Barbara J. Burkett, Ph.D., M.S.P.H.
Review History of Data Use in Government
Settings Using The Swine Flu As An Example
 Overview of a Process to Move the Virginia
Department for Aging and Rehabilitative
Services Towards A Data Driven Agency
 Successes
 Failures
 Current Outcome @ DARS
 Future of Data Driven Decision Making In
Government
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40 Million Americans Inoculated
135 Million Dollars Spent
(2017 equivalent =587 Million)
 January 1, 1976 at a county medical meeting in NJ,
the state epidemiologist bet a senior army doctor that
Fort Dix was in the middle of an influenza epidemic.
Data = 4 cases
 Simply to win the bet the army doctor sent samples
from Fort Dix to CDC
 CDC identifies Swine Flu (of great concern because it
had never been known to be transmitted from human
to human)

January 2, 1976
NJ Medical Society Meeting

February 12, 1976
CDC Results Confirmed 4 Cases of Swine Flu

February 18, 1976
CDC Decides The Situation is Serious and Informs State Health
Officials Across the U.S.

March 12, 1976
CDC/Pharmaceutical Meeting to Discuss Vaccine Formulation

March 15, 1976
President Ford Informed of Situation

March 24, 1976
President Ford with Drs. Sabin, Salk Announce Inoculation Program on
TV and ask for Congress to Appropriate 135 Million

March 30, 1976
House Appropriation Committee Meets and Approves $135 million

April 5, 1976
American Pharmaceutical Companies Send Letter Bringing Up
Liability Concerns

April 8, 1976
1.8 Million Dollars Added to Program and Congress Rules Federal
Government not Pharmaceutical Companies Hold Liability

May, June, August 1976
 Vaccine Production and Trials
 Pharmaceutical Companies and Insurance Lobby Senate


*August 2, 1976
Outbreak of Respiratory Illness in
Philadelphia. Again no serologic data and
later turned to be Legionnaire’s Disease.

August 6, 1976
Ford Addressed U.S. on TV urging
Congress to Move Forward With
Inoculation Program

October 1, 1976
First Inoculations

October 3, 1976
3 Deaths in Pittsburgh reported as heart
attacks but Pittsburgh pathologist
suggests vaccine maybe cause

October 14
33 Dead

October 22
44 Dead

November 12
First reported Case of Guillian Barre

December 2
3 More Cases of Guillian Barre

December 14
54 Cases Guillian Barre

December 16
Inoculations Suspended

“The swine flu experience had lessons to
teach, it is important that we learn them so we
might not repeat them either in immunization
policy or other government decision making
contexts.” July 1978

Lack of Data Led to Wrong Conclusions
 There was no epidemic!

Government Actions Were Swift in 1976

Power of Lobby Groups
 Pharmaceutical Companies and
 Insurance Companies

Role of Media
 Walter Cronkite doubted deaths in Pittsburgh due to vaccine.
He openly on air criticized Cryil Wecht, M.D. on his pathological
findings. Cronkite’s words had power in 1976.
DRS is now the Virginia Department for Aging and Rehabilitative
Services

2000: First year in my position as program evaluator and lead
analyst. I was only analyst at WWRC. Data was actually delivered
to me on a napkin in pencil (number of medical clients served at
WWRC). Databases ranged from tic marks, client lists on paper
and a case management system housed at the Central Office
requiring computer programmers to do basic reporting.
2001: Requested statistical software SAS or SPSS. Request Denied
2003 Received statistical software due to general assembly data
requests that could not be answered with data systems available.
 Expanded staff by one as hired junior level analyst to work with
consumer satisfaction (federally mandated)
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2000 (WWRC)
Pen and paper data, no quality
control, home made data sheets
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2003
SPSS (Tools to do work)
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December 2011
RFP University of Massachusetts
@ Boston

February 2012
Awarded $50,000

March 2012
First Meeting of Grant Cohort

Identified current barriers for our staff
in using data for decision making.
 Human Histogram showed where staff were
with belief in usefulness of data
 Needs Assessment- held @ statewide
managers’ meeting
27%

Determined usefulness of current
reports and products currently used for
programmatic decisions. -
 Two eight hour “Data Days”
held with
Regional Directors

Refined existing reports, and products
and created new products to enhance
consistent use of data.

Use of this data site was emphasized and
encouraged. Available to all staff.

Individual emailing of monthly reports no
longer occurred.
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www.decisionswithdata.com
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2015 Management Restructure
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2016 Proposal for Division of Analytics
http://www.decisionswithdata.com/proposalfor-division-of-analytics.html
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March 2017: Denied
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2007: Staffing included 3 analysts at DARS
Central and 1 at WWRC.
2017: Staffing level same
2017 budget:
 Training = $1,000 total for 4 staff
 Software = $9,200 (SPSS $8,000; SurveyMonkey
$800)
 Travel $500
 Office Supplies $200

Required to send “personal individual record
layout”. Oversight agencies no longer have to rely
on our reported data. We must know and
understand our programs at a deeper level.

Oversight agencies have power to run analytics.

Predictive Analytics Will Be Used to Show Efficacy of
Programs.
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Must have buy in from your immediate supervisor through
commissioner.
Must have resources: staff and money.
 We could not get agency IT help for website
 Still use freeware and do many projects from home pc’s.
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Agency hierarchy changes can affect your efforts
significantly.
Need to be autonomous with reporting to higher level
management or neutral management team member.