Cloud computing. Hosting applications and/or data in the cloud has provided viable options for a growing number of health departments. Cloud computing provides relief from the continual cycle of server acquisitions, upgrades and security patches. It also enables rapid increases in storage volumes or processing power in emergency situations (and in some cases, to untether from central IT shops). Such freedoms come at a cost, however, so a careful cost-analysis can help ensure it contributes to sustainability in the long term. 

Enterprise data platforms. Addressing data silos within public health is a core tenet of data modernization, as public health agencies may possess more than 100 distinct systems for data collection and storage that support various programs. While a compelling need often exists for programs to maintain individual data systems to align with system user workflow and data collection practices, significant advantages are realized by leveraging data collected and stored across multiple systems. To bridge systems, agencies are increasingly adopting enterprise data platforms. Enterprise data platforms are centralized systems that integrate data from across the agency while applying governance practices to uphold the privacy and data use regulations pertinent to each individual system. There are three primary types of platforms used by public health agencies: data lakes (for raw data that supports flexible analysis), data warehouses (for cleaned data that supports standardized reporting) and data lakehouses (for a combination of both). These platforms benefit public health by eliminating time-consuming manual data cleaning, enabling staff to focus on analyzing data to create information and take action. PHII developed a resource to further explain data lakes and data warehouses as a part of the DMI Stories from the Field project. 

Procurement. The approach for procuring information technology should be driven by the health department’s plans for strategic sustainability. Think about the following questions as the health department embarks on data modernization projects:

• • Will the health department be joining a user community in which costs for enhancements might be shared?
  • Can the health department maximize the number of option years for the vendor contract to avoid time-consuming solicitation processes and possible price hikes? 
  • Has the health department established reasonable (i.e., affordable) service level requirements for the vendor in terms of uptime, response times, etc.? 
  • Is the health department asking for expensive and one-off changes to the software that will add to costs in the short- and long-term (see the next paragraph on configuring rather than customizing)? 
  • Is the health department paying the vendor to provide services staff could do, perhaps even better?

Staff don’t always have control over the health department’s procurement policies and procedures, but developing a relationship with procurement staff helps the procurement team understand the particular needs of public health (such as a small vendor market) and may help to gain latitude where it is most needed.

Configure rather than customize. Related to procurement, if using a vendor product, resist the urge to customize the application to the point that the health department is no longer using a standard product and therefore unable to benefit from regular updates and cost-sharing. Having a one-off software product is the most expensive and least sustainable approach to software ownership and use. Being part of a community of users that jointly identifies enhancements, agrees on the requirements and shares in the costs is far more sustainable, even if it means each jurisdiction has to give up some control.