Using I.T. to Enhance Public Health Practice and Impact Outcomes

Submitted By

Informatics Workgroup Chairs Joseph Gibson and Oscar Alleyne
Marion County Public Health Department and Rockland County Department of Health, Indiana and New York
June 30, 2015

Informatics sounds like the name of a class that would put any junior in high school to sleep, and the term is often elusive even to those who work in the field of public health. But the reality is reasonably straightforward given that we live in a world driven by technology where we expect to have information electronically at our fingertips in a moment. Informatics brings to mind complicated algorithms and complex technology, but it simply refers to the use of information technology (I.T.) to improve a business process or outcome. For public health, this means the use of I.T. to enhance public health practice and impact outcomes.

For example, data from emergency rooms, ambulatory settings, and even social media is being used to supplement traditional disease surveillance methods. This includes syndromic surveillance, which can monitor potential outbreaks in near real time. Syndromic surveillance includes a range of tools and strategies—from emergency rooms reporting symptoms experienced by a patient in order to detect outbreaks to monitoring for potential bioterrorism events to tracking the side effects from a disaster like the 2010 oil spill in the Gulf of Mexico.

In general, public health departments face many challenges, such as finding consistent funding while fighting the crisis du jour, the diminishing workforce in the public sector, and facilitating collaboration among experts across their silos of information and money. These challenges often make modernizing an I.T. infrastructure a secondary priority. Even if this is not the case, challenges arise when working to develop public health informatics: who owns my data? Will a hospital exchange information with us? Is this data secured, thereby protecting an individual’s privacy? Health departments have to balance the variety of strategies, rules, and approaches across jurisdictional lines with a system-wide vision.

But amid all of the challenges lay great opportunities for the development of data systems and processes to make public health more responsive and effective. The push for improved informatics at local health departments (LHDs) is being championed by the NACCHO Informatics and Biosurveillance Workgroups-- individuals representing LHDs across the country who convene to enact their trifold mission: 1) assert the LHDs perspective in relevant national discussions (“a seat at every table”), 2) empower LHDs in the field of informatics, and 3) inform LHDs based on a two-way exchange of information. These workgroups met in person in April 2015 to reassess and recommit to their mission and vision.

The Informatics Workgroup set up a list of activities that would help develop LHD informatics capacity. For example, they plan to develop the business case for informatics. This business case will be a resource for leaders to justify the investment in informatics and offer guidance on how to implement an informatics program. Also, the Informatics Workgroup is overseeing the development of the “Informatics Champions Initiative,” which is a network of LHD staff interested and working in public health Informatics. This nationwide group will ensure that information can be shared in an effective way that empowers people working in the field.

The Biosurveillance Workgroup, which includes epidemiologists, public health nurses, and public health officers, addressed the value of syndromic surveillance to LHDs, and the ways LHDs can benefit as users of enhanced surveillance systems. They developed a mission and vision for the coming years, and the process involved enthusiastic discussions about the role of syndromic surveillance in public health. The group emphasized the growing importance of shared data and access to information that extends to state and local health departments. The conversation also involved discussion of how data systems will become more interconnected and involve growing quantities of quality data, and what that means as both a challenge and opportunity for public health decision making.

Better informatics infrastructure, including expanded surveillance opportunities, represent the future of a more responsive and effective public health effort. Ongoing advocacy and front-line efforts from individuals like those represented in the Biosurveillance and Informatics Workgroups are key to these changes. Their work continues and, with luck, next year’s in-person meeting will be a reflection on great work done and another opportunity to be inspired about the possibilities ahead.

Written in collaboration with NACCHO Informatics Staff Christina Baum, Matthew Deleon, and Sarah Chughtai

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