Posted By Amanda Girard On March 1, 2022

Public Health 3.0 Framework and EHRs to Support it

public health 3.0

Public Health has been evolving for centuries to the Public Health 3.0 framework. There are 5 pillars of this modern system that must work together for it to be successful. Technology plays a large part. Many Electronic Health Record (EHR) systems do not support Public Health 3.0 needs. However, EHRs are evolving and some EHR vendors are developing for this framework.

Rajib Ghosh, Founder and CEO of Health Roads, joined us for a Health IT Educational Webinar. He discussed Public Health 3.0 and what it means for Public Health agencies and Health IT Developers. We’ve highlighted some of the information he shared. If you would like to view the whole webinar, please visit our webinars page here.

Evolution of the Public Health Framework

Public Health 1.0

In the 18th and 19th centuries, the Public Health system of 1.0 began. It supported comprehensive Public Health protection. It was focused on primary prevention through treatment but included very little technology.

Public Health 2.0

In the later part of the 20th and early parts of the 21st centuries, Public Health 2.0 emerged. In this phase, governmental Public Health started culminating in accreditation movements. The downside was tremendous uneven Public Health capacity at the local levels.

Public Health 3.0

In the 21st century, the Public Health 3.0 framework emerged. The focus slowly began to shift to Social Determinants of Health (SDOH). The concept evolved that a large part of what health is attributed towards are the social determinants in which people live and spend their lives. 

SDOH include economic opportunity, housing, education, food insecurity, transportation, neighborhood safety, and environment. These social determinants are the various aspects of the social life of a person. They are multi-sectoral by definition. The Public Health 3.0 framework is, therefore, a multi-sectoral approach. It requires multi-system interoperability to support this enhanced and broadened Public Health practice.

5 Pillars of the Public Health 3.0 Framework

The Public Health 3.0 framework includes 5 pillars that must work together.  You cannot achieve Public Health 3.0 if these are acting as silos in Public Health operations.

1. Workforce

The Public Health 3.0 framework requires Public Health leaders to assume the role of Chief Health Strategists. You must enable your workforce to do cross-sectoral work. Your workforce must include more than Public Health workers. You must be open to public-private partnerships and CBO participation in care. And you must support your workforce in having the technical skill sets necessary for this collaborative work.

2. Infrastructure

The Public Health 3.0 framework requires a network of public and private organizations supported by IT systems. These IT systems must be capable of multi-sectoral data collection and bi-directional data exchanges. They must also have reporting systems that can analyze this multi-sectoral data. Finally, these IT systems must include outreach and marketing capabilities.

3. Partnerships

The third pillar of the Public Health 3.0 framework is strategic partnerships with many organizations. You need a workforce that understands the need for these relationships. You need an infrastructure that can enable them. Then you need the partnerships, themselves, to actually bring things to fruition. These partnerships create collaboration for data exchange. These partners are labs, health plans, homeless resource centers, hospitals, rehab centers, etc.

4. Data Analytics

Public Health 3.0 requires a change in reporting and analysis. More analysis than post-mortem reporting is required. You also need outcome tracking and data analytics. This enables you to have a predictive population health management approach to Public Health.

5. Sustainable Funding

Public Health has had funds from county, state, federal and other funders available. However, when funding dries up, Public Health projects have tended to fall by the wayside. That is a challenge every Public Health leader has been faced with. You must seek sustainable funding. You must forge relationships and partnerships for longer-term grants and investments. This is key to upholding the Public Health 3.0 framework.

None of these concepts are new to any who have been in the Public Health space for a long time. I think Public Health 3.0 is really weaving these things together into more of a coherent approach towards Public Health, not operating in a siloed way only focusing on compliance and reporting. It goes way beyond that.

Rajib Ghosh, Founder and CEO, HealthRoads

The Evolution of the Public Health EHR System

Many Public Health offices are looking to upgrade their EHR systems. Old systems and many of those in place currently only offer a few functions. The systems that can support you and the Public Health 3.0 framework introduce many new features.

The Current State of Public Health EHR Systems

Many current EHR systems in place are data entry systems. They capture client data, program-specific information, billing information, service records, etc. They really only report on what is required for funders, compliance, and accreditation. Some Public Health departments rely on very rudimentary paper-based referral systems also. Furthermore, most current EHR systems offer little ability to capture Social Determinants information. The EHR systems are not geared for capturing those.

The Future of Public Health EHR Systems

The future of EHRs, for Public Health, is to support the Public Health 3.0 framework. Modern EHRs systems include two core features. Those are the digitization of paper documentation and core reporting capabilities for compliance and funders’ requirements. Data must be captured into an EHR system in a discreet, digitized manner. That supports data sharing, data analytics, and understanding your vulnerable population. There are additional emerging features of these modern EHR systems also. They include client outreach management, client engagement management, interoperability, analytics, and usability and support for staff mobility.

Key Takeaways

Health equity has always been a driving factor of Public Health. It is becoming even more important now. To solve health equity issues, there needs to be greater recognition of the importance of SDOH. Your clinicians need tools to know the conditions of a patient’s daily life. And you must marry what you do in your organizations with a way to change the conditions in which the people in your community are living. This is integral to the outcome you are looking for in your community Public Health programs.

“Now is the time to really think about (Public Health) in a very holistic way. What do we all need to do to get to the point that we want to go? Whether it’s a Healthy People 2030 Agenda, whether it is my strategic plan that my health department has for the next 5 years, whether it is a preparation for the next pandemic or a raging pandemic which is already there (which is the opioid crisis).

How do we tackle all these current challenges and future or emerging challenges if we don’t have this whole infrastructure?

By infrastructure, I don’t mean to say the technology infrastructure. It is the human resource infrastructure. It is the policy infrastructure. How do I actually put all of that together so that we are not caught off guard whenever there is a crisis that hits?

Rajib Ghosh, Founder and CEO, Health Roads

Technology is not the only applicable factor in the Public Health 3.0 framework. However, it is a necessary piece that must work together with the whole. If you are considering a new EHR vendor, find a trustworthy vendor who can work with you as a partner. Find one who is looking to the future of Public Health and the role of EHRs in whole-person care. Find a vendor who is innovating with regular system releases. Find a vendor that can support your workforce in training on the systems so they can perform their multi-sectoral work.

About Patagonia Health, Inc.

Patagonia Health is a living Electronic Health Record (EHR) software designed to meet the complex needs and desired health outcomes of Public Health and Behavioral Health organizations. Our federally certified, easy-to-learn platform includes integrated practice management and billing software so you get one end-to-end solution. Employee-owned and organically grown, our mission is to support your business with software and service that allows you to provide your patients with the care they deserve. If you’d like more information about our solutions, contact us today.

About Amanda Girard

Amanda is the Marketing Manager at Patagonia Health, a cloud and apps-based Electronic Health Records (EHR) software company serving Public and Behavioral Health. Amanda has a passion for serving those who serve in others in healthcare. She oversees the production of informative content on industry topics and health IT solutions.