Informatics in Public Health William A. Yasnoff, MD, PhD Public Health Practice Program Office Centers for Disease Control and Prevention.

Informatics in Public HealthInformatics in Public Health

William A. Yasnoff, MD, PhD

Public Health Practice Program Office

Centers for Disease Control and Prevention

Public Health in 2010Public Health in 2010

DEMONSTRATION

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

Map

YesNo

Email Capability

MapHealth Alert Broadcast System

YesNo

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

MapDistance Learning Capability

YesNo

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]