Traditionally, health departments rely on limited funding sources, often only federal funds with some state and/or other jurisdictional general or targeted funds. Yet, in any field, having multiple funding sources is key to sustainability.
Diversifying funding. Many health departments leveraged Medicaid funding to respond to the Center for Medicare and Medicaid Services (CMS) priorities for the Meaningful Use program. While that specific match funding program has sunsetted, Medicaid programs still have available mechanisms to cost-share in information infrastructure that can meet both public health and Medicaid priorities. Other health departments have leveraged financial or in-kind contributions from health plans because of shared interests and common goals. Building such relationships will likely require engaging senior leadership at the health department, which can be a critical element to strategic sustainability. Refer to the Make the Value Case section of the toolkit for tips on engaging and communicating priority to senior leadership.
Sharing staff. While public health funding tends to be program-specific, many of the data science/informatics skills needed cross programs. Cost sharing in positions for data analysis and visualization, business analysis, project management or communications can contribute to both increased program effectiveness and sustainability.
Root cause identification
Root cause analyses (RCA) identify the starting cause (or root) of problems to create a solution that will not only fix the problem, but prevent it from happening in the future. This framework moves away from merely putting out fires when issues arise, to making sure that once the fire is put out, the same fire doesn’t arise again. Within root cause analysis, it is highly common that multiple interventions—instead of a single one—are needed to get at the root cause.
Additionally, root cause analysis aims for quality improvement over the life cycle. Therefore, interventions will constantly take place to improve the system and prevent future problems. As with data modernization, identifying problems and continually completing root cause analyses will ensure that the health department can adapt the solutions as technology and human nature changes over time. Complete the Root Cause Analysis worksheet using the 5 Why practice.
Resource: Root cause analysis
The Washington State Department of Enterprise Services created a web page devoted to root cause analysis including the goals, benefits and principles and how root cause analysis can be applied within the health department. Additionally, specific information on RCA methods like the “5 Whys” and the Fish-bone or Ishikawa Diagram are included.
Resource: Program sustainability assessment tool
This tool assesses the sustainability of the health department and helps to plan for the future. Within the tool are three sections for understanding the components of sustainability, assessing the sustainability of the current program and developing a sustainability action plan. The tool offers definitions, resources and action steps to prevent dissolution of a program’s activities.
Resource: Sustainability thinking
This course provides short, under-ten-minutes lessons for sustainability thinking. Provided by the Business School at the University of Colorado Denver, this Coursera training is applicable to data modernization projects, specifically when building longevity with new or current systems.