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While COVID-19 has shown some of the best attributes of the U.S. public health system, it has exposed the weaknesses of our data systems—wrought by chronic underfunding and further exacerbated by siloed, categorical funding and planning. Yet, even with our pandemic weariness and persistent, systemic inequities, this historic event has revealed resiliency across the country. It has also yielded new innovations, along with promising practices and partnerships in how we leverage technology and data to better respond and mitigate public health threats. To build further momentum and support the ongoing modernization efforts of our partners, ASTHO is hosting its first-ever TechXpo.

Leading Health Security Efforts Through Strategic Collaboration and Innovation Margaret Nilz This blog post illustrates how health agencies' strategic plans can improve health security and emergency preparedness. Strategic planning is a cornerstone of effective public health systems, guiding organizations in preparing for and responding to health threats. Three pivotal documents—the CDC Office of Readiness and Response (ORR) Strategic Plan, the ASTHO Strategic Plan, and the ASTHO Environmental Scan—are part of the foundation of ASTHO’s work. Each plays a critical role in shaping public health policies and practices. Understanding their synergies and differences is beneficial and crucial for enhancing our collective efforts in safeguarding public health. ASTHO’s Environmental Scan tracks U.S. public health concerns and trends. Through qualitative analyses of select health agency materials and health official feedback, this blog identifies state, territorial, and freely associated state health agencies’ (S/THAs) top current and emerging priorities across public health programs, infrastructure, and health equity and agency strategies to address them. Across 2023 and 2024, S/THAs consistently identified emergency preparedness and response as a critical priority. Callout 1-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation It is essential to align strategic plans and address emerging public health priorities in order to effectively respond to new health challenges. The ORR and ASTHO Strategic Plans share several common goals, such as implementing equitable, evidence-based practices, partnering for sustainable infrastructure improvements, and focusing on operational excellence while providing technical assistance. However, each plan also has unique missions. Callout 2-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation ASTHO’s Health Security team has a unit mission and vision that align with ORR goals and focus on supporting the needs of ASTHO members, as identified in the Environmental Scan. Callout 3-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation Aligning these strategic goals with current public health priorities is crucial in addressing existing and emerging health threats. Values The ORR and ASTHO plans express shared values like collaboration and innovation. These values guide strategic decisions and foster a cohesive public health community. Table-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation Competencies and Priorities Both organizations focus on developing competencies like leadership and technical expertise. ORR concentrates heavily on competencies specific to preparedness, including planning, response, and research for public health emergencies. ASTHO emphasizes competencies to support S/THAs, such as technical assistance, communication, capacity building, and advocacy. Building and aligning these competencies is essential for improving public health outcomes and ensuring workforce preparedness. With that in mind, ASTHO’s competencies are specifically aimed at aiding and supporting its members, and consequently the nation, in achieving the ORR competencies. Environmental Scan Observations The ASTHO Environmental Scan thoroughly evaluates current public health trends, challenges, and opportunities. Key highlights from the 2023 and 2024 Environmental Scans include: Focus on emerging threats such as infectious diseases and the impact of climate change. Changes in public health funding and resource availability. Technological advancements and their implications for public health practice. Common trends identified include a heightened focus on health equity, the importance of data-driven decision-making, and the need for increased interagency collaboration. Organizational competencies, including performance management and quality improvement, were listed as current priority areas for public health infrastructure and capacity-building. Focus issues include financial infrastructure, business processes, including procurement, recruitment, and grants management, policy development, and public health governance structures. Workforce development was listed as a priority for public health infrastructure and capacity building. Focus issues include recruitment and retention, local academic pipelines and training opportunities, staff compensation, and staff salary gaps. Data modernization and informatics are priority areas in states with state health improvement and strategic plans and were listed as current public health infrastructure and capacity-building priorities. Accountability, performance management, and quality improvement are priority areas in states with state health improvement and strategic plans and were listed as current public health infrastructure and capacity-building priorities. Implementation While ORR and ASTHO aim to achieve similar overarching goals of supporting health agencies, their implementation strategies vary. The ORR Strategic Plan focuses on four primary strategies that directly address the emerging threats and challenges highlighted by S/THAs, including: Modernizing and integrating data and systems across multidisciplinary public health entities to support data readiness and interoperability. Advancing readiness and response science to improve public health practice, including maturing and implementing evidence-based research in preparedness. Building and enhancing the response capability of CDC and state, tribal, local, and territorial health departments and driving collaboration among partners to enable rapid and effective response to public health emergencies through improved capabilities, partnerships, and funding mechanisms. Conducting rapid and ongoing readiness and response evaluation to inform continuous improvements across the detection of public health threats, readiness science, and emergency operations. While ASTHO’s Strategic Plan is less explicitly focused on preparedness, its guiding mission in supporting, equipping, and advocating for S/THOs and their agencies with a focus on leadership development highlights several strategic priorities critical to improving public health preparedness and addressing emerging priorities. Health and Racial Equity: A state and territorial public health system that prioritizes implementing policies and programs advancing health and racial equity to achieve optimal health for all. Workforce Development: A diverse state and territorial public health workforce that is engaged, well-resourced, well-trained, and connected to the communities it serves. Data Modernization and Interoperability: A state and territorial public health system supported by an enterprise-level data infrastructure in which public health data systems are interoperable, secure, and supported by a well-trained workforce. Collaborative Opportunities Maximizing the impact of these strategic plans involves leveraging the strengths of each organization through collaboration and innovation. There are numerous areas where ORR and ASTHO can collaborate to enhance public health outcomes: Joint programs leveraging CDC’s national scope and ASTHO’s state-level connections. Shared research initiatives pooling resources and expertise from both organizations. Coordinated emergency response efforts that create a unified front addressing public health emergencies. By continuing to communicate, these organizations can effectively address complex public health challenges and enhance overall public health resilience. Future Outlook Looking ahead, the strategic efforts of ORR and ASTHO will play a crucial role in shaping the future of public health infrastructure and preparedness. Engaging with and supporting these initiatives is essential for all stakeholders. To adapt to the changing health security threats, future iterations of all documents must be routinely updated to meet the needs of the nation and ASTHO’s members. A collective effort is required to improve public health resilience and response capabilities, ensuring we are well-prepared for future challenges. Ultimately, the synergy between ORR and ASTHO’s strategic plans presents a powerful opportunity to enhance public health outcomes. We can create a more resilient and effective public health system by fostering collaboration, building competencies, and addressing emerging trends and challenges. website yes

Ohio Department of Health Using Partnerships to Improve Public Health Data and Emergency Preparedness Margaux Haviland Learn how Ohio leverages partnerships to promote data modernization and improve public health emergency preparedness. In a public health emergency, it’s crucial to quickly and strategically deploy supplies such as personal protective equipment and medical countermeasures (MCM). This requires coordinated efforts among local, state, and federal partners to assess and address community needs. Timely access to actionable data about MCMs and other essential public health supplies is vital for this process. State health agencies need up-to-date information on available public health supplies to make informed decisions and respond effectively to evolving situations. In order to explore opportunities to improve data sharing for public health response, in March 2024 ASTHO, with support from the Administration for Strategic Preparedness and Response (ASPR) and HHS Coordination Operations and Response Element, selected three state health agencies—Ohio, Massachusetts, and Washington—to identify and pilot scalable solutions for enabling bidirectional information sharing regarding ASPR-deployed assets across all levels of public health. The Ohio Department of Health (ODH) proposed a highly collaborative approach to their data readiness proposal that encompassed ongoing strategic planning, which included MCM plan revisions, broadening coalitions, data modernization through standardizing systems, and last-mile delivery using equity-based allocations. Incorporating Local Perspectives As a home rule state, where public health authority is decentralized, the ODH team worked to ensure that local health department perspectives were included in the ODH data readiness project work. The ODH project team collaborated with the Association of Ohio Health Commissioners (AOHC) as well as Ohio’s seven regional health care coordinators to solicit feedback on barriers to sharing MCM inventory data, challenges with data reporting, and operational changes that could improve bidirectional MCM data sharing. ODH engaged directly with long-standing partner AOHC, a nonprofit organization representing Ohio’s local health districts, to capture the local health department perspectives by establishing a diverse focus group, facilitating surveys, and gathering feedback. With AOHC support, ODH was able to successfully field its first survey with responses from 111 public health leaders and emergency response coordinators. Survey results indicated consistent responses when considering challenges experienced or expected with reporting MCM data, with three clear themes emerging: A lack of continuity between systems and compatibility (i.e., the duplication of efforts due to having both local and centralized data solutions). Staffing constraints, including time, money, and personnel. Issues with data accuracy and efficiency, having no standard nomenclature for reporting resources and allocation. The survey also captured proposed solutions for enhancing bidirectional MCM data sharing, with a centralized system being the top-ranked theme as the most relevant to respondents. A state-wide system would allow for state and local health agencies' visibility and real-time documentation that could be easily reported for state and federal requests. Another recurring theme was the importance of collaboration and diversifying partnerships, which will only aid in furthering MCM efforts within Ohio. MCM Summit To further collaborate with local public health and health care stakeholders, ODH held a one-day summit—Medical Countermeasures for a More Prepared Ohio—focused on enhancing MCM preparedness and response through improved integration with public health partners. The summit offered an opportunity for participants to develop local and regional relationships, initiate discussions, and increase awareness and collaboration through operational data sharing. The presentations and workshop included speakers from Ohio State University, Columbus Public Health, Cardinal Health, MMCAP Infuse, the Department of Health and Human Services, and the Ohio Department of Health. The sessions centered around developing a unified operational view, the equitable and timely distribution of MCMs, better integration of the health care supply chain into public health preparedness, and medical surge response during public health emergencies. The workshop then allowed attendees to work through a developing medical surge scenario, including steady-state situational awareness and the transition into initial response decisions and subsequent MCM distribution and logistics. Feedback from the event has been extremely positive, with participants sharing takeaways that could be leveraged in their jurisdictional planning: “How we may be able to better plan for shortages by leveraging private sector opportunities.” “We have a strong working relationship with our partners that needs to be protected and promoted.” “Showing the importance of MCM and keeping better inventory along with learning more about MCM supply chain process, how my organization uses it, and who they order from.” “Overall, I enjoyed the event. I felt the morning speakers were strong and informative. I really took away a lot regarding supply chain dynamics.” Opportunities to Improve Data Readiness and Response During the data readiness project, ODH identified critical opportunities for local, state, and federal partners to bolster data modernization efforts and improve efficiencies, mainly through standardization and interoperability. Currently, MCM distribution and reporting are largely directed by two federal agencies, CDC and ASPR, which use different processes as well as reporting and tracking systems. Improving the alignment of requesting and reporting processes for local agencies would reduce administrative burden during an emergency response. The standardization of data elements across agencies, as well as the reporting requirements, would reduce duplication of effort and improve jurisdictional capacity to respond to public health emergencies where MCMs are deployed. The next phase for Ohio includes leveraging the relationships developed during the project to continue to improve state responsiveness and effective through planning, exercising, and determining a feasible data solution that supports the goals of the state’s evolving MCM strategy. article yes