In 1854, London’s Soho district was hit by a sudden and severe cholera outbreak of unknown origins, causing more than 127 deaths in three days. Following the conventional wisdom of the era, concerned residents blamed the scourge on a miasma, or bout of “bad air,” and took precautionary measures that they thought would spare them from the disease. That logic didn’t sit well with local physician John Snow, who believed his observations warranted a different explanation.
To investigate, Snow partnered with local reverend Henry Whitehead to visit each residence around the neighborhood, and the two collected and analyzed health data related to the outbreak. Snow and Whitehead found that the majority of Soho’s cholera cases were geographically clustered around a public water pump on nearby Broad Street. This led Snow to believe that water from the local pump – and not miasma – was the cause of Soho’s bout with cholera. As it turned out, Snow’s analysis proved to be correct: his revolutionary use of health data not only benefited the residents of 1854 London, but helped establish the modern practice of epidemiology.
Today’s methods of data collection and analysis have obviously come a long way since John Snow. Moreover, technology has enabled people to generate and communicate data in ways previously unimaginable. Chicago’s Foodborne app is a great example of this. Foodborne Chicago is able to identify keywords in public tweets that may indicate a case of food poisoning. From there, the Chicago Department of Public Health (CDPH) is able to respond accordingly via Twitter, and encourage affected individuals to submit a food poisoning report. Since its launch in 2013, CDPH has collected an additional 443 food poisoning reports and conducted over 200 additional restaurant inspections.
Another program that Snow would have loved to get his hands on is the Chicago Health Atlas, a website that interactively maps health-related information so users may see local rates for specific health conditions, as well as locations of various health resources. The site is designed to help policymakers, healthcare professionals, community groups, and residents by providing a tool to keep them more informed when developing solutions to overcome health challenges.
Like Snow and Whitehead’s partnership, both Foodborne and Chicago Health Atlas were developed via unique collaborations. Foodborne was developed by CDPH, the SmartChicago Collaborative, several independent developers, and Chicago’s Department of Innovation and Technology (DoIT); the Chicago Health Atlas, meanwhile, was done by SmartChicago, CDPH, and five local hospitals.
These programs are only a part of what is possible in Chicago’s growing world of data analytics. With continued—and even formalized—relationships between individuals, organizations and sectors, such data-driven innovations could transform how governments handle public health issues, both internally and externally.
CDPH is looking to establish that kind of policy fixture, ensuring a stable model for continued innovative production. The Department’s new Office of Strategy and Innovation (OSI) brings together public, private, nonprofit and philanthropic parties to pursue the same goal that Snow and Whitehead had 160 years ago—to make their city healthier and safer for its residents.
“There is a transformation happening in public health,” says Dr. Jay Bhatt, who heads OSI as Chief Innovation and Strategy Officer. “Stakeholders are taking some of the best practices from other sectors and applying them to population health challenges. In Chicago, we are leveraging the latest innovations and technologies to create a stronger health ecosystem for our residents.”
Technology for a Healthy Chicago
In recent years, CDPH has embraced new tech-driven methods to engage with the public and encourage positive health outcomes. One of the driving forces behind this is Healthy Chicago, a strategic plan the department launched in 2011. Healthy Chicago identifies twelve key priorities, as well as sets of measurable targets to define them, to improve the health and well-being of Chicagoans.
Of these twelve, it’s the final priority—public health infrastructure—that’s of particular interest. Having up-to-date data and information systems is critical for a well-functioning public health department. These are needed for emergency management, disease tracking, reporting, information dissemination, and various implementations of health interventions around public health issues. CDPH Commissioner Bechara Choucair, MD, is more than familiar with the paramount role data plays in his department’s work.
“Public health is all about data. We need to identify and collect data, share it with the public and our partners, and then leverage that data to create better policies, systems and environmental changes,” Choucair says. “Data is what is helping us eradicate lead in our city, and helping us identify potential issues at local restaurants. But that’s only just the beginning,”
In Healthy Chicago, CDPH outlines goals to enhance IT functions needed for communication with health care providers during emergency situations. Furthermore, it forges a stronger partnership with DoIT to better implement public health-related strategies and enhance overall Health IT.
DoIT’s partnership with CDPH is a key component of OSI. The department is the City of Chicago’s go-to source for municipal data, and manages the city’s open data portal. DoIT is also deeply involved in predictive analytics. Last year, it won a Bloomberg Philanthropies Mayors Challenge grant to support the continued development of the SmartData Platform, a project that will use data and prediction to help cities make smarter, more informed decisions that address a wide range of urban challenges.
“I think this city has the ability of putting predictive analytics into the hands of every department in the city and unlocking the value of predictive analytics,” says Chicago CIO and DoIT Commissioner Brenna Berman. “Our work on the SmartData platform has the potential to positively impact not just every department in our city, but in cities across the country and world.”
In addition to CDPH and DoIT, the OSI works with other government agencies, such as the Chicago Department of Business Affairs and Consumer Protection (BACP), the local county government (Cook County), and the Illinois Department of Public Health. All have scores of government records and data, and bring knowledge of government policies and procedures. Academic and private-sector partners are also contributing—with the University of Chicago’s Data Science for the Social Good, Allstate Insurance and Civic Consulting Alliance among them. Several “civic hackers,” or individual developers from Chicago’s civic innovation community, are involved as well.
The benefit here is that these varied parties, when working together, are all able to bring different resources and skills that can help maximize CDPH’s capacity for innovative development.
Making Innovation Happen: The Key Components
“When we look at the key health issues facing our department and our city, it really helps to have a broad group of professionals to work with,” says Raed Mansour, Executive Assistant to the Commissioner at CDPH and one of the driving forces behind OSI. “With so many talented people working together, it really makes things happen.”
According to Mansour, there are three key components needed for developing any new health tech innovation: informatics, application development, and predictive analytics. Each requires a different set of skills and resources typically not available in a local government agency. While creating a system that balances these three pieces isn’t simple or easy, a blueprint to do so has already been put in place, thanks to projects like Foodborne and the Chicago Health Atlas.
Informatics, the science of processing data for storage and retrieval, is the largest and most fundamental step in any tech-based public health initiative. “Data held by the city, or really any group, isn’t readymade for a specific project,” says Matthew Roberts, CDPH Informatics Project Manager. “It needs to be cleaned up and made usable for a wide range of users—from hospitals and clinics, to city employees, to the general public.” Think of the myriad of data that’s accessible on the Chicago Health Atlas—it didn’t all come from one database or source, and it sure didn’t come together by itself.
Once relevant data has been made accessible, the next level is developing the application itself. Health-related applications may be targeted towards a variety of audiences and take on a variety of forms. The Chicago Health Atlas, for example, is targeted towards the public, and takes on an interactive map-based format. Foodborne, while also targeted towards the public, uses Twitter as its main platform. Other apps that OSI develops may be made for city employees, or for hospitals, clinics, and nonprofits.
The final component of health tech innovation, though, is the biggest potential game-changer: predictive analytics. DoIT’s SmartData Platform is a key component that the department brings to the OSI network. Currently, DoIT is developing a host of pilot programs in order to shape the project’s abilities. Its first pilot, focused on preventative rodent baiting, has yielded promising results on how the City can better predict when and where rodent incidents will occur throughout the city.
The individuals and organizations in OSI’s cross-sector network each bring skills and resources that help them contribute to one or each of these three components. Yet once assembled, where does OSI start? What guides the group’s processes, and helps make “innovation” go from concept to reality?
Making Innovation Happen: Capacity Development
Mansour has the answer to this very question: he’s made a conceptual framework for developing tech-related programs and initiatives within the OSI network. The framework, which consists of a four-step process, builds upon OSI’s cross-sector design to help deliver targeted, innovative solutions to pressing health issues.
Concisely put, the OSI process is to identify a problem, convene appropriate partners, generate ideas, and then develop a model. That model may then become a new and crucial tool for improving Chicagoans’ health and well-being.
As the city’s most pressing public health challenges have been outlined in Healthy Chicago, the first step of OSI’s process is relatively easy. The challenge is determining if and how technology can best address a given issue. For example, restaurant and food inspections are a key task for any public health department, but one that can often be a challenge to efficiently execute. In a large city like Chicago, the number of establishments needing inspection is far greater than the number of inspectors available. Here lies a potential problem: food inspections being done by the City are likely not optimally efficient.
Which partners could be convened to help address this issue, and what ideas could even begin to fix the problem?
Those partners would likely be the ones who manage inspection data and the inspectors themselves—DoIT and CDPH.. Moreover, DoIT continues to develop pilot programs for its aforementioned SmartData Platform in order to test the project’s abilities. The Food inspection problem posits a question that SmartData is being made to address.
Not coincidentally, the city’s idea has been to develop a pilot around this issue. Following the pilot, Chicago’s next step will be to develop a predictive model that has the potential to make Chicago food inspections more efficient and effective.
Enhancing food inspections is only the beginning: OSI also aims to tackle issues such as tobacco violations, lead poisoning, and vulnerable population management during emergencies, among others.
A Healthier and Safer City
John Snow’s innovative thinking of 160 years ago may seem simple by modern’s technology’s standards. Yet his desire to make his city healthier and safer is a goal that remains unchanged in public health agencies today. Snow’s impact eventually spread far beyond London’s borders, ushering in modern epidemiology in the process.
Today, cities worldwide regularly exchange ideas and best practices. For Chicago, scientific publications of OSI’s health-related analytical work are currently in progress, and code for projects like Foodborne Chicago is already available. OSI and the City of Chicago plan to share information with other cities and jurisdictions, and expand national and international discourse on how to best make cities healthier and safer.