Informatics and Public Health: Research Challenges

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• Informatics and Public Health Research
  Challenges

Bonnie L. Westra, RN, PhD Assistant Professor,
UMN, SON Robert Wood Johnson Executive Nurse
Fellow
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Purpose

• Explore the Relationship Between Informatics and
  Public Health
• Discuss the Local/ National Context for
  Informatics
• Examine Research Challenges

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Informatics
Discipline Science Nursing Science Public Health
Science
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Health Care Problems

• Health Care Costs - 1.7 Trillion (CMS Est. 3.6
  Trillion Estimated in 2014)
• IOM Estimates 44,000 98,000 Die Annually Due to
  Medical Error
• 777,000 Injured or Die Annually from Adverse Drug
  Events
• 300 Billion Treatments that May Not Improve or
  are Redundant or Inappropriate
• Administrative Inefficiencies Reduced Through
  EHRs/ IS Could Save 78 to 112 Billion Annually

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NHIN Initiative

• 1998 National Committee on Vital and Health
  Statistics (NCVHS) National Health Information
  Initiative (NHII)
• 2002 Markle Connecting for Health
• 2003 Consolidated Health Information (CHI)
• 2004 - Executive Order
• Office for the National Coordinator for Health
  Information Technology (ONCHIT)
• Dr. David Brailer
• E-health Initiative
• Strategic Framework for Action
• Includes PHIN

Interconnect Clinicians
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Public Health Information Network(PHIN)

• Define And Document The Systems For Public Health
• Identify Industry Standards To Make Systems Work
  Together
• Develop Specifications To Make Standards Work For
  Public Health
• Establish Tools And Components That Support
  Standards-based Systems
• Support Certification For Interoperability

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Minnesota

• E-health Initiative
• Statewide Public-Private Collaborative
• Improve Health and Safety
• Accelerate Implementation of Health Technology
• Forming One/More Regional Health Information
  Organizations (RHIOs)
• MN-PHIN Strategic Action Plan January 2005
• Part of E-health Initiative
• Focus Is On Public Health Specifically
• Public Health Essential Functions

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Environment
Martin, K. Omaha System, 2005
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Public Health Nursing Knowledge

• Human GD across the lifespan
• Family development
• Antepartum /Postpartum
• Parenting
• Health promotion All Ages
• Chronic disease prevention and management
• Injury prevention
• Violence prevention
• Chemical health issues and/or behaviors
• Mental Health
• Death and dying grief and loss

• Human sexuality
• Family planning
• Nutrition
• Disaster and bioterrorism response
• Disease prevention and control,
• Immunizations across the lifespan
• Environmental Health and Safety
• Technical Nursing Skills
• Medication admin/ mngmt
• Health determinants
• Social and market justice

http//www.health.state.mn.us/divs/chs/phn/HenrySt
reetProject.htm
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Public Health Intervention Wheel
MDH Center for Public Health, 2003
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Nursing Data
NMDS NMMDS
ICNP SNOMED Ct
Omaha System CCC NANDA NIC NOC
Patient Care Data Set Perioperative Nursing Data
Set ABC Codes LOINC
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Public Health Data

• Laboratory (LIMS)
• Immunization (MIC)
• Communicable Disease Reporting (NEDS)
• MCH Data (TANF/ MCH Outcomes)
• Silos of Data
• Essential Functions of Public Health Omaha
  System Proposed

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Public Health Information Systems

• EHR Vendors
• State/ National Efforts
• LIMS, MIC, NEDS
• Many Silos
• No Specifications for Business Processes to
  Adequately Describe Public Health
• PHN

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Evidence-Based Practice - PH

• Scientific Evidence for Public Health
• Synthesize Into Evidence-Based Guidelines
• Imbed into Information Systems
• Decision-Support Systems
• Guidelines
• Alerts

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Informatics Knowledge Development

• Existing Scientific Methodologies
• Quantitative
• Qualitative
• Newer Methodologies Emerging
• Knowledge Discovery in Databases (KDD)
• Decision Trees
• Bayesian Networks
• Neural Networks
• Text Mining

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Challenges

• Standardized Terminology for Public Health
• Identify Business Processes for IS Functional
  Requirements
• Evidence-Based Practice
• Assure Quality Information
• Reuse Data for Research