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National Center for Public Health Informatics
HL 7 Pleniary: Grid Enabled Public Health Services Dr. Leslie Lenert, Director, National Center for Public Health Informatics 5/12/2019
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CDC – CCHIS - NCPHI ________
Centers for Disease Control and Prevention (CDC) Coordinating Center for Health Information and Service (CCHIS) ________ National Center for Health Statistics National Center for Public Health Informatics (NCPHI) National Center for Health Marketing 5/12/2019
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CDC MISSIONS: Health Protection, Health Equity, and Organizational Excellence NCPHI MISSION: To protect and improve the public’s health and to promote health equity through science and service in health information technology and informatics 5/12/2019
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NCPHI: Guiding Principles
Public health/healthcare integration Application of best practices Applied science Emphasis Areas Public Health Practice Informatics Integration of Public Health with the National Health Information Network Consumer Health Informatics 5/12/2019
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Current State Overview
NCPHI is finishing significant transformation Newly established Center Management and leadership is developing Efforts aligning to dynamic environment Evolving health IT landscape Growing number and breadth of partners Expanding resource intensive regulatory requirements Increasing public scrutiny Standards Development Organizations Public Health Informatics Centers of Excellence CDC Programs NCPHI Office Of the National Coordinator (ONC) RHIOs HIEs Health Depts. Vendors / Consultants Academia HHS NIH AHIC FDA Hospitals 5/12/2019
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Strategic Themes Moving Forward
Science & Services Future Development & Operations Partnership & Collaboration Present Systems & Applications 5/12/2019
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Select Programs & Vision for the Future
Initiate Improve Expand Sustain Program Management Operations CDC Unified Process CDC Enterprise Architecture CDC Enterprise GIS Program CDC Enterprise GIS Program CDC Vocabulary Community of Practice NEDSS Platform Countermeasure and Response Administration Outbreak Management System Epi Info BioSense CDC Information Resources Governance NCPHI Organizational Excellence Planning Measurement, Evaluation & Improvement Research & Science Present 5/12/2019
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NCPHI’s Agenda Services Approach: Partnerships
Ontology modeling Vocabulary development Standards based messaging and data exchange Single sign-on access to diverse data sources Form and questionnaire generation and administration Data validation Case identification and decision support Natural language processing Geofencing and electronic quarantine Approach: Partnerships Internal (CDC and CCHIS) Cross-agency (FDA, AHRQ, etc.) Cross-Department (DHS, FCC, etc.) External (AHIC, State, local and territorial public health, RHIOs, etc.) Strategy: Collaboration Open Source Software Service Oriented Architectures Federated Systems Grid Computing Existing Proposed 5/12/2019
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Health Protection Framework
HAN PHIN Alerting OMS CRA (CIT/CAT) PHIN Vocabulary PHIN Messaging Surveillance systems (NEDSS) Data Information Knowledge Decisions Plans Actions HEALTH THREAT DEOC Call Down List PHIN Directory Data Warehousing Enterprise Geospatial Data Warehouse Monitoring (BIC) BioSense SiteScape (i.e. GIS Knowledge Base) Epi-X 5/12/2019
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Health Protection Framework Foundation
Actions Data Plans HEALTH THREAT Information Decisions Knowledge EDUCATION POLICY EVALUATION RESEARCH APPLICATIONS & SERVICES STANDARDS 5/12/2019
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Current Approach 5/12/2019
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Service Oriented Architectures for Public Health
Collaborative, Efficient, Agile PHIN Open Source Services 5/12/2019
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Modular Approach Demonstrated
Collaborative, Efficient, Agile 5/12/2019
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Modular Approach Demonstrated
Collaborative, Efficient, Agile 5/12/2019
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Goal State Collaborative, Efficient, Agile 5/12/2019
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Public Health Information Network Data Exchange
Provider State and Local Public Health PH Observation Report Msg. Case Report Criteria Standard Msg/Question/Forms NND Reporting Criteria NND Case Classification Messaging Standards Vocabulary Standards Syndrome Criteria Standard Messaging Public Health Observation Messages Public Health Case Reports CDC Data Warehouse Data Marts PHIN MS Broker Enterprise Applications 5/12/2019
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Decision Support as a Service on the grid
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Public Health Interface with Provider Community
PHIN Services Provider PH Standardized Vocabulary Message Data Marts Vocabulary Services PH Case Reporting Criteria Case Report Criteria State and Local NND Reporting PH Data Collection Forms Message Validation CDC Programs PH Case Report Msg. Public Health Interface Public Health Interface NND Condition Classification Case Filter Information Request Processing PH Case Information Request Knowledge Management Diff Dx PH Observation Report Msg. BioSense Syndromic Detection OMS Patient Records Case/Alert Information Exchange Outbreak Detection HAN 5/12/2019
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CDC Research on Reasoner Framework For Distributed Decision Support
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Foundation: A Public Health Ontology
OBX-3 OBX-17 SPM-4 OBX-8 OBX-7 OBX-5 Links to HL7 2.X for Compatibility 5/12/2019
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Message Classification
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Case Detection Algorithm applied between the data and its
Set of relationships Different types of relationships to other concepts DATA - Attributes or instances of the object Object Concepts in the Ontology Relationships to other objects 5/12/2019
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Integration of Public Health with Clinical Decision Support
DOH sends alert to community re Legionella cases in Parkchester community in the Bronx Practice Alert in EHR this center only if patient presents with cough – matched to order set to help provider with dx and tx of possible Legionella infection Cough 5/12/2019
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After entering his chief complaints of cough and fever, along with vital signs, a new BPA appears. This BPA has been set to trigger with chief complaint of cough for patients presenting at our Parkchester center only. 5/12/2019
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The physician who sees this alert can accept an order set configured specifically for evaluation and management of possible legionaire’s disease. By selecting the “accept” button, this order set (SmartSet) will appear… 5/12/2019
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Summary and Conclusions
Transforming environment demands public health integration with clinical information systems and regional health exchange. CDC HIE RFA points the way to new model for integration of clinical and public health services Move from a network to a grid with services published on the grid for various activities Public health activities well suited to grid implementation Potential synergies with clinical decision support. 5/12/2019
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Questions 5/12/2019
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BioSense 5/12/2019
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CRA Countermeasure Inventory Tool
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PHIN Vocabulary and Distribution System
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CDC Team (SiteScape) 5/12/2019
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