CHS753 Exam 1

What is public health informatics

The application of information, science, technology, and data analysis to public health practice, research, and poliymaking

Objectives for public health

-Enhnace surveillance and monitoring

-Support evidence based decision making

-Improve public health planning and resource allocation

-Faciliate communiation and collaboration

Key Milestones

60s: Intro to computer based surveillance systems

70s: Development of electronic reporting systems

80s: Implementation of immunization & birth/defect registries

90s: Expansion of syndromic surveilance and outbreak detection

2000s: Adoption of electronic lab reporting and bio-surveillance

Challenges in public health

-Data quality and standardization issues

-Privacy and security concerns for health data

-integration and interoperability of diverse data sources

-limited funding and resources for tech implementation

-training and capcity building for PH professionals

PH Professionals

PH Informaticians: Experts in health data management

Epidemiologists: Utilize informatic tools for disease surveillance and outbreak investigation

Health and IT specialists: Design and implement PH information systesm

Data scientists: analyze and interpret population health data

Current trends

-Big data analytics for population health

-use of geospatial data for disease mapping/surveillance

-integration of social media for PH monitoring

-mobile health application for monitoring

-application of AI for decision-making

Future directions

-predictive modeling for early disease prediction/prevention

-blockchain tech for secure and decentralized health data exchange

-Interoperability and integration of health information systems

-integration of genomic data for research and surveillance

-Ethical considerations for PH informatics

Definition: Blockchain

A blockchain database stores data in blocks that are linked together in a chain

Collaboration & Partnership in informatics

-collaboration between public health agencies, researchers, and providers

-public-private partnerships for tech implementation

-interagency collaborations for data sharing and interoperability

-international collaborations for global health surveillance and response

Definition: Health Information Systems (HIS)

refere to interconnected technoogies, processes, and resources that enable the capture, storage, management, and exchange of health-related information

Key HIS functions

data collection and storage, clinical documentation, decision supporting, reporting and analysis

Benefits for HIS

improved patient care, enhanced communication, efficient work-flow, evidence-based decision making

Types of sample health information systesm

-electronic health records (EHRs)

-laboratory information systesm (LIS)

-picture arching and communication systems (PACs)

-National notifiable diseases surveillance system (NNDSS)

-Cancer registry systems

-birth and death registration systems (Vital records)

-syndromic surveillance systems

-health information exchange (HIEs)

Definition: Interoperability

refers to the sharing of data and information between different health information systems, enabling them to work together effectively

Importance of interoperability

-facilitates efficient data flow

-comprehensive patient records

-enhanced collaboration

-informed decision-making

Definition: Electronic Health Records (EHRs)

digitial versions of patient's medical records that include comprehensive health information. Provide a longitudinal view of a patient's health across different healthcare sharing for improved care coordination and decision making

EHRs cost and benefits

-significant initial investment to transition from paper to digital records

-staff resistance and workflow disruption

-can yield a positive financial return and improved patient outcomes

initial cost: software & hardware, implementation services, training

ongoing cost: maintenance and support, staff time and morale, data security

Cost savings: reduced administrative costs, increased efficiency, improved charge cpature, lower drug and test costs

EHRs Operational and Clinical Improvements

enhanced data accessibility, improved patient safety, streamlined communication, enhanced data security, support for quality initiatives

EHRs benefits for providers

decision support, efficient communication, data analytics

EHRs benefits for patients

improved care quality, access to information, empowerment and engagement, convenience, and continuity of care

Integration of EHRs

-Play a pictoral role in bridging the gap between clinical care and PH efforts

-agencies with collaborate with healthcare providers

EHRs for surveiallance outbreak response

-Can aggregate and analyze to monitor disease trends

-early identification of disease clusters for PH interventions

EHRs challenges

-Financial investiment: high initial cost for software, hardware, training and maintenance, potential budgest contraints

-Interoperability: integration challenges, ensuring data exchange between platforms

-User training and adoption

-Data Security & Privacy: ensuring security measures to protect patient data breaches, complications with HIPAA

-technical challenges

-Customization and onfiguration

-vendor support and reliability

Definition: Laboratory Information Systems (LIS)

specialized software for managing laboratory operations and data

Role of LOS in data management

-sample tracking

-test ordering and scheduling

-test result management

-quality control

-data integration

Clinical laboratories

Focus: patient care and diagnosis

Purpose: perform tests to aid in individual patient diagnosis

Testing scope: Broad of medical testss

Clients: serve healthcare providers and patients

Timeliness: emphasis on quick turnaround

Regulatory oversight: regulated by healthcare accredication

Public Health labs

Focus: Population health and disease control

Purpose: conduct test to monitor and respons to PH threats

Testing scope: specialized tests for infectious disease, environmental health, and bioterrorism agents

Clients: serve public health agencies, epidemiologists, researchers

Timeliness: emphasis on rapid detection and response to outbreaks

Regulatory oversight: regulated by public health and evironmental agencies

Challenges in implementing health information systems

privacy and security, data migration and system integration, staff training and change management, balancing cost and benefits

Health data collection

is the foundation for evidence-based decision-making, disease surveillance, resource allocation, and healthcare quality and improvement

Significance of accurate and reliable health data

-accurate data is the cornerstone of public health and clinical practice

-informs decision-making at all levels of healthcare

Methods of Health Data Collection

-Surveys and questionnaires

-medical examinations and tests

-electronic health records

-public health registries

Challenges in Data Collection

-data quality issues and sources of error (data entry errors, incomplete records, and outdated information)

-ensuring privacy and informed consent

-addressing cultural and linguistic consent

Definition: Health Data Standards

a set of agreed-upon rules, guidelines, and specifications that ensure consistency, accuracy, and interoperability in the collection, storage, exchange, and use of health-related information

Standardized data elements

uniform ways of capturing and representing data

-ex: SNOMED (for diagnoses), LOINC for lab testes, Health level seven (HL7) for message exchanges

International Classification of Diseases (ICD)

the first 3 characters represent the type of disease or health condition. there is a period or decimal point after the first 3 characters. The next 3 characters after the period give more details like the cause of the disease

-ICD-9 (9th version introduced in 1979)

-ICD-10 (10th version, US transitioned in 2024)

i.e diabetes ICD-9 = 250.0, ICD-10 = E11.9

Benefits of Health Data Standards

Improved data accuracy

enahnced data exchange

efficient data analysis

Definition: Splitters

Teast concepts out into their more atomic elements. Ex: SNOMED (Systematized Nomenclature of Medicine) permits use of separate codes for selected terms

Definition: Lumpers

Gather concepts into a single. Ex: The Logical Observation Identifiers, Names, and Codes (LOINC) permits use of a singel code for categorizing and routing information

Storage and Message: File Formats

a file structure, fixed format

A. flat files-constiting of a table of rows and columns

B. database files- a table, or set of tables, with columns, rows and descriptions

Storage and Message: Some de facto standard file format

A. comma-delimited: a flat file format with file extension (.CSV) where commas are used to delimit i.e. separate, the columns of a table, each row of the file represent a new records

B. Tab-delimited: a flat file format often with file extension (.TXT) similar to comma-delimited, but tabs are used instead of commas

Definition: Electronic messaging

A feature by which a computer system can "talk" with another system also called electronic data interchange (EDI)

Two major standards for messaging health information

1. HL7 (health level 7)

2. X12

Definition: HL7

health level 7: standardizes the format and protocol for the electronic exchange of data among health care computer application systems.

Definition: X12

has a focus on messages in business-to-business operations

Definition: Flat file

a table for storing data. Columns are assigned for different data elements, while rows represent individual records.

De facto standard flat files

1. UB10 and HCFA1500: both used for medicare insurance claims

2. National Electronic Telecommunication System for Surveillance (NETSS): used in communicable diseases untis to report to CDC

Advantages of flat files

data stored and messaged may be easier to analyze and manipulate than when the data are in other formats

Disadvantages of flat files

they do not easily represent the complex relationships and recurrent of data that are common in health care

Definition: Health Information Exchange System (HIE)

is the secure sharing of electronic health information among different healthcare organizations and systems. it enalbes the exchange of patient data across disparate healthcare provides, improving care coordination and patient outcomes

Advantages of Data interoperability and HIEs

-improved continuity of care

-faster decision-making: real-time

-enhanced patient engagement

-reduce duplicative testing

-improved public health surveillance

-cost savings

-data privacy and security

-stakeholder engagement

Definition: Public health data analysis

The systematic process of examining and interpreting data related to the health of populations. It involves collecting, organizing, cleaning, and analyzing data to identify patterns, trends, and insights that inform public health decision-making and interventions

Sources of Public Health Data

-Government health agencies

-Healthcare facilities

-Health surveys

-Vital statistics

-Disease surveillance system

-Laboratory data

-Environmental data

-Health registries

-Pharmacy and prescription data

-Social determinants of health data

-behavioral data

-global health organizations

-academic research

-digitial health technologies

-community health assessment

Challenges in Public Health Data Analysis

-Data quality and completeness

-Data privacy and security

-Data integration

-Resource constraints

-data acces, volume and velocity

-data bias

-Complexity of health issues

-data governance

-Data interpretation

-Emerging data sources

-Health disparities

-rapid response

-technological advancements

Data visualization for communicating public health data

-Clarity and comprehension

-Effective and communication

-Storytelling

-Comparisons

-identifying outliers

-Enhancing memory and retention

-Engagement and advocacy

-Real-time monitoring

-Transparency

-Policy support

-Accessibility and public engagement

Definition: Tableau

Widely used for data visualization and exploration. Allows users to create interacive dashboards, charts, and maps.

Definition: R and RStudio

Publication-quality graphics. R is a programming language and environment specifically designed for data analysis and visualization.

Definition: PowerBI

is a business analytics toold that is also useful for public health visualization. Offers features for data exploration, report creation, and interactive dashboard building

Definition: Python and Matplotlib

Python, along with libraries like Matplotli, provides robust data visualization capabilities. Popular for creating a wide range of static and interactive visualizations

Definition: Qlikeview/Qlike Sense

data visualization and bussiness intelligence tools. Used for creating interactive, user-driven dashboards and reports

Definition: ArcGIS

known for its mapping and spatial analysis capabilities, useful for geographic data and spatial epidemiology

Definition: D3.js

a Javascript library for crreating dynamic and interactive data visualizations

Definition: Descriptive statistics

provide the baseline understanding of health trends

Definition: Inferential statistics

enable public health professionals to make evidence-based decisions and recommendations for broader populations

Definition: Public health surveillance

is the systematic collection, analysis, and interpretation, and dissemination of health-related data to monitor and improve the health of populations. It involves continuous data tracking to detect patterns, trends and health threats.

Definition: Chronic diseases

is a long-term medical condition that persists over an extended period and typically progresses slowly. i.e diabetes, heart disease, cancer, etc.

Definition: Infectious disease

also known communicable disease, are illnesses caused by microorganisms such as bacteria, viruses, fungi or parasites.

Data Collection methods

Healthcare facilities, labs, health surveys, vital statistics, environmental monitoring, notifiable disease reporting, syndromic surveillance, pharmacies

Definition: Incidence rate

New cases diagnosed druing a specific period of time and by demographics

Definitio: Prevalence

the total number of cases existing in a population

Definition SEER (Surveillance, Epidemiology, & End Results Program)

collects data on cancer incidence, survival, and moratlity. operated by the National Cancer Insititute and collects and publiches cancer incidence and surival data from population-based cancer registries covering ~48% of the population