View from the states

I spent part of two days last week with a group of state health department leaders at their national meeting. These senior deputies meet annually to connect and learn from each other. The central theme of the meeting during my time there was to learn to improve business practices in public health agencies.

By saying "business practices," I think they meant the following: how can we manage our resources more efficiently, so we get the most health out of the dollars and effort that we have available?

For example: they talked about how to use GIS tools to turn data into usable information (for instance: which way is the wildfire smoke going to drift in California, and what communities will be at risk for respiratory impact?); how to use web tools to collaborate more efficiently; how to efficiently track and integrate the huge portfolio of federal money that moves into a state every year, on the way to hundreds of government and non-government public health organizations; how to develop the public health workforce in general and build key management skills in state agencies in particular.

The effort is to become smarter: to know what's happening now, know what's needed, know where the money is being spent, know how to measure change to see whether the resources need to be shifted. These are efforts, on a broad state-level scale, that mirror what you try to do in creating a business plan.

Senior deputies are essentially the top management layer for the state public health agencies, with responsibility for executing strategy more than setting it. They manage lots of data about people and communities in their state; they integrate the work of people in their own agency and with huge numbers of partners who own a piece of the health puzzle; they disburse and/or track the money that funds the work that results ultimately in healthy environments and healthy people. They want to be able to say, about the programs of yours that they fund, "this is clearly a well-designed program; the money spent on this program is likely to result in a healthier community long-term."

As a public health business planner this should sound like good news to you. Of course most organizations have areas of discontinuity, where the goals they espouse clash with their actual behaviors-- and individuals are just the same. No organization is perfect. They throw up barriers to achieving their own goals. For now I want to highlight the desire to change the structures that are barriers and move to structures that reward efficiency and effectiveness and strategic partnerships and sustainability. Progress is being made!