For as many decades as I’ve been a conscious adult – which is quite a few decades now – most professionals dealing with people’s health and well-being have understood that sharing information across silos is critically important, both to improve outcomes for individuals and to address broader public health concerns. We understood it, but we didn’t do nearly enough about it.
As a result, in more ways than anybody can count, today we’re paying the price for our collective lack of action to breach those silos. A small, annoying example is that far too many patients still have to fill out the same forms with the same information every time they see another doctor (though this particular problem is getting better). A much-more-significant consequence, and the subject of this blog, is the largely ineffectual response to the worst public health emergency in modern American history: the opioid/heroin/fentanyl epidemic.
A lack of interoperability and information-sharing across relevant domains – from public health and safety to social and emergency medical services, among others – isn’t the only reason the crisis has remained mostly unchecked for over 15 years. But when a challenge is this complex, this cross-cutting in its breadth, depth and impact, it’s hard to imagine how it could be effectively addressed without bringing all the players to the table to figure out how to devise and execute a genuinely collaborative, coordinated, multi-faceted, multi-disciplinary and multi-sector approach.
That’s exactly the path we’ve begun to travel in Virginia, where George Mason University convened nearly 300 key cross-sector officials from across the state’s northern region last month. For over eight hours, we discussed how to develop a population health strategy, broke into workgroups of specialists to delineate what its components should be, and then mapped out initial next steps in order to turn the university’s vision and commitment into a reality.
I think we all left energized and cautiously optimistic, but we also recognize that it’s very early yet – so, for now, we’ve got more questions than answers. And they’re really tough questions, ones that transcend “mandatory” issues such as how to improve prevention and treatment, as well as interoperability and information-sharing. Achieving those objectives will be hard enough, but other questions almost certainly will make this complicated task even more difficult. For instance:
- How do we change a societal culture in which people with substance-use disorders are stigmatized, in which getting a shot of naloxone can be easier than finding rehabilitation services, job training or decent housing?
- How do we define “community” in the context of this problem, since we firmly believe communities are the right level at which to do this work, and how do we best engage them when they’re engulfed by the opioid crisis and strapped for resources?
- How do we reduce crime, mitigate the harm that’s an inevitable consequence of this enduring emergency and protect children, who are its most-innocent victims? And how do we educate children so they don’t grow up to repeat the mistakes of their elders?
It’s important to acknowledge that numerous efforts to address the opioid epidemic are already underway in jurisdictions around the country, as well as through broader initiatives such as the National Interoperability Collaborative (full disclosure: I serve on NIC’s Advisory Committee). Most pointedly for the work we’re starting at George Mason, an abundance of activity is taking place in Northern Virginia. There’s no inventory of who is doing what, however, and there’s no concerted effort to make connections among those activities, to bring domains and counties together, to collaborate and share information to minimize duplication of efforts, reduce costs and, most vitally, improve outcomes.
It seems to me that an academic institution – in this case, George Mason University – is a sensible place to serve as a hub for putting together the many pieces of this puzzle, in Northern Virginia for now and perhaps as a national prototype for the future. GMU has expertise in pertinent areas including data collection and analytics, brain science, economics, law, education, psychology, nursing, public health and law enforcement. It also hosts a federally funded, multi-disciplinary homeland security center that is not only a model for this initiative, but also can contribute to it as we explore the myriad issues related to illegal substances, distribution networks, their funding, etc.
Through this effort, the opportunity will exist to make real progress in how the health and human services sectors can interact with the law enforcement and homeland security communities to improve prevention and detection, and to ensure that people with substance-abuse issues have the best possible opportunity to recover and become productive members of society again.
Over the past couple of decades, in particular, we’ve developed an increasingly full grasp of the value of sharing information across silos to improve outcomes for individuals and, most pointedly, to address public health concerns. Now, with that understanding, it’s time to do something about it.
Bill Hazel is Senior Advisor for Strategic Initiatives and Policy at George Mason University in Virginia. He is the state’s former Secretary of Health and Human Resources, and serves on the Board of Directors of the Stewards of Change Institute