informatics in public health william a. yasnoff, md, phd public health practice program office...
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Informatics in Public HealthInformatics in Public Health
William A. Yasnoff, MD, PhD
Public Health Practice Program Office
Centers for Disease Control and Prevention
Barriers to IT in Public HealthBarriers to IT in Public Health
A. Information
B. Infrastructure
C. Informatics
A. InformationA. Information• Surveillance data
– Only 15-20% of reportable cases reported
– Delays of days to weeks
– Not typically in electronic form
• Other relevant data not electronically available– Environmental, injury, etc.
– Guidelines
– Contacts
– Training materials
Information: Work in ProgressInformation: Work in Progress• NEDSS = National Electronic Disease
Surveillance System– Architectural elements– Public health conceptual data model
• Knowledge management– Preventioneffects.net– Encoding of clinical guidelines
• Disseminate through EMRs
• Point-of-care reminders
B. InfrastructureB. Infrastructure
• Information technology– Only 48.9% of local health departments
have high-speed continuous internet connections (NACCHO, 1999)
• Workforce– 83% of local health departments indicate
that computer training is a key need (NACCHO, 1996)
Infrastructure: Work in ProgressInfrastructure: Work in Progress
• INPHO = Information Network for Public Health Officials (state)– Ending in FY2001
• HAN = Health Alert Network (local)
• Frist-Kennedy authorization– Infrastructure standards/ assessment– Preparedness of public health system
Health Alert Network GoalsHealth Alert Network Goals
Ensure communications capacity at all local and state health departments (full Internet connectivity, training)
Ensure capacity to broadcast and receive health alerts at every level
Ensure capacity to receive distance learning offerings for CDC, et al.
Ensure communications capacity at all local and state health departments (full Internet connectivity, training)
Ensure capacity to broadcast and receive health alerts at every level
Ensure capacity to receive distance learning offerings for CDC, et al.
Map
HAN & Local Centers for Public Health PreparednessFunded Sites - FY 2000
HAN & Local Centers for Public Health PreparednessFunded Sites - FY 2000
Los AngelesLos AngelesDenver
Co.Denver
Co.
ChicagoChicago
DeKalb Co.
DeKalb Co.
Monroe Co.
Monroe Co.
NY CityNY City
WA
OR
CA
NV
ID
MT
WY
UT CO
AZNM
AKHI
NDMN
SD
NE
KS
OK
TX
WI
IA
MO
MI
IL
LA
AR
MS ALGA
FL
ME
OHWV
SCTN
KYNC
VA
NY
PA
MDDE
MA
CT RI
NJIN
NHVT
HAN States (N=37)HAN States (N=37)
Local CPHP counties (N=3)Local CPHP counties (N=3)
HAN Cities (N=3) HAN Cities (N=3)
Not fundedNot funded
Equip all full-function local PH systems with:Improved Internet access
55% now have continuous high-speed Internet capacity
Health alert broadcast capacity 56% now have a system for sending
urgent health alertsProvide informatics trainingDevelop critical information content
Equip all full-function local PH systems with:Improved Internet access
55% now have continuous high-speed Internet capacity
Health alert broadcast capacity 56% now have a system for sending
urgent health alertsProvide informatics trainingDevelop critical information content
Communications CapacityCommunications Capacity
Distance learning capacity at state/local public health agencies 82% of LHDs now have access to
satellite downlink within 30 minutes drive-time from work
Distance learning capacity at state/local public health agencies 82% of LHDs now have access to
satellite downlink within 30 minutes drive-time from work
Distance Learning/TrainingDistance Learning/Training
Transition to web-based distance learningIncreased capacity at CDCWeb-based informatics course
Training in bioterrorism preparednessUSAMRIID/CDC course, BT Grand
Rounds, Role of Clinical Lab, et al.
Transition to web-based distance learningIncreased capacity at CDCWeb-based informatics course
Training in bioterrorism preparednessUSAMRIID/CDC course, BT Grand
Rounds, Role of Clinical Lab, et al.
Distance Learning/TrainingDistance Learning/Training
Provide informatics trainingAnnual Conference on Public Health
Informatics and Distance LearningPublic Health Informatics course given
to 120 people, including most HAN project managers
Provide informatics trainingAnnual Conference on Public Health
Informatics and Distance LearningPublic Health Informatics course given
to 120 people, including most HAN project managers
Distance Learning/TrainingDistance Learning/Training
Website DevelopmentWebsite Development
CompletedCDC BT Preparedness and Response Website
(www.bt.cdc.gov)Health Alert Network Website
(www.phppo.cdc.gov/han)Under Development
BT Emergency Response Restricted WebsiteHAN Today Website
CompletedCDC BT Preparedness and Response Website
(www.bt.cdc.gov)Health Alert Network Website
(www.phppo.cdc.gov/han)Under Development
BT Emergency Response Restricted WebsiteHAN Today Website
HAN Emergency Notification SystemHAN Emergency
Notification System
FunctionsRapidly alert key State Public Health
officials of bioterrorist events or other emergent health threats via email and fax
Provide official CDC communications to key State Public Health officials during a bioterrorist event via email and fax
FunctionsRapidly alert key State Public Health
officials of bioterrorist events or other emergent health threats via email and fax
Provide official CDC communications to key State Public Health officials during a bioterrorist event via email and fax
HAN Plans for FY 2001HAN Plans for FY 2001 Expand web-based learner support system Partner with HRSA to develop and disseminate
national standards for information and communication systems needed in a BT emergency
75% of full functioning LHDs have Internet connectivity, 50% have broadcast alert capability, and 80% have satellite-based distance learning capacity
Disseminate a communications plan regarding rapid relay of information
Expand web-based learner support system Partner with HRSA to develop and disseminate
national standards for information and communication systems needed in a BT emergency
75% of full functioning LHDs have Internet connectivity, 50% have broadcast alert capability, and 80% have satellite-based distance learning capacity
Disseminate a communications plan regarding rapid relay of information
C. InformaticsC. Informatics• Definition: the systematic application of
computer & information science and technology to public health practice, research, and learning
• Management skills– IT projects expensive and high risk– Interdisciplinary teams required– New skills needed by public health
managers
Public Health Informatics: Developing a National Agenda
Public Health Informatics: Developing a National Agenda
• Spring AMIA Meeting May 15-17, 2001 in Atlanta (www.amia.org)
• Bringing together medical informatics and public health communities
• Areas of focus: funding; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; training/workforce
• Primary sponsor: RWJ Foundation
Informatics Training - 1Informatics Training - 1• Development of consensus competencies
– Meeting prior to Spring AMIA (Richards & O’Carroll)
– Multiple tracks expected: basic/managers/senior managers
– Goal is sample curriculum for SPH
• Book: Public Health Informatics and Information Systems (Aspen Press, 2002)– Suitable for teaching PHI– Includes case studies
Public Health Informatics Competency Categories
Public Health Informatics Competency Categories
• Information Access
• IT infrastructure view
• Information system development
• Networking & database design
• Standards
• Privacy, Confidentiality & Security
• IT planning and procurement
• IT leadership; managing change
Informatics Training - 2Informatics Training - 2• CDC short (3 day) course for public
health managers– Developed in ’96-’97– Interactive web version later this year
• CDC Fellowship– Two year program started in ’96– Still evolving
• Schools of Public Health– Courses (at least 11 now; more planned)– Degree programs in early stages
Informatics in Public Health: The Future
Informatics in Public Health: The Future
• Information Access– Databases– Knowledge management
• Information Systems– Effective management– Improved productivity
• Surveillance integrated with EMR
• Feedback to providers
For Further InformationFor Further Information
• William A. Yasnoff, MD, PhD 770/488-2503 [email protected]