Public health tech must be agile in post-COVID world, Virginia official says

As the COVID-19 pandemic swept through the commonwealth in 2020, the Virginia Department of Health was on the frontlines of the public health response, and various technology initiatives played a key role.

The department was among the first to embrace a digital marketing tool to share its messaging and public health campaigns with residents, then in August 2020 went live with an app to notify people if they had potentially been exposed to COVID. As the vaccines became widely available, the department leaned into online portals for residents to book appointments and track availability, with all this backed by millions of dollars in federal funds to support such initiatives.

Those efforts showed what is possible for public health agencies when they embrace technology. But sustaining those initiatives or launching new ones is trickier now, as federal help has largely dried up with the end of the pandemic. Suresh Soundararajan, the department’s chief information officer, said it is incumbent on leaders to consider where technology can help solve specific problems in public health, rather than just have it be used for its own sake.

“Even though you may have money today, knowing that you don't have it two years from now, you will not even have half of that, how do you think differently? How do you approach it differently?” Soundararajan said in an interview at this week’s GovExec Health IT Workshop. “It's more than a shift. It's more of a shaping of how we're approaching it.”

Meanwhile, residents’ expectations for the customer service they receive have surged, especially given advancements in the private sector by the likes of Amazon and others.

In Virginia, the health department has embraced multi-channel communications to try and meet people where they are, rather than rely on traditional methods to get their message out. They are also able to stand up public-facing dashboards within hours of an incident, whether it be an issue with drinking water, environmental contamination or something else, as people look for information quickly.

“People are used to having things at our fingertips: apps and stuff like that,” Soundararajan said. “[If] you don't keep your user experience up to date, people are going to go in different directions. We have a purpose, public health or the public sector, to serve citizens. We should have that as our mentality: how best to serve.”

Currently, the department is working on what Soundararajan called an “extensive” data modernization effort, including finding ways to rationalize and harmonize data that is collected and housed across numerous disparate sources. In time, the hope is to make that data available for research purposes, and to allow officials to make better decisions.

For now, Soundararajan said the department is focused on building a “master person index” that collates an individual’s various health records in one place and otherwise making sure duplicates are removed. Cleaning the data takes a while, however, and making sure it is not outdated is another challenge.

“An agency like a health department is going to have a large volume of data,” he said. “If it's not timely, if it's not meaningful, then it's almost like a dead block on the wall. It doesn't serve a purpose anymore. Keeping that in mind, how do we make this timely? Data quality becomes a big factor.”

Soundararajan said he is bullish on the use of artificial intelligence, machine learning and other emerging technologies in public health. Agencies are “slowly getting past” their “inhibitions and apprehensions” around the technology, he said, and can see its possibilities. Generative AI could help communicate with different communities, he said, and also help in areas like grant writing and connecting people with information they may usually seek at a help desk or online with a virtual agent.

Overall, AI has the potential to make employees’ lives easier and allow them to focus less on the repetitive tasks that take up many hours. Agencies across government have experimented with using AI in a similar way, including through giving employees quick access to information and helping them write what were once time-consuming reports.

That can make everyone’s jobs more stimulating and presents a real opportunity for the public sector to harness AI for good, Soundararajan said.

“We need to shift our people to be subject matter experts,” he said. “That's the key piece. You can't just say, ‘Oh, we don't need people.’ That's not what it is. We need people shifted from the mundane tasks.”

Being agile, then, was a major lesson from the pandemic and remains a hallmark of public health agencies’ technology strategies. But Soundararajan said COVID-19 also changed the conversation around tech and public health while accelerating digital transformation efforts.

“We started asking questions like, ‘Why not? What's possible?’ And making technology, which was not accessible to the public sector, those things became a possibility,” he said. “The biggest thing is improved service delivery. How quickly can we develop that is a big thing.”