The Difference a New Data System Makes

Special thanks to the “Healthy Homes Des Moines” team for sharing their reflections and learnings on their BUILD Opportunity Fund Award in this blog. BUILD awardees were eligible for ad hoc funding awards to catalyze efforts in policy, data, system change, and/or health equity that complemented their ongoing efforts to support community health.

Healthy Homes Des Moines (HHDSM) was a two-time BUILD Health Challenge awardee. The collaborative learned much about data in its first two years: what we needed to show outcomes, what data is possible to collect, and the challenges we face in collecting it. While this is typically true with any new program, it is especially so with a program involving health care and confidentiality concerns. Add in complicating factors, such as the many partners involved in HHDSM and the fact that the program was constantly evolving, and data discussions become even more complex.

Early attempts at developing a data system were focused on the program management aspect. With so many program elements at play – and different partners responsible for different components of the intervention – a system to coordinate and manage the various program elements for multiple referrals in process at one time was sorely needed. At the intervention level, partner responsibilities requiring coordination included:

• Making home visits for asthma assessment and education (EveryStep);
• Conducting home assessments to determine what repairs are needed (Polk County Health Department);
• Managing the process of collecting bids, selecting contractors for home repairs,and monitoring completion of the repairs (Rebuilding Together and Polk County Public Works); and
• Final follow up with the family after repairs were completed, where we delivered supplies, provided some final education, and re-assessed the level of asthma control and management (EveryStep).

Managing these diverse components, delivered by different partner organizations, was a program coordinator’s nightmare. HHDSM needed to develop a data system to track this work. Utilizing a local vendor, we developed a system, trained partners on its use, and implemented our activities. Having made some early attempts at program managing via Google Docs, the new data system was a major improvement. Then. . . along came evaluation.

Was our intervention effective? Were we making a difference in the lives of families? Were we able to tell the HHDSM story in a way that was convincing and credible?

It was when we began to explore the answers to these questions that our data challenges began to surface. The data system was built for program management, but not for extracting data to report. We had always had a focus on evaluation, but on the development side, the vendor was unfamiliar with healthcare’s complexity. On the program partner side, building a data system was out of the realm of our collective range of experience. In essence, the vendor didn’t know how to guide the partners into developing a system that would meet our data collection and extraction needs, and the HHDSM team didn’t know what to ask the vendor for to ensure that it did. All partners were well-intentioned, but the system ultimately didn’t meet our full set of needs. (And like many others, we were not without data entry issues too.)

Thus, began an arduous process of identifying exactly what we needed from the system, ascertaining whether the vendor had capacity to provide it, and if so, deciding whether we could afford it. As all partners remain committed to this work beyond the term of the grant funding, we knew the system’s ability to track activity and monitor outcomes was central to the program’s ongoing management and success. As we were nearing completion of this lengthy and detailed process, two surprise solutions to our problem appeared nearly simultaneously. The first was the BUILD Opportunity Fund, which had the potential to provide funding to help us get our data system back on course. HHDSM was able to seek additional funding to address this challenge rather than amending the budget and reducing our planned community programming.

The second solution appeared in the form of Green and Healthy Homes Initiative’s (GHHI) asthma management software. Because we had an existing relationship with GHHI, related to technical assistance they were providing around program sustainability, we learned that they had a software solution they had already adapted for healthy homes programs. It was exactly what we needed.

Thanks to these two opportunities, the course of our data path has improved dramatically. Over the past year, we have built out the system to suit our needs, all the while learning from GHHI’s experience and expertise with the system and with asthma management programs. We were able to migrate the old data over, clean it up, and are now drawing data reports that we have confidence in. Transitioning from the previous system and learning to use and maximize the new system has required significant time and energy (and patience) from staff, but the outcome is well worth the time invested – and it is paying off. With the old system, the program evaluator had to conduct much of the tedious analysis the system couldn’t perform. Now, it is a much simpler process, and we can focus on quality improvement. This adjustment helped HHDSM lay the groundwork for a deeper analysis that will build the case to move our work to the next phase. We can now tell our story, with both compelling anecdotes and powerful data to back them up. What a difference a new data system makes, indeed.