It turned out okay, but I was soon to learn that two pilots on the flight deck are better than one as there are more eyes on the changing weather ahead. This got me thinking about how people learn to stay alert as to what is changing and to what is not clearly visible. This brings me to the data about “solo parenting.”

A publication by the Census Bureau, (FM-1 U.S. Census Bureau, Current Population Survey) using data based upon both actual counts and periodic sampled surveys over the past 62 years, provides an interesting glimpse on how families across the United States have been arranging for parenting.  Here is what this unique multi-decade data set revealed: 

One parent (un-married) family with at least one child under 18 years of age present- (Includes parents of biological, step, and adopted children)

• 1950 – 7%    (85% Moms; 15%  Dads)
• 2022 – 31%  (75% Moms; 25%  Dads)

Two-parent (married couple) family with at least one child under 18 years of age present – (Includes parents of biological, step, and adopted children)

• 1950 – 93%
• 2022 – 69%

It probably comes as no surprise to the reader that the traditional “audience” for messaging  on immunizations has changed since 1950. Family arrangements for parenting in 2022 would suggest we need to rethink the communication strategies in immunization, especially for children. Sixty-two years of data may not be perfect, but it does confirm what most readers suspected about observed changes in U.S. family arrangements. It should also stimulate innovations in immunization data collection procedures and program operations.

Like flying an airplane, better awareness of the impending “weather conditions” becomes critical. Moms and dads don’t always think alike – even when they do share parenting  duties together. So keep an eye on the population “weather” ahead!

As always, I appreciate 2^nd opinions.