Hamilton County presenters demo SALT regional public‑health data platform funded by ARPA

Presenters from Cincinnati Children’s Hospital and the Health Collaborative demonstrated SALT, a cloud-based public‑health data platform funded through American Rescue Plan Act (ARPA) money and intended to support Hamilton County and regional partners with situational awareness on infectious disease and other community health threats.

The presentation described SALT as an Amazon‑cloud web portal designed to integrate multiple data sources — including Centers for Disease Control and Prevention (CDC) syndromic measures, wastewater virus concentration, U.S. Census population estimates, Ohio Department of Health case and death counts, and de‑identified Epic electronic health‑record extracts — and to offer tailored dashboards with tiered access for the public, health agencies and hospital decision makers. “The objective was to build and maintain that capability that allows for many issues ... including sharing data, coordinating and collaborating across sectors,” a presenter from Cincinnati Children’s Hospital said.

SALT’s organizers said the project began in March 2023 and is scheduled to run through June (end date as presented). They described a multi‑stage design process that included listening sessions with Hamilton County Public Health, emergency management agencies and hospital operations staff to identify which measures and visualizations would be most useful for rapid decision making. “That solution should be efficient, effective, timely, and scalable,” Tiffany Mattingly of the Health Collaborative told commissioners during the demonstration.

Presenters showed national, state and county views of recent metrics: percentage of emergency‑department visits for COVID‑19, influenza and RSV; COVID‑19 incidence per 100,000 by age group; wastewater virus concentrations for regional sewer districts; and emergency‑department admissions from an Epic Cosmos dataset. They said federal and state feeds had experienced disruptions in recent months but were back online; presenters emphasized the value of having local data feeds so the region would not be dependent solely on external sources.

Speakers described the legal and operational work that enabled data sharing. According to the Health Collaborative, nearly a year of agreements — master service agreements and business associate agreements (BAAs) — had been negotiated with hospitals to permit de‑identified data submissions to the collaborative, and a federal emergency order had previously eased some exchanges during the height of the pandemic. Presenters said the team is testing hospital submissions directly to the collaborative and parallel ingestion via CliniSync (the state health information exchange) and Epic Cosmos, and that quality assurance work is underway to reconcile differing data elements across sources.

On sustainability, presenters said SALT will be offered on a fee basis outside of declared public‑health emergencies to cover staffing and technical costs, while remaining available without charge during an emergency. “We’re developing cost models to understand our costs and what it takes to apply SALT to a given project,” one presenter said. They outlined potential non‑COVID use cases, including asthma risk mapping, overdose surveillance and suicide‑related measures, and noted interest from University of Cincinnati researchers and local child‑health programs in using SALT for dashboards and analyses.

Commissioners and county staff asked questions about users, legal frameworks and costs. The Health Collaborative said stakeholders for the platform include Hamilton County Public Health, a regional hospital steering committee, skilled‑nursing facilities, emergency management agencies and community health partners; presenters said they had engaged several hundred stakeholders during COVID‑era sessions. Presenters confirmed that the platform supports multiple access levels (public, protected) and that the collaborative had completed the legal agreements necessary for routine data submission.

Next steps described by presenters include continuing tests of hospital data submission workflows, finalizing cost models and offering SALT as a shared resource for regional public‑health analytics. Presenters asked commissioners and county officials to consider SALT as a preparedness tool that can be adapted to other health priorities in Hamilton County and surrounding counties.