1. Informatics in Public Health William A. Yasnoff, MD, PhD Public Health Practice Program Office Centers for Disease Control and Prevention

2. Public Health in 2010 DEMONSTRATION

3. Barriers to IT in Public Health A.Information B.Infrastructure C.Informatics

4. A. Information Surveillance data –Only 15-20% of reportable cases reported –Delays of days to weeks –Not typically in electronic form Other relevant data not electronically available –Environmental, injury, etc. –Guidelines –Contacts –Training materials

5. Information: Work in Progress NEDSS = National Electronic Disease Surveillance System –Architectural elements –Public health conceptual data model Knowledge management –Preventioneffects.net –Encoding of clinical guidelines Disseminate through EMRs Point-of-care reminders

6. B. Infrastructure Information technology –Only 48.9% of local health departments have high-speed continuous internet connections (NACCHO, 1999) Workforce –83% of local health departments indicate that computer training is a key need (NACCHO, 1996)

7. Infrastructure: Work in Progress INPHO = Information Network for Public Health Officials (state) –Ending in FY2001 HAN = Health Alert Network (local) Frist-Kennedy authorization –Infrastructure standards/ assessment –Preparedness of public health system

8. Health Alert Network Goals Ensure communications capacity at all local and state health departments (full Internet connectivity, training) Ensure capacity to broadcast and receive health alerts at every level Ensure capacity to receive distance learning offerings for CDC, et al. Ensure communications capacity at all local and state health departments (full Internet connectivity, training) Ensure capacity to broadcast and receive health alerts at every level Ensure capacity to receive distance learning offerings for CDC, et al.

9. Map HAN & Local Centers for Public Health Preparedness Funded Sites - FY 2000 HAN & Local Centers for Public Health Preparedness Funded Sites - FY 2000 HAN States (N=37) Local CPHP counties (N=3) HAN Cities (N=3) Not funded

10. Equip all full-function local PH systems with: Improved Internet access 55% now have continuous high-speed Internet capacity Health alert broadcast capacity 56% now have a system for sending urgent health alerts Provide informatics training Develop critical information content Equip all full-function local PH systems with: Improved Internet access 55% now have continuous high-speed Internet capacity Health alert broadcast capacity 56% now have a system for sending urgent health alerts Provide informatics training Develop critical information content Communications Capacity

11. Map

13. l Distance learning capacity at state/local public health agencies n 82% of LHDs now have access to satellite downlink within 30 minutes drive-time from work l Distance learning capacity at state/local public health agencies n 82% of LHDs now have access to satellite downlink within 30 minutes drive-time from work Distance Learning/Training

14. Map

15. Transition to web-based distance learning Increased capacity at CDC Web-based informatics course Training in bioterrorism preparedness USAMRIID/CDC course, BT Grand Rounds, Role of Clinical Lab, et al. Transition to web-based distance learning Increased capacity at CDC Web-based informatics course Training in bioterrorism preparedness USAMRIID/CDC course, BT Grand Rounds, Role of Clinical Lab, et al. Distance Learning/Training

16. Provide informatics training Annual Conference on Public Health Informatics and Distance Learning Public Health Informatics course given to 120 people, including most HAN project managers Provide informatics training Annual Conference on Public Health Informatics and Distance Learning Public Health Informatics course given to 120 people, including most HAN project managers Distance Learning/Training

17. Website Development Completed CDC BT Preparedness and Response Website (www.bt.cdc.gov) Health Alert Network Website (www.phppo.cdc.gov/han) Under Development BT Emergency Response Restricted Website HAN Today Website Completed CDC BT Preparedness and Response Website (www.bt.cdc.gov) Health Alert Network Website (www.phppo.cdc.gov/han) Under Development BT Emergency Response Restricted Website HAN Today Website

18. HAN Emergency Notification System Functions Rapidly alert key State Public Health officials of bioterrorist events or other emergent health threats via email and fax Provide official CDC communications to key State Public Health officials during a bioterrorist event via email and fax Functions Rapidly alert key State Public Health officials of bioterrorist events or other emergent health threats via email and fax Provide official CDC communications to key State Public Health officials during a bioterrorist event via email and fax

19. HAN Plans for FY 2001 Expand web-based learner support system Partner with HRSA to develop and disseminate national standards for information and communication systems needed in a BT emergency 75% of full functioning LHDs have Internet connectivity, 50% have broadcast alert capability, and 80% have satellite-based distance learning capacity Disseminate a communications plan regarding rapid relay of information Expand web-based learner support system Partner with HRSA to develop and disseminate national standards for information and communication systems needed in a BT emergency 75% of full functioning LHDs have Internet connectivity, 50% have broadcast alert capability, and 80% have satellite-based distance learning capacity Disseminate a communications plan regarding rapid relay of information

20. C. Informatics Definition: the systematic application of computer & information science and technology to public health practice, research, and learning Management skills –IT projects expensive and high risk –Interdisciplinary teams required –New skills needed by public health managers

21. Public Health Informatics: Developing a National Agenda Spring AMIA Meeting May 15-17, 2001 in Atlanta ( www.amia.org ) Bringing together medical informatics and public health communities Areas of focus: funding; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; training/workforce Primary sponsor: RWJ Foundation

22. Informatics Training - 1 Development of consensus competencies –Meeting prior to Spring AMIA (Richards & O’Carroll) –Multiple tracks expected: basic/managers/senior managers –Goal is sample curriculum for SPH Book: Public Health Informatics and Information Systems (Aspen Press, 2002) –Suitable for teaching PHI –Includes case studies

23. Public Health Informatics Competency Categories Information Access IT infrastructure view Information system development Networking & database design Standards Privacy, Confidentiality & Security IT planning and procurement IT leadership; managing change

24. Informatics Training - 2 CDC short (3 day) course for public health managers –Developed in ’96-’97 –Interactive web version later this year CDC Fellowship –Two year program started in ’96 –Still evolving Schools of Public Health –Courses (at least 11 now; more planned) –Degree programs in early stages

25. Informatics in Public Health: The Future Information Access –Databases –Knowledge management Information Systems –Effective management –Improved productivity Surveillance integrated with EMR Feedback to providers

26. For Further Information William A. Yasnoff, MD, PhD 770/488-2503 WYasnoff@cdc.gov