This guest post is presented by Maximus, sponsor of APHA’s Annual Meeting Blog. Its Center for Health Innovation offers programs and services to help governments improve public health infrastructure so that they can respond to population health needs and emerging public health threats.

Amber Cox, PhD, MPH, senior director of public health epidemiology at Maximus, shares ideas on how human-centered design principles are necessary when modernizing data and information systems in order to improve public health outcomes.

Modernization of data and information systems holds profound promise for health departments across the country. Through the process of assessing, planning and implementing solutions will come innovation, agility to respond to public health threats and improvements in service delivery. However, to achieve the greatest success, stakeholders — the workforce and the communities they work with — must be involved in modernization initiatives to increase acceptance, participation and trust.

Most public health data and information systems were developed decades ago when there were fewer requirements for standardization, interoperability, agility or user input. Today, these requirements are central to modernization. Public health departments must identify, track and respond to emerging health issues, rapidly share information with local communities and stakeholders, and report to state and Centers for Disease Control and Prevention authorities within days or even hours.

One way to advance the needs of the public health workforce and communities is through use of human-centered design. Developed in the business and technology fields, human-centered design is a set of principles that guides an iterative, problem-solving process by understanding and detailing the needs of the customers. Public health can apply these principles to the current data modernization initiatives and create ideal opportunities for health departments to cultivate relationships with their local communities. Collaboration in the process of designing and implementing better systems will improve communication, understanding and ultimately protection of the public’s health.

Here are four reasons why human-centered design in public health is essential.

1. Public health is about people — Distinct from clinical medicine because of its focus on understanding and improving population-level indicators of health outcomes, public health provides a broad safety net. Public health systems identify and track emerging and priority health conditions, which benefit from building a high level of trust within communities. A people-centered process begins by bringing together relevant stakeholders in focus groups or key interviews to articulate problems and needs.

With human-centered design, changes and innovations are tested with these same groups, informing them throughout the process and using a feedback loop to continuously improve all stakeholder experiences. Only then does a modernized data and information system reflect the needs of the users and improve the outcomes.

2. Solve the right problem — New technologies often promise to solve data problems with a new system or with applications, and yet technologies aren’t adopted unless the system successfully addresses requirements of users and organizations. Prioritizing problems requires a deep dive to understand the complexity of an entire information system, its workflows, resources, stakeholder interactions and external system interoperabilities. Human-centered design provides a qualitative and quantitative research methodology to uncover core problems and inform developers about how to customize technology that will fix problems that requiring innovative improvements. Solving the right problems compels us to ask the right questions of the right stakeholders and, most importantly, listen to their responses.

3. Everything is a system — Today’s systems don’t function in isolation, so developers need to know how the public health data systems connect with clinical health data systems. They also must understand how health-related information is transmitted across the larger health care ecosystem of hospitals, health departments, state and local governments, researchers, payers, and the public.

The path to gaining these insights is to engage informatics and public health experts in a human- centered design process. How do health workers track down cases of measles in their county? Software and public health experts working together on real-world scenarios such as this expose their experiences and challenges with current data systems. This process creates opportunities for incremental improvements to complex interrelated systems without losing efficiencies.

4. Move fast, but don’t break anything — Using human-centered design, public health informatics has an opportunity to improve systems and use data without compromising data safety, privacy and confidentiality. The rapid iterations of prototyping and testing products, continuous improvement, and even rolling back changes if necessary all ensure that data systems continuously meet the needs of all parties throughout modernization.

Modernized data systems that connect public health departments with local, state and federal agencies will improve the flow of information and the responsiveness of the entire ecosystem to identify and respond to potential health threats. But improved data systems alone do not replace the need for human interactions. Program success requires pathways for users to participate and increase their trust in the system’s ability to meet their needs. Human-centered design sets up public health agencies for a successful modernization that will improve their programs, efficiency, communication and ultimately their engagement with communities.

Photo courtesy Maximus.