Historically in government, the decision-making process is something that has occurred behind closed doors. When the fate of a program, a budget, or the response to a disaster or epidemic takes place without transparency, it leads to distrust and a deep sense of uncertainty. The pace of Social Media and news cycles profoundly affect the perception of decisions. Your constituents’ satisfaction with a strategy or an outcome hinge on perception, and it’s increasingly clear that information needs to be truthfully represented. Data is truth, and not only will data help communicate and justify a decision made, data will unsurprisingly lead to better decisions and better leadership.
Let’s use the opioid epidemic as an example. Most cities and counties are not equipped to overcome the institutional hurdles necessary to understand the depth and detail of how the epidemic is affecting them. There are ‘big picture’ numbers about deaths in the United States, there are news stories of overdoses in their communities, and there is a sentiment that picture is getting worse. Yet many cities and counties are unable to say with certainty where the overdoses are occurring, how many are resulting in death and what combinations of drugs were involved in the toxicology. The main challenge preventing this from happening is that there are barriers to collecting and sharing data to gather a common, cohesive vision of the problem.
Disparate Sources, Disparate Systems
Two of the major local groups involved with responding to the opioid epidemic have different perspectives on the problem, and are ultimately concerned with handling distinct aspects of the problem: First Responders and Health and Human Services organizations. Their systems are shaped by the work that they’ve done for decades, and many are struggling to adapt their systems to cover the overlap of epidemic response.
First responders are frequently the front line to handling addiction, homelessness and mental health issues. They will be called to respond to overdose situations, to triage with immediate medical assistance, transport to hospitals and to assess if there are any investigatory leads. ‘Triage’ means information is assessed and shared quickly, sometimes with a degree of uncertainty, to provide an appropriate level of service and resourcing. The data frequently reflects uncertainty of the overdosed drugs, and because many first responders overlap response activities, there’s duplication in each of the systems that needs to be identified and addressed. Location and date are the primary keys to determine as accurate of a picture of the overdose as possible. Keeping track of deployment of the reversal agent Naloxone and assigned stock also helps communicate one of the aspects of the way the community is responding.
Coroner and Medical Examiner systems are intended to document cause of death with legal authority and implications. Medical examination is precise, and toxicology reports declaring cause of death with certainty can take 6 or more weeks. They are the final authority for overdose death data, but the pace can be slower than what’s needed for short-term and focused response and preventative measures.
Public Health and Human Services organizations are focused on assessing community risk factors and trends, providing treatment options and publicizing preventative measures. They typically are responsible for drug drop-off programs and keeping inventory of addiction and pain management alternatives, however there is no common approach or system to do so. Brochures quickly become out of date, and it’s increasingly difficult to provide timely and accurate information about addiction resources when someone needs it at a critical moment in their lives.
Overcoming the Barriers to Sharing
The data gathered from first responders and health agencies is location data by nature, and the problems are understood and overcome by thinking spatially. Where are the programs operating most effectively? Which areas are more at risk? The response to this epidemic is coordinated best when disparate agencies share their view of problem. ArcGIS provides tools to easily obfuscate personally-identifiable health information by aggregating data to useful neighborhood geographies. Portal-to-portal collaboration with ArcGIS Enterprise or ArcGIS Online enables agencies to share the determined level of detail to facilitate a real-time Common Operating Picture.
Elected officials and Community Stakeholders are ultimately responsible for coordinating the collective effort of voicing a cohesive strategy to their constituents. Sharing “this is how this problem is affecting us, and this is what we’re doing about it” is the first step to removing the uncertainty and unease that constituents feel about the problem.