Using Digital Tech to Improve Population Health
Episode 444

Shelley Argabrite, Chief Health Strategist, Garrett County Health Department

Using Digital Tech to Improve Population Health

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Using Digital Tech to Improve Population Health

Episode 444

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Using Digital Tech to Improve Population Health with Shelley Argabrite, Chief Health Strategist, Garrett County Health Department transcript powered by Sonix—the best audio to text transcription service

Using Digital Tech to Improve Population Health with Shelley Argabrite, Chief Health Strategist, Garrett County Health Department was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.

Saul Marquez:
Hey, everybody Saul Marquez here with the Outcomes Rocket. Are you going to HLTH? That's HLTH. It's the largest and most important conference for health innovation. HLTH pronounced health is one of a kind of ecosystem event for the health industry. And they're on a mission to bring together 5,000 plus senior leaders to solve the most pressing problems facing healthcare today and actualize the most promising opportunities to improve health. They bring together senior leaders from across across payers, providers, employers, investors, fast growing startups, pharma, policymakers, and innovation centers to ask one question. How do we create the future of health? I'll be there. And I hope to see you there, too. If you use outcomesrocketpodcast150 as the promo code that's outcomesrocketpodcast150. You'll get a hundred and fifty dollars off your ticket. Looking forward to seeing you there. Go to hlth.com to sign up. That's hlth.com to sign up. Use that promo code outcomesrocketpodcast150. And I am excited to see you there. I'll even have a booth recording some podcasts live at the event. The MGM in Las Vegas. So, so excited to see you there. If you do sign up, don't be afraid to say hi and we're going to learn a lot there. So go ahead and sign up hlth.com.

Saul Marquez:
Welcome back to the podcast. Today I have the privilege of hosting Shelley Argabrite. She's the Chief Health Strategist at the Garrett County Health Department in Maryland. She leads organizational strategy, oversees the design, build and launch of digital applications, and leads diverse teams of partners to create local data and form vision by meaningfully and transparently engaging residents. The award winning dynamic digital application found at mygarretcounty.com co-created by her and the team she leads ensures the community vision becomes actionable and is the basis for a comprehensive and responsive community health improvement plan. Her team also developed the Universal Community Planning Tool, sponsored by the Public Health National Centers for Innovation. Thanks to her and her team, this work is being replicated nationwide. Shelley also serves as the Accreditation Coordinator and Performance Improvement Director. She received her Bachelor of Arts degree from Community Health and a Master of Arts Degree and Wellness Management and Gerontology from Ball State University. We're gonna be diving through some of her thoughts on digital innovation, improving outcomes at the community level. I'm so excited to have Shelley on the podcast here. Shelley, welcome.

Shelley Argabrite:
Thank you so much. I'm delighted to be here.

Saul Marquez:
So, Shelley, tell me, what is it that got you into healthcare?

Shelley Argabrite:
Well, I've always been interested in pursuing my own health. And I pretty much just fell in love with a service orientation of public health.

Saul Marquez:
Love it. And so it really is different. Right. I mean, what you do in public health compared to a provider or, you know, an industry player is really unique and I feel like entrepreneurial.

Shelley Argabrite:
I think it can be. I mean, we certainly focus on the health of populations instead of individualized approaches. But it's really important, I think, to for us and public health to make sure we kind of drill down and really get to the heart of the community that we're serving. And that does involve actually working with individualized people. So it's kind of the best of both worlds.

Saul Marquez:
Yeah. Yeah, for sure. So in the realm of public health, Shelley, what would you say is the thing that needs to be front and center for health leaders listening to this podcast today?

Shelley Argabrite:
I would say to explore open source. And I'll just say it again in case someone missed it, explode open source. It's actually incredible. And we all need to be thinking about the ways that we can utilize and collaborate with projects like open source projects. We have incredible challenges that we're all facing. And if someone has already figured out an approach that works, I feel like we should share that and we should use our precious time to focus on unresolved challenges.

Saul Marquez:
So, Shelley, tell me a little bit more about open source. And you know, on the one hand, there's the open source coding where you could go on GitHub and download code and get things done there. And on the other hand, there is open source such as like the outcomes rocket where you could listen in on another health leaders improving outcomes. Which one are you referring to?

Shelley Argabrite:
So I think just in general, this notion of kind of opening up processes is really important for growth and for collaboration. But specifically, the example that I would like to share from our local health department is the way that we've been able to utilize the open source framework to actually address a specific issue in our community. So if you'd like me to share a little bit more about that now, I can. We have basically are… our health improvement work and our community solutions type work. When I first started at the Health Department, we had about 150 people involved in out of a population size of twenty nine thousand, approximately. And so that was certainly a challenge that we had to address. And I know that many agencies and organizations struggle to really meaningfully engage with their community in processes, in plans. And our local health department was certainly no exception. So when we thought about ways to do that, our answer was to just open up. It was to open up the process. It was kind of designed to think about how we can create pathways and overcome challenges with people participating. And certainly creating a digital pathway was one of those options. And when we really started looking for software and different things that were available on the market. We just really didn't have the budget to be able to kind of buy and then maintain some of that software. And then it didn't actually address all the issues that we wanted to kind of focus on. So it was either a dashboard or it was just pieces and kind of parts of what we actually thought we needed. So we were able to essentially just create our own internally and through grant funding through the Robert Wood Johnson Foundation, we've been able to share that and make a portion of that platform open source so that other communities don't have to reinvent, reinvent the wheel and that they can use the same platform that we've had success with in our community.

Saul Marquez:
Love it. That's so great. And yeah, I mean, software can get really expensive. And, you know, like you said it ends up being just fragments of technology that solve for little things here and there. So, yes, piece this together and now are offering it to other communities and it's being used nationwide now, right?

Shelley Argabrite:
It is. That's probably one of the mistakes. Is really exciting. We were able to do a replication pilot through the Public Health National Centers for Innovation and we are replicating in D.C.. Clackamas County, Oregon, Montana, Flathead, Montana, Allegheny County and Madinah County in Ohio. Those were the first kind of replication sites to that grant funding. And since then, now that that cycle is over, we have installations popping up all over. We're working with Cecil County in Maryland. We're working with Richmond. We're working with Rhode Island. So it's been a really exciting journey.

Saul Marquez:
That's awesome. Well, kudos to you and your team for being innovative then and putting it out there for open-source, folks. It's… and whether it be something that you've created that you could offer to a community or somebody, it's something that somebody else has created, explore it because there's definitely an opportunity to scale there. And so as you and your team have done some great work, what would you say is maybe in a time when you had a setback during the process and what you learned from that setback?

Shelley Argabrite:
Those are great. That's a great question. There are many setbacks. And so I think anytime you're innovating or trying something new, there's all kinds of failures. And I think that's actually what helps us improve and grow. But I think probably our biggest mistake throughout this process is our failure to see and kind of plan for growth, because when we created the process, we had no intention. We didn't even know if it was going to work, to be quite honest, in our own communities. So we really didn't intend for it to grow the way that it did. And so we didn't really have the infrastructure in place as far as personnel. And just the optimization that needed to happen for the actual site to maintain the amount of people. So we really had some growing pains and we used a lot of resources just to kind of keep it running rather than forecasting and being able to grow with a little less pain, I suppose. So I would and we do currently encourage our communities to think through that process and, you know, give them a heads up that we didn't have. So I hope we're passing it along in a positive way.

Saul Marquez:
I love that. Yeah. You know, at the same time, I mean, you don't know what you don't know. Right. And then, yes. Had no idea this thing was going to take off like it did. So, yeah, you know, I guess thinking through it's definitely a good practice to to think ahead scaling. What are you gonna do? I mean, a it's a great tip for everybody listening. How about one of the proudest experiences that you've had to date? What would you say that is?

Shelley Argabrite:
That's a tough one. But I would say just empowering community members, seeing champions come forward in our own community especially. We have several non-profits and volunteer agencies that have really embraced the planning tool in a way that we would have never anticipated. And so watching them track literacy rates, for example, in the little Appalachian community is pretty incredible and it's all volunteer based. And then also working with some of our communities nationwide. I have a volunteer who reached out to me after she heard a webinar. She's not associated with any organization. And she said, "I would like to try to do this in my town. I have some outcomes I'm trying to address with a group of people. Is it something that I can do as a volunteer?" And I'm like, "why not?" Know we were able to get her up and running. And she has been working pretty diligently in her community to work with the agencies that are established and build some collaboration around this. But that's one of the have been one of the most exciting because we were hoping that anyone could do this as part of our mission as far as just improving equity and all that equity can mean. And I think that making sure that anyone that anyone can have access and then helping them build the capacity to do something like this is definitely rewarding. And I think probably my proudest moment so far.

Saul Marquez:
I love that. Yeah. I mean, you've got people walking up, calling, emailing, saying, "how can I do this for free?" That tells you something, right? I mean, that tells you you've created something of value where somebody else wants to replicate it.

Shelley Argabrite:
Yes.

Saul Marquez:
Now, that's great. And so you guys are making a huge difference. You're adding different communities to the platform. You're finding ways to scale better and educating, you know, the users. What would you say is the most exciting focus area that you guys are working on today?

Shelley Argabrite:
Well, I have an incredible team behind me. You read a lot about the team and my bio when we started. And obviously, these things aren't just because of one person.

Saul Marquez:
Right.

Shelley Argabrite:
So I have an incredible, incredible team. And I think the most exciting thing is that we actually are of our own WordPress plugin now. So that is a new venture and something we've worked very hard to accomplish. So that's exciting. And then obviously the replication piece just continuing to build that and making sure that this tool is accessible for the largest of communities and even health systems and large public health agencies. But also, like I mentioned, volunteer groups and people that don't have maybe that infrastructure bill that we maintain the ability to be able to work with them.

Saul Marquez:
So tell me a little bit more about the WordPress Plugin, what does it do?

Shelley Argabrite:
So it's exciting for us because it it basically makes this work a little bit easier right now. All the codes on GitHub, as you mentioned. But sometimes that's becomes a little bit difficult. We do have an installation guide that communities have been using, but the WordPress Plugin is just more seamless. It's just creates even more equity because more people can use it a little bit easier.

Saul Marquez:
Got it. Got it.

Shelley Argabrite:
And obviously, it is supported. And so anytime we make any updates or changes, it's automatically supported. And it's just a smoother transition for people. And that's what we're about.

Saul Marquez:
So I love this. And and again, you know, back to your comment about using open source. If you guys haven't really had a chance to work with WordPress and the plug ins, it's really these widgets on the back end of WordPress, which is a platform. Kind of Wix, a different Digg out different ones and you use it and it just seamlessly gives you what you need and a provider offers. And I imagine your team's doing updates through that. And so known as there has to be done manually by the users anymore, right?

Shelley Argabrite:
That's exactly right. And so again, we all only have a certain amount of energy and focus and it really creates more space to be able to work on other challenges and do other things. So the more automatic we can become. And stay within this within this kind of body of work that is constantly being evaluated and people are adding to and making improvements. I just think that there's no other way to do it. It just makes the most sense.

Saul Marquez:
I love it. And for the folks not familiar with it now and include myself in that group right now, you know what what functionality does your software give the user what it what are they able to collect or do?

Shelley Argabrite:
Well, I think the so the Garrett County planning tool is a multi-faceted, extremely dynamic piece of software, and we say that we help communities create vision. So how do you do that? And I think that one of the biggest keys is to really empower the community organically. So anyone can go on and they can create this action group about any topic that they choose. Other people can join that group and they can design a strategy and then measure that strategy. And so we have right now and in Garrett County, about 170 different action groups at all kinds of levels. And there are a multitude of collaborators working on different projects. Some of them are directly based on outcomes data that we're trying to improve. Others are really grass root kind of efforts, trying to get people to think about different things. It's a great way to address gaps. So you have maybe a community and small community and different a different part of the county that's interested in something. And no one else has really done that or is working on that or they're trying to find funding. So it's just a really neat way to be able to tackle a lot of different things. But I think one of the keys is tracking your success, tracking the work that you're doing. And in the action groups, our communities are able to really, we call it hyper local data. So whatever strategy they choose, if it's a small program, a lot of them are tracking that on a monthly basis. And that helps us be extremely responsive. Something isn't working or we need to change something. It's a whole lot better than waiting for a few years for state or county level data to come out and then figuring out, well, what worked and what didn't. And so it really has transformed the way that we're able to look at our planning and address the issues. And it helps build transparency. It's all there for anyone to see. And it has built a lot of trust in our community. We have over 2,000 people in this little tiny Appalachian community involved in processes. And a few years ago, before the planning to remember, I said only one hundred and fifty people even knew we were doing anything like this. So it's an incredible change and we still have a lot of work to do. But I think those are the main keys. And then, of course, we're linked with Maryland's open data portal. So again, it goes back to access. And who has the data and what does the data say? So it's putting all the data sources we can find into one location that helps us with trying to when we think about funding, writing grants, it helps us to identify the kind of baseline data that we need. So that's just been really tremendous. And then it builds capacity within the community because in the planning tool, we have some data visualizations. You can turn fields on and off and it really helps people become more comfortable with how they can use data and what the data is actually showing them.

Saul Marquez:
Love it. Now, that's brilliant. Appreciate you explaining that a little bit in more detail. And gosh, I mean, having to wait years versus having month level data, you know, it really can inform a strategy's effectiveness. And I think that's great. So kudos to you and your team for for making that available.

Shelley Argabrite:
Thanks. I do want to just mention, too, that we certainly still use all of the federal data sets and anything that's available in the hyper-local data doesn't take the place of that. It simply creates just a more dynamic picture.

Saul Marquez:
I love it. Love it. Yeah. Worth worth mentioning for sure. And so fantastic work, folks well, we'll leave a link here in the show. Notes for you to check out the WordPress Plugin as well as the tool on the website. So getting here to the lightning round, got a couple of questions for you, Shelley, and then we'll follow that with the book you recommend to the listeners. You ready?

Shelley Argabrite:
Hmm.

Saul Marquez:
All right. What's the best way to improve healthcare outcomes?

Shelley Argabrite:
Well, I would have to say that you should install the Garrett County planning tool in your area. And honestly, I think that that's something that we're all striving to do. And it takes a multitude of different things. And it's not just one thing, but I would think working with our communities, building trust, trying to engage organically and address your community's main concerns and then being able to track that is really, really important because we have to know if what we're doing is actually working and then how to do more of that or how to change that. And so I think their responsiveness to what we're actually doing as it's kind of mirrored up with what we want to do, that needs to be a little bit closer so that we can reach an improved health outcomes.

Saul Marquez:
What would you say is the biggest mistake or pitfall to avoid?

Shelley Argabrite:
I would say just keep doing the thing. Things that you're doing the same way, right? So don't change. Maintain your silos. Keep reinventing the wheel and paying people excessive amounts to do that. No we just need to stop stop doing that.

Saul Marquez:
And I was like, what?

Shelley Argabrite:
Right. Completely remove all of those things and I think allow people to innovate.

Saul Marquez:
It's awesome. How do you stay relevant despite constant change?

Shelley Argabrite:
I think you need to invest in your people. And I keep saying it, but it's just creating this culture of innovation. You know, making sure that you're investing in the people that you have and allowing some mistakes to happen, allowing different failures, knowing that. You're hoping it's going to produce something that that's extremely valuable in the long run.

Saul Marquez:
Yeah. Now, that's a a good one. Investing in your people is huge. And what's an area of focus that drives everything in your work today?

Shelley Argabrite:
I would say just continuing to create those pathways I spoke about earlier. Anytime we can remove obstacles or barriers for people to meaningfully engage and be a part of their community and a part of something larger than themselves to create purpose is, I think, a tremendous value. And it's something that every community needs. Every person needs. And I think it's our job to continue thinking about ways we can do that.

Shelley Argabrite:
And these next two are more on a personal note for the listeners to get to know you. What's your number one health habit?

Shelley Argabrite:
So this is kind of broad, but I would say that I absolutely need to take time out for myself and whatever I choose to do with that time out keeps me balanced and healthy.

Saul Marquez:
Love it. And is it weekly? Is it daily?

Shelley Argabrite:
It's probably it needs to be daily, but it's probably ever few days.

Saul Marquez:
Gotcha. Now, that's good. That's key. And now what would you say your number one success habit is?

Shelley Argabrite:
It's the same thing. I get totally stressed out. It's toll taken me and figure out just finding that time to really listen to my own body, my mind. Time out for that solitude, whether it's a little yoga, run, doing some hobbies I like, just making sure that time is there so that I'm refreshed.

Saul Marquez:
I love it. Yeah. You know, this morning I was feeling kind of like, I don't know, I just wasn't feeling 100% psyched. So I went for a bike ride. Got a little path by my house and I came back jazzed up. I was ready. So, yes, I agree. I love that habit. That's a great one. What book would you recommend to the listeners?

Shelley Argabrite:
So one that's really relevant to what we talked about today is called Coders by Clive Thompson. I think it was is out last year, but it's an interesting read. It kind of presents a lot of different topics about software and ask some questions that we all need to be thinking about and kind of peeks into the culture of coders and development. So it's pretty interesting.

Saul Marquez:
Love that. Yeah. So if you're working with the coding organization, maybe it's not your forte. It's sort of like… is it like an anthropology?

Shelley Argabrite:
Yes.

Saul Marquez:
And better understand the code or culture?

Shelley Argabrite:
Absolutely.

Saul Marquez:
Cool. That's pretty cool. Great recommendation. Folks, in order to find all of the resources, links to the things that we've discussed, including the tool that Shelley and her team have developed. Just go to outcomesrocket.health in the search bar type in Shelley and you'll find that this entire transcript with links there. Shelley, this has been fun. I'd love if you could just leave us with a closing thought. And then the best place for the listeners could get in touch with you to continue the conversation.

Shelley Argabrite:
Great. So I would say to invite others to continue building a culture of collaboration and not only across sectors, but within neighborhoods, they can work together and we can accomplish so much more. And you can check me out on my garrettcounty.com.

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