public health data standards consortium phdsc

Public Health Data Standards Consortium http://www.phdsc.org

Towards Common Work Processes: Business Process Analysis and

Functional Requirements Analysis for Public Health

Anna Orlova, PhDPublic Health Data Standards Consortium

[email protected]

PUBLIC HEALTH DATA STANDARDS CONSORTIUM~ 2009 BUSINESS MEETING OF MEMBERS ~

November 12-13, 2009, Hyattsville, MD

Where We Now

State Health Department: Organizational Chart

All public health activities are supported by customized information systems (databases, registries) developed to address the programmatic needs.

Use of IT in Public Health: Where We Now

Our information systems do support our programmatic needs

Our information systems cannot exchange data between programs within and across public health agencies and with clinical information systems

AND……

HIT Standards in Public Health: Where We Now

BUT……

Towards a Nationwide Health Information Network

Where Should We Be in 2014

Why Standards - National Context

US Nationwide Health Information Network (NHIN) in 2014

Source: Dr. Peter Elkin, 2006

RHIEs as NHIN ComponentsSource: Dr. Peter Elkin, 2006

Source: Eileen Koski. Quest Diagnostics. PHIN-2004, May, Atlanta GA

Percent of Children Tested for Lead with BLL>10 µg/dL in the USA

Vision: PH Surveillance under NHIN

Standardizing Health Information Exchanges

From Business Processes to

Functional Requirements to

Standardized IT Solutions

PHII Common Grounds Project“We hope to develop a shared understanding of public

health work and identify areas of commonality among public health agencies," said Dave Ross, Sc.D., director of the Common Ground National Program Office at the Public Health Informatics Institute. "The Common Ground program offers public health agencies the opportunity to collaboratively develop requirements for more effective information systems and better data exchange.”

Source: Public Health Informatics Institute (PHII). URL:http://www.phii.org/programs/CommonGround.asp

Describing Business Processes

Describing Functional Requirements

The purpose of the requirements elicitation is to specifythe information system features from user’s perspectives in a structured Functional Requirements Analysis Document (Functional Standard).FRAD Features:• Information System Goals (Tasks)• Actors• Functions (Actions)• Data Sources• Workflow and Dataflow• High Level Architecture

Requirements Elicitation

Functional Standard

Functional Standard describes work processes that support data exchange between users (e.g., clinicians and public health practitioners) in a format of functional requirements specification for electronic communication between settings (e.g., clinical and public health settings).

Functional Standard

Functional standard is a vehicle to assure that the work processes of stakeholders (e.g., clinicians and public health practitioners) related to the electronic data exchange are well understood and agreed upon by stakeholders themselves and then communicated clearly to the developers as functional requirements for the information system.

“Defining system requirements is the most important step in developing or acquiring any information system. A well-conceived and planned health information system can help organizations understand the need to adjust tasks or processes to be more effective or proactive in protecting community health….”

Source: Public Health Informatics Institute (PHII). URL:http://www.phii.org/subjectareas/requirementsdevelopment.asp

Defining Requirements

Early Hearing Detection and Intervention Content Profile, 2009-10

Standards for Public Health Data Exchanges: Working with Vendors (Newborn Screening, Diabetes, Quality), 2009

Standards for Public Health Data Exchanges: Functional Requirements Standard for Diabetes Care Management and Surveillance, 2008

Towards a Functional Standards on Electronic Data Exchange between Clinical Care and Public Health, 2007

Developing a Vision for Functional requirements Specification for Electronic Data Exchange between Clinical and Public Health Settings: Examples of School Health and Syndromic Surveillance in New York City, 2006

PHDSC FRAD Projects*

*Supported by Health Resources and Services Administration, 2005-2009URL:http://www.phdsc.org/health_info/com_nhin_activities.asp

From Business Processes to

Functional Requirements to

Standardized IT Solutions

Using SOA(Service-Oriented Architecture)

Example of Environmental Public Health Tracking

What are the impacts of pesticide exposure on children’s health?Are changes in the environment related to dramatic increase in

asthma?Are there increases in Systemic Lupus Erythmetosis (SLE) and

multiple sclerosis (MS) in communities with hazardous waste sites?

Track health, disease, and risks to target interventions to those populations most affected by environmental hazards and exposures.

Detect new adverse health events associated with environmental exposures.

Detect unusual occurrences, trends, or clusters of specific health events associated with environmental exposures.

Monitor and assess the effects of policies and the efficacy of interventions and established prevention strategies.

Raise awareness about environmental health issues among consumers, policy makers, health practitioners, industry, the public, and the media.

Examples of Tasks to be Addressed by the Environmental Health Tracking Network

Source: Dr. Nabil Issa, CDC/NCEH

Public Health Questions

Public Health Actions – Business Processes

Environmental Public Health Tracking NetworkEnvironmental Public Health Tracking Network

•Population Census

•Environmental Exposure Tracking

•Environmental Hazards Tracking

•Health Outcomes Tracking

State and National Data Collection Systems

Integrated Environmental Health

Tracking, Analysis, EvaluationAnd Dissemination

Exposure

Hazards

• Track health, disease, and risk trends

• Establish program priorities

• Develop, implement, and evaluate public health policies and program strategies

• Develop rapid-response mechanisms to investigate outbreaks and clusters

• Develop guidelines/standards

• Generate hypotheses and initiate applied research

Public Health Actions

Source: Dr. Nabil Issa, CDC/NCEH

USER VIEW

System Architecture forEnvironmental Health Risk Detection, Assessment & Management

System Architecture forEnvironmental Health Risk Detection, Assessment & Management

GIS/Spatial Epidemiology Risk Analysis Data Mining & Knowledge Discovery Statistical ModelsExposure Detection & Risk Analysis

• Track health, disease, and exposure risk/trends• Detect & evaluate risk of exposure to env. hazards• Develop & evaluate public health &

environmental stewardship policies & programs

• Develop rapid-response mechanisms to investigate outbreaks and clusters

• Develop prevention guidelines/standards• Generate hypotheses and initiate applied research

Environmental Stewardship & Public

Health Actions

Source: Dr. Nabil Issa, CDC/NCEH(*) Based on risk assessment and national priorities

Environmental Hazards, Ecology and

Disease Data Collection Systems

Disease Tracking*

•Hospital Discharge•Birth Defects•BRFSS•Cancer Registries•Health Surveys•Vital Statistics

Population Demographi

cs*

•Census Data

Exposure Tracking*

•Human Exposure to Environmental Chemicals

•Toxic Exposure Surveillance

HazardsTracking*

•Hazardous Substances-Emergency Event Surveillance

•Toxic Release Inventory

Ecological Tracking*

•Marine Life•Animals •Plants

Population

DiseaseIndicators

Population Demography

Health Outcomes

Exposure Profile

Environmental Hazard

HazardousMaterial Profile

ExposureIntegrated Environmental

Health Indicators Data Warehouse

Biomonitoring

NaturalAccidentalIntentional

Ecological Indicators

Data Linking/IntegrationMetadata Data Standardization Data Quality AssuranceData Integration,

Transformation & Geocoding

Geocoding

Informatician View

System

System

System

System

System

System

System

System

Environmental Public Health Tracking Information Exchanges

Developer View

Source:HITSP, 2009

State Health Department: Organizational Chart

Use Cases

Business Processes

Business“Top Down”User Driven

(Requirements Driven)

“Top Down”User Driven

(Requirements Driven) Use Case

Business Processes

Use CaseUse Case

Business



Business Processes

FunctionalRequirements/

Capabilities

Use Case


Capabilities

Use Case


Capabilities

Business



Business Processes


Capabilities

Use Case


Capabilities

Use Case


Capabilities

Business

Working with Developers at the Integrating the Healthcare Enterprise (IHE)

Integration Profile

Transaction

Transaction

Transaction

TransactionContentProfile

Actor

Actor

Transaction

Transaction

Transaction

Transaction

Actor

Actor

Transaction

Transaction

Transaction

Transaction

ContentProfile

Actor

Actor

IHE Technical Frameworks “Bottom-Up”

Health IT Solution Driven

PIX, PDQ, RFD, XDS

Integration Profile

Transaction

Transaction

Transaction


Actor

Actor

Transaction

Transaction

Transaction

Transaction

Actor

Actor

Transaction

Transaction

Transaction

Transaction

ContentProfile

Actor

Actor



PIX, PDQ, RFD, XDS



Business Processes


Capabilities

Use Case


Capabilities

Use Case


Capabilities

Business

Task Service Layer

Entity Service Layer

Utility Service Layer

Service Layers

Service-Oriented Architecture (SOA)

Entity Services

Utility Services /IHE Integration Profiles

Task Services

PIX Mgr PDQ Mgr Registry Repository Audit

Identity Document

GetPatientLHR

Example of Service Layers / Integration Profile Mapping

Integration Profile

Transaction

Transaction

Transaction


Actor

Actor

Transaction

Transaction

Transaction

Transaction

Actor

Actor

Transaction

Transaction

Transaction

Transaction

ContentProfile

Actor

Actor



PIX, PDQ, RFD, XDS



Business Processes


Capabilities

Use Case


Capabilities

Use Case


Capabilities

Business

IHE & SOA White Paper

Integration Profile

Transaction

Transaction

Transaction


Actor

Actor

Transaction

Transaction

Transaction

Transaction

Actor

Actor

Transaction

Transaction

Transaction

Transaction

ContentProfile

Actor

Actor

IHE Technical Frameworks


(Requirements Driven)

“Bottom-Up”Health IT Solution Driven

Task Service Layer

Entity Service Layer

Utility Service Layer

PIX, PDQ, RFD, XDS

Use Case

Business Processes


Capabilities

Use Case


Capabilities

Use Case


Capabilities

Business

Value of SOA

SOA links business and functional requirements to standardized interoperable IT solutions

For Users (Public Health Professionals and Clinicians)

Ability to navigate and select appropriate IT standards/ products for a service that is understandable for a non-technical audience, ie, identity service, document service, etc.

Ability to relate user requirements to IHE technical solutions (capabilities)

Ability to see commonalities for technical solutions across business processes

Value of SOA


For Developers Help users and their IT vendors to navigate through

interoperability standards Help IT vendors to correctly use interoperability

products in their applications Develop new IT products for services requested by

users, ie, identity service, document service, etc.

Value of SOA


So, together we can built interoperable, standards-based IT products that will adhere to user needs to assure “meaningful use” of Health IT

Resources:

A Service-Oriented Architecture (SOA) View of IHE Profiles – White Paper at the Integrating the Healthcare Enterprise (IHE). (URL: https://sites.google.com/site/projecthrsaphdsc/objective-2

Questions?

public health data standards consortium phdsc

Documents

public health agencies

public health practitioners

public health settings

health department

effective information

nowour information systems

public healthanna orlova

electronic data exchange