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

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

RationalePublic 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

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

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

Adjacency Matrix

Networks & Complexity

Different kind of data

Relationships among

nodes & edges

METHOD: ORGANIZATIONAL NETWORK ANALYSIS

An empirical, descriptive technique for modeling organizational systems as interlocking networks

people, knowledge, resources, tasks

PremiseOrganization as information processing entityNetwork measures use graph theory to describe structural features

PurposeUnderstand the flow Find patterns, draw inferences from theory--social sciences, complexity, behavioral

ProductVisualizations, statisticsInsight on structure Implications for decision-making , planning , overall culture

ORA: Organizational Risk Analyzer Carnegie Mellon University

ORA uses relational datasets organized into adjacency matrices analyzed as a metamatrix

People Knowledge Resources Tasks

People Social network

Who talks to who

Knowledge Network

Who knows what

Resources Network

Who has access

Assignment Network

Who does what

Knowledge Information Network

Connection among types of knowledge

Resources Usage Requirements

Knowledge to use resources

Knowledge Requirements

Knowledge needed for tasks

Resources Interoperability Requirements

Connections among resources

Resource Requirements

Resources needed for tasks

Tasks Precedence Dependencies

Tasks related to tasks

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

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 informationfrom whom do you get information

Finalized with expert consultation, pilot tested

Secondary data from informatics competency surveyConverted to relational variables

Data Tables

1. Agent by Agent 156 x 156Communication network questions

2. Agent by Task 156 x 190 Job level, relevance resources, job functions, job title,

communication w/ other orgs

3. Agent by Knowledge 156 x 39 Education, experience, self rated skills

4. Agent by Resource 156 x 52Info resources used, program, outside network

5. Agent by Organization 156 x 85 Outside organizations employees communicate with

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

Commissioner

Health Planning & Education

Health Information Administration

Environmental Health Medical Examiner Public Health Nursing Clinical Physician

Environ Water Lab

Comm Dx Control

Department of HealthFormal Hierarchy

Commissioner

Environmental

Water Lab

Administration

Public Health Nursing

Communicable Dx Control

Public Information Office

Medical Examiner

Health Information

Clinical Physician

Communication Network by Division

Communication Network by Division

Commissioner

Environmental

Water Lab

Administration

Public Health Nursing

Communicable Dx Control

Public Information Office

Medical Examiner

Health Information

Clinical Physician

Environmental staff

All other staff

Use of electronic resources by front line staff

Shows core resources in the center. Note large number of unconnected staff

Use of electronic resources by supervisory/management staff

Comparison of Redundancies Number of people w/ same Knowledge, Assignment and Access

*PHN includes Preventive, Home Health and Clinical

0

10

20

30

40

50

60

70

80

90

100

DCDOHPlO

ADMINCDC

EnvEngEnvHealth

PHN*PrevServHomeHlth

ClinicalSpNeeds

Redundancy/Access

Redundancy/Assignment

Redundancy/Knowledge

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

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

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

Proposed Application of Findings

• Use findings to inform the agency’s ongoing strategic management initiative

• Identify appropriate redundancies

• Connect more programs and people internally (mentoring and pairing staff) to improve redundancy and communication

• Provide more) communication tools and infrastructure (mobile devices)

• Apply knowledge of network to preparedness

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

THANK YOU