#030: Unlocking Community Health: The Power of Data Sharing

Angie Grover, COO of Metopio, talks about the transformative impact of data sharing in healthcare. Learn how Metopio democratizes data access to bridge community gaps and improve health outcomes and how cloud-based tools make data accessible and actionable. Listen to real-world examples of how data-driven interventions have addressed health issues.  

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- Liz Church, Host + Producer of The Atrómitos Way

Transcript

00:00:00:00 - 00:00:21:09

Liz Church, Atrómitos

Welcome to the Atrómitos Way podcast, where we have meaningful discussions on the challenges in healthcare and the solutions behind them. I'm your host, Liz Church. Each episode, we dive into the complexities of our health and social system, gaining the experiences and insights of the guests shape our lives and our communities. And we're back, ladies and gentlemen, we're back with season three.

00:00:21:15 - 00:00:55:11

Liz Church, Atrómitos

And we are starting the season with Angie Grover, Materials Chief Operating Officer. I was introduced to Angie by a member of my team, and we hit it off immediately, and I knew I needed to have her on for season three. Her vast knowledge and excitement about bridging gaps in communities are astounding, but a quick background about Angie. She has over about 30 years of experience in healthcare, government, technology and public policy, and she's led diverse teams nationwide in addressing healthcare's most complex issues.

00:00:55:13 - 00:01:24:03

Liz Church, Atrómitos

So what are we talking about today? Data sharing and how it is critical for organizations to have the right data at their fingertips? Metopio does just that assisting organizations analyze data more easily to make better decisions with technology. We'll explore how Metopio was innovative tools and data accessibility efforts transform how organizations understand and address community health challenges, from ensuring data quality to promoting data equity.

00:01:24:05 - 00:01:45:02

Liz Church, Atrómitos

Angie will share her insights on making data accessible, affordable, and actionable for all. That sounds familiar, folks. Without further ado, Angie. Hello and welcome to the podcast. To get started, can you provide an overview of Meadowview and its mission in democratizing data access and insights for organizations?

00:01:45:04 - 00:02:12:02

Angie Grover, Metopio

Thanks, Liz. I'm so happy to join you on this podcast. And you know, Meadowview is really about ridiculously easy data and tools that help you understand places and populations you care about. So, you know, when we talk about democratizing data, really what we're talking about is data literacy and data equity. Every day in our work, we see how data silos and limited or gated access to data analysis really cripples decision making.

00:02:12:04 - 00:02:44:05

Angie Grover, Metopio

So we set out to do two things. We curate critical verified data that is essential and understanding community context. And we provide tools that turn that data and information that anyone can understand. So really we have PhDs who use our platform because they know that the visuals visualizations are easy to understand, even if the data is complicated. And then on the other end of the spectrum, we have advocates and community members and nonprofit organizations who access data through our tools like the Health Atlas.

00:02:44:07 - 00:02:54:01

Angie Grover, Metopio

And often these people have limited data training. But the same important need to access and understand their community. And that's what we look to deliver on.

00:02:54:03 - 00:03:10:08

Liz Church, Atrómitos

So the people that you serve are those in the public space trying to help their communities, you know, said public health officials, healthcare leaders, economic development professionals. And then rural hospital leaders. How do the offerings you provide support them?

00:03:10:10 - 00:03:28:24

Angie Grover, Metopio

Yeah. So I'm sure you've talked a lot about workforce development on your podcast and how important that is in healthcare. But if you've tried to hire a data analyst or anyone with data skills these days, you know it's extremely competitive. And, you know, if you're a public health department or a rural hospital executive, it's simply hard to find and keep talent in this space.

00:03:28:24 - 00:03:56:05

Angie Grover, Metopio

And, you know, not necessarily with tools like Metopio. So the Metopio platform empowers clients to do more because now they have access to these updated, verified data sources. And why is that important? Because if you have limited analyst resources, you don't want them spending their time doing data wrangling. It's not the rodeo, right? You don't need them finding and cleaning and curating data and then oh, going back and maintaining it and updating it.

00:03:56:07 - 00:04:19:11

Angie Grover, Metopio

Instead, you can focus on the questions that are being asked of the data and tapping into the right data sets to inform their analysis and strategy. So that's really critical when you have limited data science resources. And then second, you know, having the ability to tell really effective stories with data. So we're all visual people. You know, if we had this on a TV screen we'd be showing you all kinds of great images, etc..

00:04:19:11 - 00:04:47:06

Angie Grover, Metopio

So, you know, we are able to couple an anecdote about, say, a senior patient not having a way to get to their checkup with an analysis of transportation in that area and coupling that qualitative story with the quantitative data really reinforces that this isn't just another story or this isn't just another outlier. This can actually help you bring additional resources to your community and to the priorities that you feel are essential to address.

00:04:47:08 - 00:05:10:21

Angie Grover, Metopio

And then finally, you know, we help organizations think strategically across multiple disciplines to find solutions to these questions. So whether it be improving health outcomes or reaching more diverse populations are really understanding the impact of a health outcome or community variable on a subpopulation. Now that all that's at your fingertips so you can actually move at the speed of need.

00:05:10:23 - 00:05:25:15

Liz Church, Atrómitos

So can I go back up just a little bit with talking about the platform that many of you offers? It's a cloud based analytical software. So what are the main features and functionalities that make data insights accessible, affordable and actionable?

00:05:25:17 - 00:05:52:06

Angie Grover, Metopio

Yeah, and I think you are referring to our Atlas product. So we do have two products. They're both built on the same technology. And I absolutely love our Atlas product. I mean, fundamentally it is about effective data sharing which is a key takeaway from Covid. Many of our clients in the public health space talk about how expectations have really increased around public access to things like surveillance data.

00:05:52:08 - 00:06:14:04

Angie Grover, Metopio

And after two years of reporting, you know, data, statistics, you've kind of conditioned the public to want this from data from public health institutions. And they just don't have that capacity. So the atlas really moves us away from static dashboards. I mean, how many times have you found an interesting insight online that somebody has put together using data, but you can't see yourself in it?

00:06:14:04 - 00:06:36:03

Angie Grover, Metopio

You're just reading what they're giving you so you can access and understand what you need for your community. So it's like that. It's you can't scratch, right? So clearly they have the data, but they're telling you their story, not your story. So that Atlas really makes this data accessible. So the user can decide what insight they need to what that insight needs to look like, what benchmarks they need to use.

00:06:36:05 - 00:06:56:04

Angie Grover, Metopio

So it's, you know, really important to move past that picture into using the data. And that really is the definition of actionable, right. and then affordable, I would just make this point because we work in the equity space every day, and we believe everyone should have access to data and be able to use it in their work.

00:06:56:04 - 00:07:20:04

Angie Grover, Metopio

And that's why we've really developed a pricing model that reflects geography and population this way. You know, the city of Chicago, with 2.6 million people can access and use the data, but also Allen County, Ohio, with like 100 and 101,000 people. They can do the same. And if we want people to be able to assess disparities and address them in a meaningful way, they must have the data.

00:07:20:10 - 00:07:27:23

Angie Grover, Metopio

And often some smaller organizations just have less resources. So the impact we can have working with them is actually greater.

00:07:28:00 - 00:07:44:02

Liz Church, Atrómitos

So let's talk about the data a little bit more in guidelines and compliance. So can you describe how much of your software complies with the CDC guidelines on data sharing and facilitates accessibility to other researchers and institutions?

00:07:44:04 - 00:08:17:19

Angie Grover, Metopio

Sure. You know, the CDC has really committed and put staff time and resources towards figuring out data modernization. People refer to it as DMI, the data modernization initiative. And what does that mean for a very diverse set of entities with varying capacity and different governance structures? And it's not as easy as it sounds, right? And so, you know, I can touch really on the CDC's five priorities because I think they're very relevant and will be for decades to come because they are building and funding around these, these five priorities.

00:08:17:19 - 00:08:41:10

Angie Grover, Metopio

So the first one is just building the right foundation to improve data collection. So data collection, analysis and sharing at the CDC, across the public health surveillance system for all diseases and conditions is really a priority. This would look like real time data collection or cloud based services automation, making sure state and local have same capabilities, so that is their first priority.

00:08:41:12 - 00:09:05:02

Angie Grover, Metopio

The second one is accelerating data into action, which we just talked about, which means having more data sources to promote health equity and increase the capability for scalable response forecasting and predictive analytics. This is like open data interoperability and dealing with privacy and security, that type of thing. The third one is developing a state of the art workforce.

00:09:05:02 - 00:09:25:00

Angie Grover, Metopio

So this is a crisis across healthcare. And one of the reasons Metopio I think is so valuable. It is also why it must be an essential part of the agenda, because we need to have a workforce with next generation skills for this to have actionable pop up, for us to have actionable public health insights. It's a priority, whether it's recruitment, training, forecasting.

00:09:25:02 - 00:09:47:07

Angie Grover, Metopio

All of it needs to be baked into what we're doing to move us forward. The fourth one is, supporting and extending partnerships. Fundamentally, working to address these issues is not a one woman or one man show or one person show, but it needs to be a collaborative effort. So ensuring data transparency and access is really the only way to get there.

00:09:47:09 - 00:10:10:05

Angie Grover, Metopio

And then the final one is managing changing and governance. And I alluded to this a little bit. But government has never been good at in this space. And it's really essential that these priorities evolve. And we do have better data collection and better data sharing and the right change management and monitoring and evaluation all in place, so people can have confidence in using the data that the government is putting together.

00:10:10:07 - 00:10:32:23

Angie Grover, Metopio

And so as I think about Tokyo, we're building the right foundation for data sharing by providing that cloud based interface that leverages a data governance framework so that all these diverse data sets can come together and be used in harmony. And we want users to be able to put this data into action. So we are constantly talking to leaders in the field and our clients to identify what's next.

00:10:33:00 - 00:10:58:21

Liz Church, Atrómitos

And I'm really glad we're going to be able to get the opportunity to go into the good stuff. The outcomes and how the data has been used, helping organizations to figure out disparities and such. So before we get to that, I do want to ask, moving into talking about federal, state and local sources, if you will. How does what Tokyo does, how does it facilitate the seamless integration of diverse data sets?

00:10:58:23 - 00:11:16:13

Angie Grover, Metopio

You know, really, this is a hallmark of our work. When I talk about curating all these data sets, I really sounds easier than it is. And of course, technology can help us and we're constantly iterating and and trying to make it better and faster. But what is important to understand is that not all these data sets are created equal.

00:11:16:15 - 00:11:39:08

Angie Grover, Metopio

Just as I was talking about collecting, kind of you know, racial stratification data, there are data sets that have age, but not race or maybe sex, but not age or sex, race and age, but not they're only available at the county level. It is a whole bunch of possibilities that are really endless. And that's why I'm grateful to our Tokyo data team, who are just relentless and following up when the data is released.

00:11:39:09 - 00:12:04:00

Angie Grover, Metopio

What the data facets look like, how they can work together and like, believe it or not, in Illinois the state still releases data and PDFs. How are you supposed to put that into any kind of operational analysis if it's in a PDF? Right. And so that means any organization that needs to access that data and understand it has to put a person to that effort just to get the data and that's not in an insignificant amount of time.

00:12:04:02 - 00:12:33:22

Liz Church, Atrómitos

Yeah. And also to you're putting data in PDFs like are the graphs really small. Can you read the numbers. Are they too jointed together? I mean come on now. Right. You do not. We have to expand a little bit. We got to get interactive state federal, local. Everybody home. So then to kind of go a little bit more granular with it, how would you say Metopio helps tackle social and health issues, promoting fairness and create positive community changes?

00:12:33:24 - 00:13:03:10

Angie Grover, Metopio

Yeah, Liz, you know, I think I would go back to an earlier statement about data literacy and data equity. Often working with our clients and their partners, we find that people with lived experience don't have access to data, and the people with data don't have lived experience. So this is the essential ground truth thing that must happen in order to really, truly understand a place and then tell the people who live there have the ability to access data to understand why things are the way they are, or to tell an effective story about the need for resources at scale.

00:13:03:12 - 00:13:21:17

Angie Grover, Metopio

We can't solve for poverty, which is really what's underlying all of the social determinants of health. So when we talk about the social determinants of health, we really are talking about, you know, if you have a job, did you graduate? What's your family makeup? Do you have a car. How much do you pay for rent? I mean, it really is the fabric of your life.

00:13:21:17 - 00:13:42:08

Angie Grover, Metopio

And study after study have shown that your zip code has more to do with your health outcomes in nearly any other factor. And you know why is that? Because the fabric of your life either helps or hinders your health journey. It is what it is, right? And so when we are able to pair community data with our clients proprietary data, that's really when the magic happens.

00:13:42:09 - 00:14:06:20

Angie Grover, Metopio

It opens up questions of root causes, provides answers and solutions, and really helps guide and focus limited resources on some of the more difficult challenges we have to solve. It can also help identify key collaborators that go outside your scope of service, right? So when data is driving all of that, and we're driving solutions and investing to build more resilient and healthier communities, we're all going to win.

00:14:06:22 - 00:14:15:07

Liz Church, Atrómitos

Okay. So then, you know, following on that note, what transformative changes do you envision when more organizations adopt Utopia software?

00:14:15:09 - 00:14:40:19

Angie Grover, Metopio

Transformative. What a powerful word, right? dare I say, it's a bit of boundary spanning. Transformative change really can't be possible unless we're all sharing this data. We can't work across data silos or data or organizational silos. Not one of us can solve these systemic, persistent challenges alone. It's not like I said, a one woman, one person, one man job.

00:14:40:21 - 00:15:07:21

Angie Grover, Metopio

We must find new ways to identify and partner with the people in the most under-resourced communities and make investments that will be transformative. And we have to do that together. So I hope you the data we provide, the tools we provide, the effective data sharing, growth and data literacy all to be key essential ingredients and a catalyst for moving us forward.

00:15:07:23 - 00:15:35:13

Liz Church, Atrómitos

An amazing way to close this part of the conversation. So let's talk about how innovative tools facilitate better decisions when preparing for this conversation. And you provided me a interesting breakdown of the governance framework that my top use software uses and their eight branches. And now, while we can not get into each one right now, Angie, can you share with me why it's important to have a diligent governance structure?

00:15:35:16 - 00:16:01:19

Angie Grover, Metopio

Data governance really is critical to building longitudinal data sets or data sets you can look at over time, regardless of who is curating them. So really what this means is that you're standardizing each facet of your data to ensure the data sets are consistent across staff time, and then all the metadata, all the different pieces needed for an organization to be efficient, are there on a consistent basis.

00:16:01:19 - 00:16:21:08

Angie Grover, Metopio

So really the key is to implement a system that is flexible enough to accommodate some hyper local data, yet standardize to optimize use across all your data sets. That governance just really think of it as a checklist of how you have to put your data together so that you can use it effectively.

00:16:21:10 - 00:16:42:10

Liz Church, Atrómitos

And so one of the branches on it was security. And to briefly remind folks about the ransomware attack on Change Healthcare in February of 2020. This occurrence has stirred everyone in the digital space. So Andy can you elaborate on the correct way to protect sensitive information?

00:16:42:12 - 00:17:05:14

Angie Grover, Metopio

Sure, and I'll give my legal disclaimer that I am by no means an expert, but obviously work with in this space with experts so I can, you know, their entire law firms that spend every day advising and creating infrastructures that are supposed to be able to protect sensitive information. It is very in the information age. So this is something we're dealing with every day across all industries.

00:17:05:16 - 00:17:30:10

Angie Grover, Metopio

But in particularly sensitive is your health information. Right. So it really is paramount in today's digital landscape. And the US, you know, looks at this much different than the EU. So again, not being a legal expert, the two keys I might mention would be effective use of technology and the absolute commitment to training and compliance and probably not what you expected.

00:17:30:10 - 00:17:59:21

Angie Grover, Metopio

But this includes things like, you know, on the technology side, robust encryption protocols, regular security audits and engaging your employees and training on cybersecurity best practices, having stringent access controls and all the things contemplated under HIPAA and all the rules that were built to protect health information. And so, you know, phishing changes every day, people need to be aware of what the latest criminal minds are thinking so you can protect yourself.

00:17:59:21 - 00:18:24:04

Angie Grover, Metopio

So it's not a one and done. It's an ongoing process. And so in addition to entire law firms, there are also fleets of security, chief security and information officers are CISOs. And so there's a whole profession dedicated to understanding these emerging threats and to addressing those vulnerabilities promptly. You know, we have taken a unique approach at Tokyo to try and remove the threat altogether.

00:18:24:06 - 00:18:46:17

Angie Grover, Metopio

So all the data on our platform is de-identified and aggregated, which means you're looking at populations, not individuals. And this is achieved a couple of things. First, it removes the risk. We're not putting any hi or PII on the platform. So there's nothing we're not putting anything at risk. So the users of Tokyo can gain insights and share them, which is the whole point.

00:18:46:17 - 00:19:06:02

Angie Grover, Metopio

Like we want you to understand the population and be able to share that to inspire action. So I also think, you know, while it's valuable to know a lot about Angie Grosvenor, when you're talking to Angie, the types of disparities we're trying to expose can only be done when you find 100 Angie's for a thousand. Angie's all experiencing the same challenges.

00:19:06:02 - 00:19:17:22

Angie Grover, Metopio

So I think that population angle and our commitment to not putting compute eye on the platform really makes us a dynamic tool that can result in action.

00:19:17:24 - 00:19:34:15

Liz Church, Atrómitos

So we're talking about data sharing and using data. Can we kind of go a little in depth. Some definitions here. So data quality is a significant need when making decisions on research and analytics. But why is it important to ensure data quality.

00:19:34:17 - 00:19:55:06

Angie Grover, Metopio

can I take us back to Covid again, which will I think, as you referenced, will be a lifetime of use cases to Covid is a perfect example for poor data quality. Really. It starts with data collection reflects what we just pointed out about data governance. So during Covid there were multiple definitions of a Covid death, for example.

00:19:55:08 - 00:20:12:19

Angie Grover, Metopio

And sometimes it was the primary reason listed on a death certificate. Sometimes it was a tertiary region, sometimes it was not listed at all, even if the person died with Covid, but they died of a heart attack, right? So we're all over the place that this data set, and each jurisdiction was able to decide how they wanted to record Covid deaths.

00:20:12:19 - 00:20:30:15

Angie Grover, Metopio

And I don't have to tell anyone that this was not a scientific question, but more of a political one, right? So what we ended up with was really bad data that we had to use, and it wouldn't allow us to look from state to state, and sometimes even from county to county, because there were there was no discipline.

00:20:30:15 - 00:20:53:16

Angie Grover, Metopio

And the curation of the data and the quality just wasn't there. So, you know, I hope, you know, we do a couple things to ensure and prioritize data quality, because we do believe it's so important. We source data from reputable and trusted sources, ensuring its accuracy and then reliability. Just knowing where your data comes from is the absolute starting point, right?

00:20:53:18 - 00:21:14:10

Angie Grover, Metopio

Second, our data team really employs robust data cleaning and validation techniques to identify and rectify any area errors or inconsistency. A lot of this is survey data. So we need to understand what that looks like. And our platform also has the ability to our data upload to identify anomalies and require the user to do some additional quality checks.

00:21:14:10 - 00:21:38:23

Angie Grover, Metopio

So having those checks at every point is super important. and we are constantly deploying vetted quality control measures to assess data integrity before we add it to the platform. And again, that goes back to that data governance framework which we maintain. It's transparent. We have documentation throughout the data lifecycle. And that enables us thorough validation audit ability.

00:21:39:00 - 00:21:57:07

Angie Grover, Metopio

and even more important, in my opinion, understanding by the user who is accessing our data set. So, you know, we revisit these standards and methodologies to deliver the highest standard data quality to our clients, and that empowers them to make informed and impactful decisions that are based on data that they can trust.

00:21:57:09 - 00:22:18:01

Liz Church, Atrómitos

So as I mentioned earlier, data sharing is essential. And Andy, you agreed off camera, though we were talking about the challenges with data sharing and governance and how it ties into equity. So one more definition of you will if you could define this for me, can you explain what data equity is?

00:22:18:03 - 00:22:46:21

Angie Grover, Metopio

Sure. Data equity refers to the fair and unbiased access, representation and treatment of all individuals or groups within data sets, ensuring that no one is systematically advantaged or disadvantaged. That is kind of your textbook definition, right? A really, you know, it involves recognizing and addressing potential biases, looking at inequalities or exclusions in your data collection and your analysis and your interpretation processes.

00:22:46:23 - 00:23:12:14

Angie Grover, Metopio

And really, data equity aims to promote fairness, inclusive inclusivity and transparency and how the data is sourced, managed, analyzed and used. Right. But for people who might not work in this sector every day, there's also an important distinction between equality and equity. Right. So equity acknowledges that individuals have different needs and circumstances and barriers that may require different levels of support and resources to achieve that fairness.

00:23:12:16 - 00:23:25:19

Angie Grover, Metopio

So it really aims to level the playing field by distributing resources and opportunities based on individual needs and contexts. So in essence, equity means giving everyone the shoe size that fits them best.

00:23:25:21 - 00:23:36:10

Liz Church, Atrómitos

So then in what ways does prioritizing data equity contribute to a more inclusive and effective decision making processes within organizations and communities?

00:23:36:12 - 00:23:59:19

Angie Grover, Metopio

Yeah, you know, we're going to we're going to take a little bit of a deep dive into one of the most valuable resources as an example of this. Right. So we can just take a look at the US census. So dating back to 1790, I think you and I calculated 234 years. It really holds immense importance as the nation's most comprehensive demographic survey, capturing vital data about our population as it changes.

00:23:59:19 - 00:24:27:18

Angie Grover, Metopio

So it really plays a pivotal role in shaping government representation. We use it to draw political lines and resource allocation. There's lots of funding formulas in the government that are based on population and subpopulations and policy decisions. So ensuring equitable distribution of resources and services across to diverse communities really must have good data collection. And it must be collected equitably.

00:24:27:18 - 00:24:53:10

Angie Grover, Metopio

So I would I would also add, you know, in that vein that we're really encouraged by all the progress that has been made by the Census Bureau and other federal statistical agencies to address equitable data collection as really core to what they do. And I have two quick examples that have been in the works for some time. so one is the mean standard definition for larger racial subpopulations.

00:24:53:10 - 00:25:15:17

Angie Grover, Metopio

For a long time we used to choose black or not black, but there wasn't a middle Eastern and North African identification. So buying allowing individuals to, you know, choose that identification or choose more than one race on a forum rather than just clicking to or more as a race. Because really, you know, my kids are biracial and two or more is not their race.

00:25:15:19 - 00:25:43:13

Angie Grover, Metopio

This is critical. And being able to look at subpopulations, and it also extends to the recent executive order, sexual orientation and gender identity data collection. It has been really hard to assess disparities on the population because it has existed in our data set. So that executive order really provides a framework for this data collection and directs all the federal statistical agencies to include it in their collection going forward.

00:25:43:15 - 00:26:05:23

Angie Grover, Metopio

And I really think it's going to have a significant impact on our understanding of health outcomes, access and barriers facing the LGBTQ plus community. You know, it is it is essential. And we haven't had that luck because we haven't collected the data. So it really is critical because the way this is represented, even in current data sets, isn't always equitable.

00:26:06:00 - 00:26:26:02

Angie Grover, Metopio

And understanding bias and how the data was collected is really the first step, right? So being able to identify bias in data sets is a core part of the analysis process. And in some ways it's unavoidable. But director Sam Santos at the US Census Bureau has been very keen on saying that government should set the gold standard in data collection.

00:26:26:08 - 00:26:42:16

Angie Grover, Metopio

So there are no shortcuts. so, you know, when you ask that question, I really look at the census as that cornerstone of our nation's pursuit of understanding accurately the diversity, the rich, rich diversity and dynamics of our population.

00:26:42:18 - 00:26:58:11

Liz Church, Atrómitos

That I, I as a person who was asked to be in the census and it was an ongoing thing for a couple of years. If you are asked, it is important to do so because it is defining your population. It's defining the data that people need to make decisions in our area.

00:26:58:11 - 00:27:00:15

Angie Grover, Metopio

So absolutely, absolutely.

00:27:00:17 - 00:27:22:10

Liz Church, Atrómitos

That's my plug into little call to action. Everybody get involved. We get called for the census. okay. So I know someone's going to be asking in this. So let's just go ahead and get this question out of the way. If someone is listening and they're trying to gain insights on the data that they're seeking to use, what steps do you recommend that they take to familiarize themselves and feel confident to use said data?

00:27:22:12 - 00:27:40:13

Angie Grover, Metopio

Yeah, it's a great question. And I'm going to say ask questions of the data. So there really are two key questions I would encourage you to ask. And that is what is the source and how much data do you have to work with. So you know, I referenced this earlier, but is this a source you can trust who collected it?

00:27:40:13 - 00:28:03:15

Angie Grover, Metopio

How did they collect it? Was it a survey? Was it a count? Understanding all of those things and being able to verify, verify and validate them are important before you move forward. And then how much data do you have to work with. So, you know, do you have 234 years of stratification, or do you have one year of one state and no stratification?

00:28:03:17 - 00:28:24:22

Angie Grover, Metopio

And that's what you have to work with. So once you can understand where the data is coming from and how much you have to work with you, answer those questions. You can really move forward with confidence in your analysis because you've done the basic vetting of the data, what you want to use, and you can explain to someone else why you've chosen those data sets and how you've used them in your analysis.

00:28:24:24 - 00:28:35:06

Angie Grover, Metopio

So that would be my my tip for anybody going forward. And I hope that people will, you know, dive into data sets that maybe they haven't looked at before using these key questions.

00:28:35:08 - 00:28:56:14

Liz Church, Atrómitos

All right. So let's dive into talking about those outcomes like that. I meant that we mentioned earlier talking specifically about how data sharing and technology impact social determinants of health across social service sectors. So, Angie, how do socioeconomic and environmental factors impact communities, individuals and families differently?

00:28:56:16 - 00:29:16:18

Angie Grover, Metopio

this is a great question because there is a whole rubric that's been built around the social determinant of health, because we know where you live matters and it impacts your health outcomes. So when we talk about the social determinants of health, we're talking about if you have a job, are you unemployed? Do you not have the resources to get the things you need?

00:29:16:20 - 00:29:44:05

Angie Grover, Metopio

What is your education level. And can you understand the health information that's being given to you? You know what is your family makeup? And are you a single parent running around with no time to go to the grocery stores, or you're shopping at the local bodega? You know, these are the things that we want to understand. And this is where additional data like transportation access, commute times, standard hours, work can help identify what kind of barriers across many sectors impact the community that you serve.

00:29:44:07 - 00:30:10:03

Liz Church, Atrómitos

Okay. So let's look at a specific study. How we use analytics software was used to find the root cause of asthma admissions at a large metropolitan hospital. And the big question was to figure out why so many uninsured were visiting the air for their asthma. So, Angie, can you give us a little bit more detail what this meant, what the impact was, you know, breaking it down from start to finish?

00:30:10:05 - 00:30:36:22

Angie Grover, Metopio

Yeah. So that was the question they were trying to solve what, you know, with a strong clinical asthma program, what is causing all these EDI visits for asthma. And so working with our hospital client, we took three steps to really get down to the root cause. So we started with their utilization data. And we looked at almost 5000 Ed visits related to asthma to see where they were coming from on a map.

00:30:36:24 - 00:31:01:09

Angie Grover, Metopio

You know, what zip codes where these patients coming from. Once we understood their geography, we went to those social determinants of health and we applied community data. So hospital leaders use their data, along with my copious curated data to investigate the relationship between their patients zip codes and dozens of different social determinants of health variables. through our recommendation engine.

00:31:01:11 - 00:31:23:00

Angie Grover, Metopio

Once we went through those, what we found was that poor, poor housing was a root cause and we looked at age of housing, crowded housing and found that building violations and lead paint were highly correlated to asthma Ed admissions in the ZIP codes that we had identified for them. And the exciting thing about that is that's what drove action.

00:31:23:00 - 00:31:45:10

Angie Grover, Metopio

So now that we knew that housing was related to asthma, when folks came into the Ed, what they did is they would screen for the conditions of the patient's home. If if they had poor housing conditions, they asked if they would have their home screened and they partnered with UN, a nonprofit organization, to go and do that in-home assessment.

00:31:45:12 - 00:32:08:10

Angie Grover, Metopio

So for one of their cohorts, they had 20 uninsured asthma patients who had been to the hospital in the past year who had agreed to this. And they went and they looked at the housing and there was rodents in the HVAC, HVAC, there were carpet replacement pest management, mold remediation, all of these things that were asthma triggers, no matter how good your care plan was.

00:32:08:12 - 00:32:27:12

Angie Grover, Metopio

And once those were remediated, not one of the 20 patients in that initial group came back to the Ed. And I think that really just speaks to the power and the magic of understanding that utilization and that geography, along with those community conditions to find a solution.

00:32:27:14 - 00:32:48:00

Liz Church, Atrómitos

And then with the next study and also for insight, everybody. And you shared these things with me pre conversation build and I will happily share them with you in the episode Show Notes. If you would love to learn more I highly recommend you do so. But there was another case study that focused on improving outcomes for pregnant people and their babies.

00:32:48:05 - 00:32:57:22

Liz Church, Atrómitos

So, Andrew, can you emphasize what this project needed to analyze in maternal health interventions? What were the steps taken and the overall outcome?

00:32:57:24 - 00:33:23:02

Angie Grover, Metopio

Yeah. So again, much like the last case study, we were able to talk to the client who was committed to addressing health disparities among their pregnant population. And they had identified certain adverse maternal outcomes in specific ZIP codes. So their analysis, much like the asthma example, had those three key steps. We looked at the utilization data that was de-identified and aggregated.

00:33:23:02 - 00:33:50:00

Angie Grover, Metopio

So we were looking at populations. And the next step, once we identified where the zip codes where these adverse outcomes were most prevalent, we we jumped into those community conditions. So what was happening in those zip codes that might be correlated with this higher level of babies being in the Niku. And what they found was these higher adverse outcomes were were correlated with food deserts.

00:33:50:02 - 00:34:27:03

Angie Grover, Metopio

And as we all know, you know, you're hungry when you're pregnant. And two kids, I can vouch for that. I probably am still carrying all that weight. And what you feed yourself, you're feeding your baby, right? And so the intervention that they deployed was partnering with a food delivery service that focused on good nutrition and those essential vitamins and minerals necessary when you're pregnant for providing that for these pregnant women leading up to the birth and then six months after the birth, and the pilot was so successful that it led the plan to use the same formula to identify other communities in their network that had those same challenges and would benefit from the same

00:34:27:03 - 00:34:31:00

Angie Grover, Metopio

intervention. So taking that data again and putting it into action.

00:34:31:02 - 00:34:54:00

Liz Church, Atrómitos

Positive outcomes, I love it. I say that a lot, but it shows that the good work is being done and that's what we need. So, Angie, my last question for you. We're wrapping up talking about Metopio, data sharing and technology, how it affects outcomes. So what do you envision as a future role of data sharing and technology in addressing social determinants of health?

00:34:54:00 - 00:34:58:15

Liz Church, Atrómitos

And how do you see Mid-Ohio continuing to drive change?

00:34:58:17 - 00:35:34:09

Angie Grover, Metopio

You know, the simple answer is just that data sharing and community context are non-negotiables. And if we want to see something change, we must do that. We must bring this into our process. And if we're going to find a way that everyone can have access to data when they need it to understand the people, places and people that they care about, you know, we need to be able to look at those populations, understand them, and strategically invest our limited resources to dismantle the systemic and persistent challenges that exist.

00:35:34:11 - 00:36:01:24

Angie Grover, Metopio

Like I said before, this is not a one and done. This is an investment in communities and in my in my future. It's really bright, right? Because I can say that every day we work with committed individuals and organizations. Are you who are using data justice to do that? We had two examples here. We have plenty more where somebody really cares about the community, wants to understand the driver of a poor outcome, and wants to do something about it.

00:36:02:01 - 00:36:18:15

Angie Grover, Metopio

So I see Metopio as that catalyst to continue to drive collaboration and address data equity. So we can all move forward. And I'll have healthier, more resilient communities, live happier and healthier lives. Right.

00:36:18:17 - 00:36:43:05

Liz Church, Atrómitos

The Atrómitos Way is produced by me, Liz Church. Editorial assistance for this episode was by my fantastic team at headquarters. I would like to express our heartfelt appreciation to our guests who've shared their expertise, stories and insights with us on the podcast. And finally, a big thank you to our listeners. Your support and engagement have meant the world to us. Atrómitos boutique consulting firm with the imperative mission of creating healthier, more resilient, more equitable communities, I encourage you to connect with us. Let's continue these conversations and work together towards positive change. You can listen to all of our previous episodes on our website, atromitosconsulting.com/atromitos-way. That's a r t o i m o s. We can also be found on Apple Podcasts, Spotify, Amazon Music, or wherever you get your podcasts. We'll see you next time.