PRESIDENT’S & EXECUTIVE DIRECTOR’S Q&A
Building Sustainable Data Infrastructure,
One Step at a Time
Public health laboratories seem to have
unique considerations in regards to
sharing of public health data. Why is
this an issue for them?
I think some of the success
we’ve had traces back to the fact
that our IT applications staff have
been embedded in the lab. They
sit with us and engage with our
laboratorians daily.”
Grace Kubin, president, APHL
Grace Kubin: Public health laboratories
and their parent agencies are trying to
move forward and improve data exchange
among states. One of the trickier aspects
of this is that every state has certain
limitations on what it can share and how.
How deep can you go into the data? My
laboratory just had a discussion the other
day about newborn screening. We asked
ourselves, “Well, you know they want zip
codes. How about county? How about
regions in our states?” Trying to ensure
that the data is not completely identifiable
is very complicated.
Scott Becker: Yes, we want to make sure
that we’re always protecting the privacy of
individuals.
Kubin: Yes. Another concern is the aging
of our data. We have to go through and
scrub our data to make sure we don’t
have duplicates. This takes a lot of time
and effort. By the time the data is all
cleaned up and “ready for primetime,” it’s
old. We’re missing the boat on real-time
review of data.
Becker: I was struck by a conversation we
had last year with the director of CDC,
Dr. Redfield. He identified data as one of
CDC’s major commodities and cautioned
that the agency would essentially become
a data archive if it didn’t find ways to
make its data available faster. Because
public health is action-oriented, we need
to make sure that this doesn’t happen. So
I was excited to see how CDC embraced
our campaign, Data is Elemental to
Health. When we took our campaign
proposals to Congress, CDC was able
to explain its needs for data exchange
with states and the broader healthcare
community. It’s critical that we be able
to use our data for real-time decision
making.
2
LAB MATTERS Fall 2019
How will public health decision making
change once systems for interpretation
of complex data are in place?
Becker: I can give you a real-time
example: the cases that we’re seeing
of lung injury associated with vaping.
We have both clinical specimens and
product samples associated with each
case, and these are being handled by
multiple agencies at the state and
federal level. We need data scientists
to pull this information together and
make sense of it. I’m pleased that CDC
is undertaking this complex work. This
is not about sending a simple lab result
to an epidemiologist for interpretation
and action. It’s a much more complicated
and fluid situation, and data scientists
are essential to understanding this life-
threatening condition and providing their
special expertise in resolving the crisis.
Kubin: I agree with Scott wholeheartedly.
It seems that anytime we have a new
incident, the data issues become more
and more complicated. There are so many
more variables being put into effect. Our
results should go to the physician, and the
physician should work with the patient
to determine what the outcome should
be. But now we’re getting sources of data
from so many different places. Another
example is collating data on different
mosquito types from laboratories with the
capability for testing of those mosquitoes
and from healthcare professionals
connected to people diagnosed with West
Nile. There are a lot more inputs that can
be collected to give a better picture of
what’s actually going on.
PublicHealthLabs
@APHL
APHL.org