PUBLIC HEALTH INFORMATICS: AN INTRODUCTION
input, storage, processing and output
- these components combine to form a system that helps end users, public health professionals, capture, manage, and analyze information to inform decision-making and drive business processes.
clinical health
- has a primary focus on individuals with health problems (such as disease or injury), and a -primary strategy of treatment after the occurrence of the disease or injury
public health (PH)
- has a primary focus on populations, and a primary strategy of prevention (of disease, injury, disability, or environmental impact).
Council for State and Territorial Epidemiologists (CSTE)
- identified informatics as a top training priority to support achievement of public health department capacity needs
Public Health 2.0
- in the late twentieth century through the early twenty-first century, public health matured as a service and expanded in response to the Institute of Medicine's The Future of Public Health report - public health services transitioned from a focus on infectious to chronic diseases, and responded to major epidemics like HIV/AIDS as well as SARS
LOCAL LEVEL OF PUBLIC HEALTH
- includes not only county HDs and metropolitan area HDs, but also tribal public health and regional collaborative organizations
Programming
- instructions that tell computers how to store, manipulate, transform, and display data
Recognition
- is a sign that informatics is maturing as a discipline within public health.
STATE LEVEL OF PUBLIC HEALTH
- is considered to hold the primary responsibility for public health in the US
Public Health Informatics
- is the defining factor that differentiates PH Informatics from all the other health informatics specialties, such as bioinformatics, clinical informatics, and other sub-disciplines
Centers for Disease Control and Prevention (CDC)
- nation's leading science-based, data-driven, service organization that protects the public's health
Context
- operation within a governmental context, as opposed to private, profit seeking context
public health informatics (PHI)
- primary domain = public health - which itself is composed of several important disciplines: epidemiology; biostatistics; social and behavioral sciences; health administration; and environmental science
Communicable Disease Center
- product of the Malarial Control in War Areas (MCWA) program established in Atlanta, GA in 1942
one health
- recognizes the connection between people's health, animal health, and the environment
Public Health 1.0
- refers to the period from the nineteenth century through the twentieth century when public health established itself as an essential government service
The Patient Protection and Affordable Care Act of 2010
- signaled a shift in the market towards "bundled payments" that reward maintenance of and improvements in health with minimal utilization of health care services.
London Bills of Mortality
- sixteenth century, the recording of vital statistic ·-History of PH in US began on 1874
information system (IS)
- sometimes referred to as INFORMATION AND COMMUNICATIONS TECHNOLOGIES or ICT - are common in medicine, education, and every other domain
Current State
- support the public health enterprise. In 2017, the Association for State and Territorial Health Officers (ASTHO) added informatics as a health department role to its Public Health Workforce and Information Needs Survey
Networking
- technical methods to connect two/more computer systems
Prevention
- the application of information science and technology to focus on prevention of disease or injury, rather than treatment of existing conditions in individuals
Population health
- the application of information science and technology to further the health of populations rather than of individuals
Public Health Information Systems
- are the technical components used to support the business of public health organizations
informatics
- brings methods, knowledge, and theories from both computer science and information science to support the field of public health
Data sources and partners
- can be considered as the input for PHI applications
INFORMATIK
- denote automatic information processing (means computer science in German)
Public Health 3.0
- desire PH organizations to form vibrant, structured, cross sector partnerships in which they leverage timely, actionable data and metrics to guide population decision-making - The vision is a call-to-action statement in which HHS challenges the public health enterprise to invest in its infrastructure, move towards interoperability with the health care system, and implement intelligent public health IS that align with the National Academy of Medicine's concept of the Learning Health System
The Applied Public Health Informatics Competency Model
- developed by the Public Health Informatics Institute (PHII), built upon earlier work to develop a framework for the knowledge and skills needed for PHI
Information science
- focuses on the effective collection, storage, management, retrieval, and use of information among humans in the context of social, organizational, and individual needs
Computer science
- focuses on the methods and techniques to store, manipulate, transform, and display data and information by means of computer systems
one health
- "collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national, and global levels —with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment"
public health informatics (PHI)
- "systematic application of information and computer science and technology to public health (PH) practice, research, and learning"
Communicable Disease Center
- 1946, ancestor of today's Centers for Disease Control and Prevention (CDC) was established
mHealth and uHealth
- A rise in the availability and adoption of devices (e.g., smartphones, tablets, smart watches) is driving a move towards mHealth (mobile health) and uHealth (ubiquitous health)
The Patient Protection and Affordable Care Act of 2010
- ACA, also known as Obamacare - ushered in a new era in health care reform that focuses on population health
Precision Public Health
- Advances in genomics now enable doctors to precisely prescribe a medication regimen to treat diseases, especially cancer, based on an individual's genetic profile.
informatics
- Coined by Karl Steinbuch
Input
- Data and information; organizations typically collect or capture data and information from one or more sources - Population surveys; vaccination records; census data; birth certificate data
Janet Hamilton, MPH
- Director of Science and Policy at the Council for State and Territorial Epidemiologists - "data is moving slower than the disease" - "...paper records, phone calls, spreadsheets and faxes requiring manual data entry are still in widespread use..." in public health
Public Health 3.0
- In 2016, the US Department of Health and Human Services laid out a vision for what it termed 'Public Health 3.0
Processing
- Includes information retrieval (e.g., search) as well as data integration and analysis functions; organizations often use more than one application to perform these functions as part of the information system - SAS™, R, enterprise master index; Citrix; internet browser
Precision Public Health
- Increasingly health care systems are implementing 'precision medicine' programs to treat disease through designer drugs and tailored therapy
smallpox
- One of the biggest success stories in twentieth century PH - deaths of around 300 million people, but a dedicated global PH vaccination program eradicated the disease in 1977
Output of PHI Efforts
- PH data are gathered in order to promote PH goals - PHI aims to advance the "business of public health" which is to improve the health of populations.
clinical health
- Preventive measures are usually not the primary focus, although they may be a secondary focus.
Storage
- Repository for data and information; organizations use a combination of hard drives, "mapped" network drives, servers, and cloud-based storage components to manage the data and information captured by the organization - Relational database; virtual file folders; CSV files; Google Drive
INFORMATIQUE
- Russian denoting the theory of scientific information
Public Health 2.0
- Systematic development of public health governmental agency capacity across the United States. - Focus limited to traditional public health agency programs
The Applied Public Health Informatics Competency Model
- The framework included broad categories of o informatics principles and strategic thinking; o informatics standards and interoperability; o project management; o knowledge of infrastructure, including hardware, software, and networks; o effective communication; o evaluation of workflows and technology; o data analysis, visualization, and reporting; o policy and regulations
Output
- The result of the processing; most often the output takes the form of a report, graph, chart, table, or map. The output could be in the format of an electronic message, like an email, that is sent to another organization - Map of neighborhoods with high incidence of disease; list of newly diagnosed cases of measles in county; graph depicting the prevalence rate of chlamydia over the past 3 years
Precision Public Health
- These efforts are guided by advanced-omics (genomics, proteomics, etc.) but they also take advantage of modern informatics approaches like 'predictive analytics' as well as machine learning
Public Health 3. 0
- addresses the collaboration necessary to achieve that integration - enhance and broadened public health practice that goes beyond traditional public department function
Causal chain
- applications that target points in the causal chain leading to disease, injury, or disability
information system (IS)
- are the primary tools by which PH informatics professionals design, implement, and operate systems to facilitate the collection, management, analysis, use, and exchange of data and information.
information system (IS)
- used in everyday life is an email client like Microsoft Outlook™ or Google's Gmail. - used in public health include the Behavioral Risk Factor Surveillance System (BRFSS) and the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE).
post-World War II era
- ushered in the Age of Computing in which the world sought to improve the speed of computation, a required ingredient to put humankind on the moon as well as play video games
Public Health Informatics (PHI)
- which expresses its interdisciplinary nature and denotes its application to all aspects of public health
Public Health 1.0
-Tremendous growth of knowledge and tools for both medicine and public health -Uneven access to care and public health
Public Health 3.0
A significant upgrade in public health practice to a modern version that emphasizes cross-sectorial environmental, policy and systems-level actions that directly affect the social determinants of health.
Association for State and Territorial Health Officers
ASTHO
PH Core Activities
Assessment, Assurance, and Policy
FEDERAL LEVEL
CDC - is not only perhaps the most widely recognized, but also the primary federal public health agency
PHI Practice
Design, Implementation, and Operation of Public Health Information Systems
1. health reform 2. IT advances 3. big data 4. disruptive innovation
Drivers of Change for Public Health Informatics and Information Systems
electronic health record systems
EHRs
PHI Research
Evaluating Impact of PH Information Systems
NATIONAL LEVEL
FEDERAL LEVEL EQUIVALENT IN THE PHILIPPINES
LOCAL LEVEL
LOCAL LEVEL EQUIVALENT IN THE PHILIPPINES
epidemiology biostatistics social and behavioral sciences health administration environmental science
PHI DISCIPLINES
1. severity 2. prevalence 3. preventability
Qualifying conditions/factors necessary for a public health response:
REGIONAL LEVEL
STATE LEVEL EQUIVALENT IN THE PHILIPPINES
1. assessment 2. policy development 3. assurance
The 1988 IOM report, The Future of Public Health, identified three core functions:
1. underlying principles 2. data sources 3. output of informatics efforts
Three important distinctions:
Population Health Prevention Causal Chain Context
Underlying Principles of PHI:
Public Health 2.0
began with a 1988 report on the "Future of Public Health," which concluded that the nation's public health system had fallen into disarray jump started a national effort to clearly define essential public health services - focus limited to traditional public health agency programs
Public Health 1.0
encompassed the development of public health from the mid-19th century up to the time of the 1988 Institute of Medicine Report (now Academy of Medicine) report (Core Functions of Public Health). (Late 1800's - 1988)
STATE LEVEL OF PUBLIC HEALTH
funds distribution, both federal and state, to local health departments (LHDs); policy and legislation development, coordination of state programs and initiatives, such as vital statistics; and assistance to LHDs, such as during outbreak investigations.
information system (IS)
is a collection of computer-based tools used to collect, store, and process information
Centers for Disease Control and Prevention (CDC)
is not only perhaps the most widely recognized, but also the primary federal public health agency
Public Health 3.0
represents an effort to build on the past and put forth "a new era of enhanced and broadened public health practice that goes beyond traditional public department functions and programs"
Computer science
Ø algorithms and programming o networking o representation of data and information o system architecture o and artificial intelligence
