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Public health information
Introduction to Public Health Informatics: Health Information Systems Principles and Building blocks Sherrilynne Fuller, PhD Professor, Biomedical and Health Informatics, School of Medicine Co-Director, Center for Public Health Informatics School of Public Health University of Washington, Seattle, USA Center for Public Health Informatics University of Washington, Seattle Washington, USA Learning Objectives • Describe the key dimensions of health systems • Identify three health informatics “rules” for effective systems design • Give some reasons why health information systems implementations fail? Center for Public Health Informatics University of Washington, Seattle Washington, USA What Does This Have to do With Health Information Management? Center for Public Health Informatics University of Washington, Seattle Washington, USA What Does This Have to do With Health Information Management? ISOLATED DATA – in Silos Center for Public Health Informatics University of Washington, Seattle Washington, USA Pharmacy Patient Records Laboratory Facilities Data Community Health Data Souce: Rear Admiral Patrick O’Carroll, Region 10 Health Administrator Center for Public Health Informatics University of Washington, Seattle Washington, USA 6 Global Health Challenges for the Next Decade • New viruses that can travel more rapidly, transforming local afflictions into worldwide epidemics; new and re-emerging infectious diseases (70% of which are zoonoses) • A modern lifestyle that travels just as fast, contributing to swelling epidemics of non-communicable diseases • A human resources crisis is directly linked to transnational labor, economics and migration • The growth of vertical (e.g. HIV/AIDS, TB, malaria) initiatives has pushed advances for specific diseases but has also put pressure on individual countries’ public health systems. – This underscores the need to work to improve those systems, and highlights the need to improve both the human and technical competencies used to manage them. Reduce need to access health care providers Support PH underlying prioritization and policy setting Patient ability to enter healthcare system once intervention needed (financial means, logistical access) Identifying underlying condition and needed intervention Catering diagnostics for regional needs Administration of medical care Reduction of health care expense for populations Tracking health of patients, populations and compliance with treatment regimens Tracking efficacy of new treatments Health Systems Dimensions Prevention Access Diagnosis Delivery Monitoring Health care delivery system Efficiency Relative population health improvement for each dollar invested Equity Ensure good health outcomes are shared by entire population regardless of income or education Quality Relative effectiveness of healthcare system and medical interventions Public health organizations, governments, R&D, donors Source: WHO Source: Karl Brown, Rockefeller Foundation Center for Public Health Informatics University of Washington, Seattle Washington, USA Health Information Systems “Silos” Broad range of initiatives, but few integrated interventions Telemedicine diagnosis EMR for AIDs and TB care EMR for AIDs and TB care (2) Hospital Management Software for rural hospitals HealthNet Eritrea for health information Antiretroviral Therapy Information System (ARTIS) Uganda Health Information Network (UHIN) HealthNet info network HealthNet information network (2) HealthNet information network HealthNet info network HealthNet info network HealthNet info network (2) Register for immununization tracking AMREF remote clinical diagnosis by specialists Mosoriot medical record system EMR for AIDs and TB care (2) Cell-Life clinic workers remotely monitor health patient problems EMR for AIDs and TB care HealthNet information network (3) HIV-EMR system Careware medical record system for HIV treatment HealthNet info network Source: BCG research Patient vaccination records Monitor Vitamin A distribution Voxiva disease survelliance system in Tamil Nadu Remote eye diagnostics East Bhutan Tele-ECG Telediagnostics Telepatholog y Assess availability of HIV/AIDS-related services AMREF remote clinical diagnosis by specialists Regional HIV data center Web based clinical information system for researchers PIH-EMR electronic medicalrecord supports TB and HIV SICLOM delivery ARV treatment Teledermatology District public health tracker GENNET forum for gender issues On Cue SMS drug reminders for TB patients EMR for AIDs and TB care (2) HealthNet info network (6) HealthNet info network (8) Health Metrics Network Global / Regional WHO GoE GOARN Weekly EPI Record (WHO) NEDSS (CDC) Antimicrobial inform. bank FluNet and RABNET APEC EINET Health InterNetwork (US) Roland Koch Institute Country / local and many more HAN (CDC) eLearning to train nurses Prevention Access Diagnosis Delivery Monitoring Sample demonstrates wonderful progress, but significant fragmentation Center for Public Health Informatics University of Washington, Seattle Washington, USA Karl Brown Rockefeller Foundation Health Information Systems Challenges: Vietnam 2007 Huong PTM, Hue VTK. Vietnam HIT Case Study. NBR Center for Health & Aging 2007. 1-5. Center for Public Health Informatics University of Washington, Seattle Washington, USA Definition: Medical Informatics … the discipline that concerns the management of medical (clinical) information and the conversion of the information into useful knowledge for decision making… Norris, T, Fuller SS, Goldberg HI, Tarczy- Hornoch, P. eds. Informatics in Primary Care: Strategies in Information Management for the Healthcare Provider, Springer,2002. Center for Public Health Informatics University of Washington, Seattle Washington, USA [...]... capabilities and limits of technology in improving health • Develop approaches to appropriately use computers to complement human skills and human needs Center for Public Health Informatics University of Washington, Seattle Washington, USA Health Information Systems: Approach to Design and Implementation • The hardest part of implementing useful health information systems Is ensuring that users of those... and indicator of need for or success of preventive efforts • Risk factor analysis – e.g water quality, sanitation, malaria outbreak prediction • What are some of the public health information systems in use in Veitnam? Center for Public Health Informatics University of Washington, Seattle Washington, USA Public Health Informatics: From Disease Surveillance to National and International Health Information. .. unnecessarily impede access to, and sharing of, information •Since it is so difficult to join these data together, partners in the public health system cannot fulfill all of their information needs or efficiently manage the delivery of services.” Stovepiped systems require custom interfaces to exchange info Hospital 1 Clinic Hospital 2 Pharmacy Lab Gov't Custom interfaces expensive risky to build and maintain... Washington CONCLUSION: Learning Objectives • Describe the key dimensions of health systems • Identify three health informatics “rules” for effective systems design • Give some reasons why health information systems implementations fail? Center for Public Health Informatics University of Washington, Seattle Washington, USA Center for Public Health Informatics University of Washington University of Washington... Information •Literature •Reminders •Alarms/Alerts •Guidelines •Protocols •Decision Support •Diagnosis •Care Plan •Prognosis •Orders •Observations •Research Center for Public Health Informatics University of Washington, Seattle Washington, USA •Outcomes Center for Public Health Informatics University of Washington, Seattle Washington, USA Center for Public Health Informatics University of Washington,...Definition: Public Health Informatics The systematic application of information science, computer science and technology to public health (individual and population) practice, research and learning* “prevention informatics” *O’Carroll et al Public Health Informatics and Information Systems.Informatics University of2003 Center for Public Health NY, Springer, Washington, Seattle Washington, USA Health Informatics:... Resources •Research Literature •Guidelines •Protocols •Policies •Procedures •Laws •Regulations Health Workers •Diagnose problem •Access, Collect Data and Knowledge Resources •Analyze •Plan intervention •Monitor results Center for Public Health Informatics University of Washington, Seattle Washington, USA •Evaluate outcomes Key Public Health Information Systems: Monitoring for Prevention • National Vital Statistics... systems impeded efforts to control the hantavirus outbreak in the Southwest Data were locked into separate databases that could not be analyzed or merged with others, causing public health investigators to analyze paper printouts by hand.” Hospital 1 Standard data format Clinic Hospital 2 Pharmacy Lab Gov't 23 Source: CDC, US General Accounting Office To avoid stovepipes, need to ensure data can be communicated... one health care organization Personal Health Record An electronic record of health- related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual Family Health Record An electronic record of health- related information about all family members including information. .. important part of health informatics • In this course we will bring the social, political, cultural contexts together with the technical to provide a comprehensive framework for creating effective health information systems Center for Public Health Informatics University of Washington, Seattle Washington, USA Clinical Decision Support Systems PATIENTS KNOWLEDGE DATABASES Electronic Health Record •Encounter