Division of Public Health

1. STATE HEALTH OFFICER Division of Public Health Bi-Monthly Webcast May 5, 2011

2. Overview • Announcements • National Health Observances – May • Overview on the Office of Health Informatics • Health Informatics Programs in Wisconsin FOCUS ON HEALTH INFORMATICS Protecting and promoting the health and safety of the people of Wisconsin

3. Announcements Protecting and promoting the health and safety of the people of Wisconsin

4. Deb Clausen, Health Officer in Douglas County will be retiring in May, 2011. • 36 local agencies (tribes and health departments) were funded to improve readiness for public health accreditation and action toward meeting the national public health standards. Funding came from competitive application to CDC for PH infrastructure. Protecting and promoting the health and safety of the people of Wisconsin

5. Linda Lee, Public Health Nutritionist with LaCrosse County, received the DHS Partners in Public Health Award for her work to promote successful community partnerships to address public health issues such as obesity, nutrition, and physical activity. Protecting and promoting the health and safety of the people of Wisconsin

6. Health Observances http://www.dhs.wisconsin.gov/Health/MinorityHealth Protecting and promoting the health and safety of the people of Wisconsin

7. Health Observances - MAY • Arthritis Awareness Month • Community Health Promotion • Hepatitis Awareness Month • Communicable Disease & Emergency Response • Melanoma/Skin Cancer Detection and Prevention Month • Community Health Promotion Protecting and promoting the health and safety of the people of Wisconsin

8. Health Observances (con’t) • National High Blood Pressure Education Month • Community Health Promotion • National Physical Fitness and Sports Month • Community Health Promotion • National Toxic Encephalopathy and Chemical Injury Awareness Month • Environmental & Occupational Health Protecting and promoting the health and safety of the people of Wisconsin

9. Health Observances (con’t) Protecting and promoting the health and safety of the people of Wisconsin

10. Health Observances (con’t) Protecting and promoting the health and safety of the people of Wisconsin

11. Health Observances (con’t) Protecting and promoting the health and safety of the people of Wisconsin

12. Health Observances (con’t) Protecting and promoting the health and safety of the people of Wisconsin

13. Health Observances (con’t) Protecting and promoting the health and safety of the people of Wisconsin

14. OFFICE of HEALTH INFORMATICS Overview Oskar Anderson, Director Protecting and promoting the health and safety of the people of Wisconsin

15. AVR Update (Analysis, Visualization & Reporting) Jim Grant Director, Public Health Information Network Protecting and promoting the health and safety of the people of Wisconsin

16. AVR provides the ability to: • Integrate Data – combine data sources • Analyze Data – SAS procedures • Display Data – charts, graphs, maps • Share Data & Technologies – role based web access Protecting and promoting the health and safety of the people of Wisconsin

17. SAS Business Intelligence Server – analytics, tables, graphs ESRI ArcGIS – thematic maps Current Technology & Data • Births & deaths • Hospitalizations • Environmental • Communicable • Syndromic Protecting and promoting the health and safety of the people of Wisconsin

18. EPHT LEAD POISONING

19. Syndromic Surveillance – Wisconsin Health Information Exchange April 2010 – April 2011

20. SharePoint SQL Server Reporting Service (SSRS) Fusion Maps/Charts ESRI ArcGIS Viewer Future Technology & Data • Birth data geocoded to census tract and lower • Census demographic data • American community survey data • ESRI Business Analyst data • eHealth – clinical data Protecting and promoting the health and safety of the people of Wisconsin

21. Economic Hardship Index Protecting and promoting the health and safety of the people of Wisconsin

23. HIE Update Denise Webb State Health IT Coordinator Protecting and promoting the health and safety of the people of Wisconsin

24. State HIE Program: WIRED for Health • $9.441M federal grant award for HIE planning and implementation • WIRED for Health Board and its committees developed Wisconsin’s HIT Strategic and Operational Plan, April – August 2010 • ONC approved plan 12/21/10 and released remaining grant funding Protecting and promoting the health and safety of the people of Wisconsin

25. State HIE Program – Roles and Responsibilities Protecting and promoting the health and safety of the people of Wisconsin

26. State HIE Program – Meaningful Use and HIE “White Space” • Six HIE Meaningful Use Requirements in Stage 1 and Wisconsin’s status • e-Prescribing (Core) • Patient clinical summary exchange among providers and patient authorized entities (Core) • Structured lab results • Reportable lab results to public health (Menu, Hospitals only) • Immunization data to public health (Menu) • Syndromic surveillance data to public health (Menu) • Ensure all providers have at least one option for meeting the HIE requirements Protecting and promoting the health and safety of the people of Wisconsin

27. State HIE Program - Technical • Includes architecture and core HIE services to help eligible professionals and hospitals meet meaningful use requirements • Near-term plan is to enable providers use of Direct secure messaging services in 2011 • Principles: • Network-of-networks approach • Statewide deployment roadmap • Standards-based architecture • Use of existing assets • Technical services to support Stage 1 HIE MU Core/Menu Set Requirements • Exchange with Public Health for Stage 1 HIE MU Menu Set • Plan for 2012 is to have infrastructure and HIE services to support robust query-retrieve HIE—“push and pull” health data • WISHIN contracted with WHIE to serve as the Technical Manager to manage and lead the technical aspects of the WIRED for Health project, i.e., implementation of the Statewide Health Information Network and HIE services Protecting and promoting the health and safety of the people of Wisconsin

28. WISH Update (WI Interactive Statistics on Health) Torrey Nelson Research Analyst Protecting and promoting the health and safety of the people of Wisconsin

29. Web Based Custom Data Queries Available for These Topics: Protecting and promoting the health and safety of the people of Wisconsin

30. Multiple Measures (counts, rates, rankings, etc.) Geographic Area Choices (region, counties, etc.) Choice of Years Choice of Age Groups Sex, Race, and Ethnicity Choices Contents of a Typical Query Protecting and promoting the health and safety of the people of Wisconsin

31. Contents of a Typical Query • Specific Choices Related to Query Topic (such as maternal characteristics in birth or cause of death in mortality) • Ability to Choose Row and Column Variables for Results Table • Drill Down in Output • Sign Up to be Notified of Updates (check WISH) http://www.dhs.wisconsin.gov/healthcareinfo/forms/docs.asp Protecting and promoting the health and safety of the people of Wisconsin

32. SVRIS Update Statewide Vital Records Information System John Kiesow Protecting and promoting the health and safety of the people of Wisconsin

33. SVRIS Statewide Vital Records Information System • Birth Module • SVRIS to SPHERE • Death Module • Out of State, Resident births • STEVE, State and Territorial Exchange of Vital Events Protecting and promoting the health and safety of the people of Wisconsin

34. Improving Data Population Health Information Exchange(PHINEX) Lawrence P. Hanrahan, Ph.D., MS Director of Public Health InformaticsChief Epidemiologist Protecting and promoting the health and safety of the people of Wisconsin

35. PHINEX • Vision To develop the best information system for understanding population health. • Mission To organize population health information and make it universally accessible and useful. Achieving Healthiest Wisconsin A Performance Management Framework for Statewide Health Improvement Protecting and promoting the health and safety of the people of Wisconsin

36. PHINEX Data Driven Conceptual Model FIND PATTERNS COMPARATIVE TRIALS CONTINUOUS QUALITY IMPROVEMENT Promote what works to new standard of care (for 1, 2, or 3). Continuously improve: Repeat pattern analysis and comparative trials to find what works best for each unique population segment Extract clinical EMR data (1,2) Link it to community data (3) Perform data mining (1+2+3) to gain insight From insight, design & run a customized effectiveness trial. Then measure to see what works (1 or 2 or 3) • With Data, Improve All Aspects of Chronic Care Model: • Self Care • Health Care Organization • Community Health Resources (Public Health Interventions)

37. Initial FocusUW Clinical EMR – Public Health Data Exchange • Asthma • Diabetes & Pre-Diabetes • Obesity • Influenza • Plan to look at other outcomes Protecting and promoting the health and safety of the people of Wisconsin

38. UW Clinical EMR – Public Health Data Exchange 2007-2009* *Updates Approved through 2012 / De-Identified Data HIPAA Privacy Rule Compliant for Limited Data Sets

39. UW Department of Family Medicine Patient Population Location Geographic Density of 195,000 Patients

40. Mapping UW EMR Data Protecting and promoting the health and safety of the people of Wisconsin

41. Fresh Fruit & Vegetable Consumption IndexMilwaukee & Suburbs – Census Tracts Color Ramp Grey –Lowest White-Low Cream-Medium Yellow-High Red-Very High Source: ESRI / BLS Consumer Expenditure Survey

42. Fresh Fruit & Vegetable Consumption IndexWith Individual Store Location / Sales VolumeMilwaukee & Suburbs – Census Tracts Color Ramp Grey –Lowest White-Low Cream-Medium Yellow-High Red-Very High Circle size = store sales volume Source: ESRI / BLS Consumer Expenditure Survey

43. PHINEX Next Steps • ESRI Community Indicators • UW-EMR Disease Burden Uniform Report • Build System • Link to Other Initiatives • UW Partnership Strengthen CHIPPs WALHDAB • Maps for CHIPPS • All Surveillance Programs • Timeline – 4.5 yr activity Protecting and promoting the health and safety of the people of Wisconsin

44. PRAMS Update Eleanor Cautley Project Coordinator Protecting and promoting the health and safety of the people of Wisconsin

45. PRAMS = Pregnancy Risk Assessment Monitoring System • CDC surveillance system, with State Health Departments. • Random sample survey of mothers who recently had a live birth. Protecting and promoting the health and safety of the people of Wisconsin

46. African American Oversample • Large increase in sample of African American mothers, 2011 • Focused on Kenosha, Milwaukee, Racine and Rock Counties • Results will be used to evaluate Lifecourse Initiative for Healthy Families (LIHF) community projects • Expected to be ongoing for several years Protecting and promoting the health and safety of the people of Wisconsin

47. Wisconsin Data Results:WIC Participation, 2007 - 2008 Protecting and promoting the health and safety of the people of Wisconsin

48. Smoking 2007 – 2008, Wisconsin 48

49. Publication • Postpartum Depression fact sheet • First in the series What Moms Tell Us http://www.dhs.wisconsin.gov/births/prams/index.htm Protecting and promoting the health and safety of the people of Wisconsin

50. What Moms Tell Us Wisconsin PRAMS Murray Katcher, Ph.D., MD, Principal Investigator Katherine Kvale, Ph.D., Project Director: Katherine.Kvale@Wisconsin.gov Eleanor Cautley, Project Coordinator, OHI Kim González, Data Manager, OHI Kathryn Jones, Resource Technician, OHI Angela Rohan, Ph.D., CDC Assignee Protecting and promoting the health and safety of the people of Wisconsin