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Informatics and Public Health: Research Challenges

Informatics and Public Health: Research Challenges. Bonnie L. Westra, RN, PhD Assistant Professor, UMN, SON Robert Wood Johnson Executive Nurse Fellow. Purpose. Explore the Relationship Between Informatics and Public Health Discuss the Local/ National Context for Informatics

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Informatics and Public Health: Research Challenges

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  1. Informatics and Public Health: Research Challenges Bonnie L. Westra, RN, PhD Assistant Professor, UMN, SON Robert Wood Johnson Executive Nurse Fellow

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

  3. Informatics Discipline Science Nursing Science Public Health Science

  4. 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 Thompson, T.G., Brailer, D.J. (July 21, 2004). The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care: Framework for Strategic Action. ONCHIT: http://www.os.dhhs.gov/healthit

  5. 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 Thompson, T.G., Brailer, D.J. (July 21, 2004). The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care: Framework for Strategic Action. ONCHIT: http://www.os.dhhs.gov/healthit

  6. 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 CPHIN Architecture. (n.d.) Center for Disease Control. Retrieved June 1, 2005 from http://www.cdc.gov/phin/architecture/index.html.

  7. Minnesota • E-health Initiative • Statewide Public-Private Collaborative • Improve Health and Safety • Accelerate Implementation of Health Technology • Forming One/More Regional Health Information Organizations (RHIO’s) • MN-PHIN Strategic Action Plan – January 2005 • Part of E-health Initiative • Focus Is On Public Health Specifically • Public Health Essential Functions Minnesota Department of Health. (January 2005). MN-PHIN Roadmap & Recommendations for Strategic Action, Retrieved May 31, 2005 from www.health.state.mn.us.

  8. Collect and assess data Evaluate problem outcome State problem Individual Family Community Population Identify admission problem rating Identify interim Disch problem rating Relationship Plan and intervene Clinician Client Environment Martin, K. Omaha System, 2005

  9. Human G&D 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 Public Health Nursing Knowledge http://www.health.state.mn.us/divs/chs/phn/HenryStreetProject.htm

  10. Public Health Intervention Wheel MDH Center for Public Health, 2003

  11. Nursing Data NMDS NMMDS ICNP SNOMED Ct Omaha System CCC NANDA NIC NOC Patient Care Data Set Perioperative Nursing Data Set ABC Codes LOINC

  12. 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

  13. 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

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

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

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

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