Protect Public Health: Better Health Policies
Public Health Ontario aims to understand the root causes affecting the public's health beyond injury and illness by collecting health data to not only detect, track, and prevent pandemic-related threats, but also infectious agents, environmental contaminants, occupational exposures, unstable housing, food insecurity, obesity, injury prevention, and morbidity and mortality factors in addition to the harms that result from these threats. Collecting, using, and sharing this data can help tailor prevention, protection, and promotion strategies to people, groups, and communities where they will have the most impact.
Tackling Diabetes
Challenge: Diabetes is one of the leading chronic health conditions impacting First Nations peoples in Ontario, according to the First Nations Regional Health Survey. A First Nations–specific study of diabetes in Ontario found the prevalence of diabetes among First Nations people was 16.6% compared to 8.1% among other people in the province.
How health data was used: First Nations, Inuit, and Métis communities have collaborated with ICES to develop unique partnerships that include data governance and data sharing agreements, enabling Indigenous-driven analyses using ICES data.
Result: This project was the first to be reviewed by the COO First Nations Data Governance Committee, informing the application and review process for future research requests. The findings are being used to inform community diabetes programming.
Opioid Mortality
Challenge: Prior to the pandemic, the province was responding to an opioid crisis. Though public health units had access to hospitalization and emergency department (ED) visit data from the Canadian Institute for Health Information (CIHI), access to mortality and drug type information was limited to one-off requests to the Office of the Chief Coroner for Ontario (OCC).
How health data was used: Public Health Ontario (PHO) worked with the OCC to obtain timely data on opioid-related deaths. PHO was then able to produce a publicly available Opioid Interactive Tool that includes hospitalization, ED visit, and mortality data. Users are now able to see trends over time for different geographic regions as well as information on the type of opioid found at death.
Result: Public health units now have access to the opioid mortality information and are able to compare their results with others in their geographic area. Displaying the information this way enables more efficient/targeted interventions at the local level (e.g., in development of application for safe consumption locations). Using the data from the OCC, PHO was also able to evaluate the impact of the COVID-19 pandemic on the opioid crisis.
Tracking COVID-19
Challenge: COVID-19 provided a challenge unlike any other in public health. For example, the volume of lab test results reported to public health units made it unfeasible for local public health units to enter this data manually. This forced the province to explore other options to streamline and expedite the transfer of lab results into a provincial public health information system. The existing system, the integrated Public Health Information System, had technical limitations that prevented it from integrating with the Ontario Laboratory Information System (OLIS).
How health data was used: Public Health Ontario (PHO) worked with the Ministry of Health to develop a new public health information system for COVID-19: the Case and Contact Management system (CCM). It enabled lab test result information to be electronically ingested into the system and then it automatically created public health investigations by prepopulating the data from the test results. These data were used by local public health units, PHO, the Ministry of Health and others and formed the basis for COVID-19 daily and weekly, epidemiological reports, the PHO COVID-19 Data Tool and many other publicly available reports.
Result: CCM vastly reduced the manual effort to sort through lab test results and permitted better use of resources for other aspects of pandemic response. It also improved the overall data quality, timeliness, and accuracy of COVID-19 data necessary for public health surveillance, reporting, and provincial decision making. This can be applied to other high impact and emerging infections (e.g., influenza, RSV, other respiratory pathogens that could potentially impact hospital and health system capacity). Ontario is working on expanding CCM for all Diseases of Public Health Significance.