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So, public health leaders know that digital-enabled reform is crucial. But most are still tinkering at the edges of transformation rather than embracing radical change.
Just 39% would describe their transformation plans as strategic rather than tactical, and only 34% say they are extensive rather than limited.
When it comes to implementing new technology, just one in three (34%) is pursuing root-and-branch upgrades of their IT systems, and a mere 10% are integrating this activity into a transformation of their wider systems.
Why is the change so limited?
As we have seen, decision-makers in public health acknowledge that COVID-19 has revealed weaknesses within their organizations and undermined their reputation for political neutrality. They agree that public health needs to get better at proving the value of its interventions.
But these attitudes are less prevalent among operational teams in public health delivery: just 39% of these employees say that their organization needs to modernize, compared with 82% of the most senior leaders among our sample (see Figure 5).
Figure 5. Decision-makers are the most likely to say there is a need for improvement
If we shift from respondents’ perception of the problem to their understanding of the technologies that enable change, we find another gap. Overall, executives at the operational level are far less optimistic than decision-makers about the potential for digital technology, automation and innovation sourced from the private sector (see Figure 6).
Figure 6. Operational teams are less optimistic about the promise of digital technology
One reason for these differences could be that operational executives are more preoccupied with tackling new and fast-evolving demands in the wake of the pandemic. Understandably, they may not be looking at the deeper structural challenges of public health or considering the longer-term benefits of technology innovation.
But until widespread agreement is reached about the need for transformation and what will achieve it, implementation is likely to happen slowly.
Transformation needs resources, and public health funding is often in short supply. Just 35% of respondents say that their organization has the budget to expand on its existing activities. A similar proportion (33%) do not even have enough to maintain these. The rest are treading water.
The funding shortfall not only restricts what organizations can achieve day to day, but it also leaves little room for contingency. Just half of respondents believe they could get the money they needed to manage another crisis of the magnitude of COVID-19. For nearly one in five (19%), the money simply would not be there.
Figure 7. Public health budgets are holding back progress
Figure 8. Organizations that lack budget also lack confidence in their ability to respond to crises
Our research paints a mixed picture of the evolving talent environment. One in three respondents say that they are very satisfied with the progress they have made over the past year in recruiting new skills and talent, while 35% are somewhat satisfied.
But public health organizations do have problems retaining the talent they need: 56% say that, in the past two years, they have seen increased attrition among employees with the most valuable skills. Only 14% disagree.
The most elusive skills are community engagement and public health communication and promotion (see Figure 9). These are the capabilities that will be essential for rebuilding and strengthening relationships with the public — especially people in traditionally underserved populations that were difficult to reach even before the pandemic.
Figure 9. So-called soft skills are in short supply
Additionally, respondents say that they are struggling to find the right data and analytics talent: 53% are finding it harder to secure the talent they need to implement their technology and data plans. This is a problem that is likely to get worse. As traditional IT companies expand and other sectors digitalize, public health will have to compete to attract skills.
Three steps to innovation: how to get ahead
Clarify and inspire from the top down.
Don’t wait for funding.
Appeal to talent by highlighting a commitment to public service.
The future comes around fast. Whether COVID-19 becomes easier to manage or new strains of the virus extend the crisis for years to come, public health leaders should ask now how they will meet the unknown challenges of tomorrow.
Download the full EY Public Health Industry Survey
EY US Public Health Services Transformation Leader
MPH and MBA; collaborating with clients to transform and help optimize public health services; a public health professional; focuses on working with clients to Prevent. Promote. Protect.
