Leading the Fleet – One of the Healthiest States in the Nation
Vermont is consistently ranked as one of the healthiest (and sometimes happiest) states in the Nation. In 2017, Vermont tied with South Dakota for the top spot in the Gallup-Sharecare 2017 State of American Well-Being Rankings, with high scores for physical health, social connections, finances, community, and sense of purpose. For the past 15 years, The United Health Foundation has ranked Vermont in the top five overall healthiest states (they ranked #1 for four of those years, and ranked #2 in 2017).

Some of Vermont’s notable achievements in health improvement include:

  • In the past four years, immunizations among children increased 22% from 63.2% to 76.8% of children aged 19 to 35 months
  • In the past five years, the percentage uninsured decreased 58% from 9.0% to 3.8% of the population (Vermont e-SHIP)
  • Since 1995, the prevalence of youth smokers in Vermont reduced from 40% to 11%, which is similar to the national average. (Vermont e-SHIP)
  • Despite these feats, Vermont’s public health system recognizes the need for continued improvement to ensure that all Vermonters have equal opportunity to experience good health and quality of life.
  • So how does Vermont remain one of the healthiest states in the nation? And how can you follow their lead?

Setting Sail with the Right Tools for the Voyage
Vermont uses the Results-Based Accountability methodology as a model for continuous improvement and they bring a results-based lens to all planning and strategy implementation. It is this dedication to continuous improvement that has helped Vermont become a national leader and achieve increasingly better health outcomes for its residents.

To fulfill their commitment to continuous improvement, transparency, and accountability, Vermont uses the Clear Impact Scorecard to build, manage, and share their State Health Improvement Plan in an electronic format (e-SHIP).

Vermont is one of a growing number of health departments around the country who has digitized their community/state/tribal/neighborhood health improvement plan using the Clear Impact Scorecard. The Scorecard is an online performance dashboard that helps health agencies, departments, and organizations track health indicators, speak to the story behind health trends, and showcase what they’re doing to improve. It allows organizations to link together indicators and performance measures and group them into topic areas. It’s about putting population outcome data and performance measures in the hands of managers and decision-makers so they can allocate resources and engage in quality improvement.

With the software, Vermont shares their e-SHIP scorecard publicly on their website so that visitors can get an overview of strategies and planned interventions designed to impact health priorities. By collecting and sharing this information with the public via the Clear Impact Scorecard, Vermont Department of Health has identified themselves as leaders in the new culture of accountability and transparency that is growing among government agencies.

“From the standpoint of public health as a field, the focus is always on the population. It has, therefore, not been a great leap for us to incorporate a new tool which helps us track data and make decisions with regard to all of our major strategic initiatives and across all sectors. The Scorecard is an integral part of our ability to display and share across our network and assists programs to gauge their own progress towards achieving our population goals. The Scorecard also aligns well within the RBA framework we utilize to prompt data-driven decision-making.”– Heidi Gortakowski, Director of Performance Management, Vermont Department of Health

What Sets the Vermont e-SHIP Apart?
According to the state’s health department website, Vermont’s e-SHIP is a five-year blueprint that sets three broad Healthy Vermonters 2020 outcomes, and 13 indicators, as the top public health priorities for 2013-2017 – with recommended strategies and interventions. While there are many health outcomes the Health Department and partners are working to improve, the SHIP represents strategic priorities by focusing on conditions that are preventable and, when addressed by the public health system, will help improve a number of health outcomes.

What sets the Vermont e-SHIP apart is its:

  • Brevity – Brevity is an important part of public communication. Vermont focuses on tracking 3 focus areas: reducing the prevalence of chronic disease, reducing substance abuse, and improving childhood immunization rates.
  • Transparency – Vermont’s e-SHIP is embedded right into its website for any visitor to access. The e-SHIP is well organized and it’s easy to find the information you’re looking for. The navigation bar on the left-hand side of the page allows users to easily navigate between the SHIP and other relevant website pages and information.
  • Vermont has experienced many benefits from switching to the e-SHIP format using the Clear Impact Scorecard (as opposed to writing the plan in document form). Some of these include:
  • Staff better understand the connection between programmatic performance and population-level changes

Data is more accessible and timely

  • Increased transparency (partners have quick access to data and action plans)
  • Reduction in duplication of efforts (scorecards can easily be shared with people interested in progress, instead of programs having to create separate status reports)
  • (Assess → Improve → Achieve) Streamlining All Departmental Planning in One Platform
  • In addition to the e-SHIP, Vermont also uses the Scorecard to build, maintain, update, and share their health assessment (Healthy Vermonters 2020) and department strategic plan.

The Healthy Vermonters 2020 initiative uses the Results-Based Accountability approach to document the health status of the state’s residents and define the Results the Department of Health intends to achieve by the end of the decade. The Clear Impact Scorecard enables the health department to share with the public live, real-time scorecards that capture all of this information through the Healthy Vermonters Toolkit on their website.

The simplification, transparency, and accessibility provided by the Clear Impact Scorecard helped Vermont become one of the first PHAB nationally accredited health departments on June 19, 2014. The Scorecard helps Vermont simultaneously fulfill PHAB’s performance management system, public education, and documentation requirements.

“We encourage all of our program managers and leaders to use the Scorecard to help them make decisions – using the data and the narrative to tell their story – and, as a web-based solution, the Scorecard provides an opportunity to communicate consistently with partners – in and out of the state government”. – Heidi Gortakowski, Director of Performance Management, Vermont Department of Health

About the Author: Kayleigh Weaver
Hi, I'm Kayleigh, the Communications Manager at Clear Impact. I create educational content to help organizations create measurable impact in their communities and reach their peak performance. Send me your story ideas at