Public Health Informatics

1. Public Health Informatics Donald Steinwachs, Ph.D. Dept Hlth Policy and Mngt Johns Hopkins Bloomberg School of Public Health

2. Perspectives • Goal of public health informatics • What problems will informatics solve? • Training of leaders in public health informatics • What will their role be in public health? • Training at Johns Hopkins • What do we need to provide?

3. Vision for Health Statistics Enterprise: Overarching Conceptual Framework (Dr. Daniel Friedman) …helps to maintain a focus on needed data and guides the health statistics enterprise. • Focuses on health, the population, and the community • Emphasizes distribution and level of health • Delineates major influences on health • Defines research agenda for improving the population’s health

4. Influences on the Population’s Health

5. State Health Data • Many data systems with limited scope and purpose • Limited capacity for linkage of data • Lack of framework for integrating information from different data systems • Result is little information relevant for the public’s health

6. Archetypical State Data Systems • Claims and billing • AIDS treatment • Breast and cervical cancer prevention programs • Dental • Early Intervention • Emergency Medical Services • Family Planning • Medicaid • Acute care • Clinics • Hospitals • Individual providers • Long term care • Substance abuse services • Tobacco prevention • WIC • Client case management • AIDS Drug Assistance Program • Child and adolescent service encounters • Early Intervention • Family Planning • Healthy Start • Homecare and hospice • Medicaid eligibility • Pediatric nutrition services • Refugee and immigrant health • School health • Services for children with special health care needs • Substance abuse • WIC

7. Archetypical State Data Systems • Cost reports • Ambulatory care centers • Bad debt and free care • Home health agencies • Hospitals • Mental health centers • Neighborhood health centers • Nursing homes • Substance abuse services • Encounters • Ambulatory surgery • Cardiac surgery • Emergency departments • Hospital discharges

8. Archetypical State Data Systems • Facility surveys and reports • Abuse reports • Home health • Hospitals • Nursing homes • Annual surveys • Ambulatory care • Home health • Hospitals • Mental health • Neighborhood health centers • Nursing homes and long term care facilities • Substance abuse services • Health care facility complaints • Medical errors • Environmental health • Asthma • Emissions Inventory System • Environmental exposure reports • Food monitoring • Ground water and solid waste information system • Hazardous substance emergency reports • Hazardous waste information reporting system • Radon assessments • Restaurant monitoring • Swimming pool and bathing beach water quality • Water quality

9. Archetypical State Data Systems • Occupational health • Census of Fatal Occupational Injuries • Fatal Accident Circumstances Evaluation system • Sentinel Event Notification System for Occupational Risks • Survey of Occupations and Industries • Population based surveys • Behavioral Risk Factor Surveillance Systems • Community health • HIV Family of Seroprevalence Surveys • Insurance coverage • Pregnancy Risk Assessment Monitoring System • Smoking and tobacco use • Youth Risk Behavior Survey • Youth substance abuse

10. Archetypical Problems (Dr. Friedman) 152 data sets: • Unifying conceptual framework? • Population health focus • Models of population • Inter-operability? • Common identifiers • Common definitions • Common content • Common codes • Common transaction standards • Communication among. . . ? • Data providers • Data collectors • Data analysts

11. Training Opportunities in Public Health Informatics • Master’s level • Capacity to use PH-MIS to answer management and policy questions • Capacity to design effective PH-MIS • Doctoral level • Research into applications and extensions of MIS to address PH program and policy issues; including linkage of MIS to other data sources

12. Demand for PH-MIS professionals • Current MIS infrastructure in PH is relatively weak and investments are modest • Capacity to use MIS more effectively in management and policy likely to be valued • May be able to attract students to minor in PH informatics, and a few to major in it. • Not clear where PH-MIS jobs in public health will be most available

13. Johns Hopkins Offerings • Courses • Tracking of Health of Populations • Informatics in Public Health • Health Management Information Systems (MIS) • Health Information Privacy and Policy • Goal: Develop a certificate in PH Informatics that would be available to MPH students, and to professionals for continuing education

14. Future • PH and medicine are information intensive • NHII and LHII can provide new capacity for PH surveillance, analysis, and intervention • Need to go beyond medicine and morbidity, to understand factors affecting health • Transformation of PH will be when we move from mortality statistics to health statistics

15. Archetypical State Data Systems • Licensures, health professionals • Acupuncturists • Adult care home administrator • Asbestos abatement technicians • Audiologists • Dentist • Dental hygienist • Dietitian • Emergency medical technicians • Lead abatement technicians • Nurse • Nurse midwife • Nursing home administrator • Optometrists • Pharmacist • Physical therapists • Physician • Physician assistant • Podiatrists • Veterinarians