A Network Analysis of Information Use in a Public Health Organization

1. A Network Analysis of Information Use in a Public Health Organization Jacqueline Merrill, Suzanne Bakken, Maxine Rockoff, Kristine Gebbie, Columbia University Kathleen Carley Carnegie Mellon University AcademyHealth June 25, 2006

2. Overview Organizational Network Analysis is a research and a management technique Potential to • Aid decision making in PH management • Improve effectiveness agency processes • Implications for system wide performance

3. Rationale Public Health Agencies • complex information processing entities • specialized information and knowledge networks • networks interact dynamically – affect performance • complex, nonlinear, hard to understand, therefore unmanaged • information needs not well met • need to justify investments to improve information management

4. Research Objectives Pilot study • Empirically describe the structure of information flow in a health department using organizational network analysis • Determine possible links between information flow and agency performance, as suggested by the network model • Assess the utility of the method for public health information management

5. Acknowledgements Research funding • New York Academy of Medicine through a research grant from the National Library of Medicine, Maxine L. Rockoff, Principal Investigator Research • Columbia University School of Nursing through a grant from the National Institute of Nursing Research, Suzanne Bakken, Principal Investigator Supplementary data for secondary analysis • New York Medical College through a grant from the National Library of Medicine, Diana Cunningham, Principal Investigator Consultation • Center for Analysis of Social and Organizational Systems, Carnegie Mellon University, Kathleen Carley, Director • Special thanks to Michael Caldwell, Commissioner, Dutchess County Health Department

6. Networks & Complexity Adjacency Matrix Different kind of data Relationships among nodes & edges

7. METHOD: ORGANIZATIONAL NETWORK ANALYSIS An empirical, descriptive technique for modeling organizational systems as interlocking networks people, knowledge, resources, tasks Premise Organization as information processing entity Network measures use graph theory to describe structural features Purpose Understand the flow Find patterns, draw inferences from theory--social sciences, complexity, behavioral Product Visualizations, statistics Insight on structure Implications for decision-making , planning , overall culture

8. ORA:Organizational Risk Analyzer Carnegie Mellon University ORA uses relational datasets organized into adjacency matrices analyzed as a metamatrix

9. Setting and Sample • County health department • Urban, suburban and rural population • 156 employees (4 vacant positions) • 9 divisions, 19 programs • Representative of PH workforce • Representative range of services • Case study for applying method in public sector

10. Network Survey Development Modified standard network analysis questions • work-related relationships and communication among workers • how individuals receive and share info in routine work To aid response used • recognition • two-sided questions allow reconstruction of network position to who do you give information from whom do you get information Finalized with expert consultation, pilot tested Secondary data from informatics competency survey Converted to relational variables

11. Data Tables • Agent by Agent 156 x 156 Communication network questions • Agent by Task 156 x 190 Job level, relevance resources, job functions, job title, communication w/ other orgs • Agent by Knowledge 156 x 39 Education, experience, self rated skills • Agent by Resource 156 x 52 Info resources used, program, outside network 5. Agent by Organization 156 x 85 Outside organizations employees communicate with

12. Data Analysis Presentation of preliminary results via web conference to: For collaborative interpretation (essential) To direct focus of analysis To stipulate goals for results Data analysis plan Overall network description with visualizations Key actors (6 measures) Organizational quality comparisons (15 measures) Report on experienced staff Analysis of a planned merger between two units

13. Commissioner Health Information Administration Health Planning & Education Environ Water Lab Environmental Health Medical Examiner Public Health Nursing Comm Dx Control Clinical Physician Department of Health Formal Hierarchy

14. Public Health Nursing Environmental Communicable Dx Control Administration Commissioner Clinical Physician Public Information Office Water Lab Health Information Medical Examiner Communication Network by Division

15. Public Health Nursing Environmental Communicable Dx Control Administration Commissioner Clinical Physician Public Information Office Water Lab Health Information Medical Examiner Communication Network by Division Environmental staff All other staff

16. Use of electronic resources by front line staff Shows core resources in the center. Note large number of unconnected staff

17. Use of electronic resources by supervisory/management staff

18. Higher the number in relation to total people in each group = greater likelihood more redundancy than needed for efficient operation Lower the number = greater likelihood too little redundancy for efficient operation if anyone is absent

19. Findings • Problems • sub-groups control knowledge, resources • may be overspecialization of knowledge • potential for significant knowledge loss -retirement • little back up for personnel turnover • informational silos • Strengths that contribute to effective processes • efficient communication paths • good social density in the programs

20. Findings Complexity and Task Environment Context • public health tasks = well understood, but considerable instability in the public health environment • unplanned events like outbreaks, water main breaks, extreme weather Agency needs • redundancy • greater cross-program coordination • regular within and cross-program briefings • allow personnel to build up transactive memory (knowledge of who knows who & who knows what) to cope w/ novel situations

21. Proposed Application of Findings • Use findings to inform the agency’s ongoing strategic management initiative • Identify appropriateredundancies • Connect more programs and people internally (mentoring and pairing staff) to improveredundancyandcommunication • Provide more) communication toolsandinfrastructure (mobile devices) • Apply knowledge of network to preparedness

22. Significance Health department Strategic planning Managerial value: process, resources Public health organizations Private sector method--case study for public sector Evaluation metric outside incentive-based market logic Public health informatics Collaborative PH/informatics knowledge building Refine information management Public health system Establish baselines, compare, identify preferred structures

23. THANK YOU