2. INTRODUCTION

3. Motivation  Federal policy and others see interoperability as central  Interoperability is key to public health  Public health has a low level of representation in the national discourse  Public health is at risk at not getting its unique and important needs met  Doing work better  Achieving better population health in jurisdiction  Only public health professionals can advocate adequately for public health  Can we increase the participation of public health in this national discouse?

4. Outline  Present our conception of the business case for public health participation in national standardization efforts  Outline our plan for increasing participation  Present the development of a resource we are making publicly available  Demonstrate the use and updating of the resource

5. MAKING THE BUSINESS CASE

6. PHDSC PLAN FOR INCREASING PARTICIPATION

7. BUILDING THE “STORIES” RESOURCE

8. Interactive Model  Module 1 (M1): HIT Adoption’s Stories  Identifying and documenting best practices in HIT adoption in public health  Module 2 (M2): HIT Standards Resource Center  Educating the public health workforce on public health informatics and HIT standards  Module 3 (M3): Public Health Needs for HIT Projects  Identifying and documenting business processes and functional requirements for interoperable EHR-PH systems  Module 4 (M4): Public Health Participation in HIT Standardization Process  Developing on-line tools to enable local and state public health participation in the national HIT standardization process, including participating in on-line surveys, tracking participation, the experience with participation, and lessons learnt

9. Functional Requirements Analysis Specification Document (FRAD)  Goal  Participants  Actors, i.e., users - public health practitioners, clinicians, vendors  Functions  Actions, i.e., rolebased  Activities in relation to each module  e.g., Story submitter, reviewer, reader, etc.  Nonfunctional requirements  e.g., Content update schedule, role-based access to the web-site content revisions/updates  Software and hardware requirements  Evaluation plan  Timeline Bruegge B. and Dutoit A.H. Object-Oriented Software Engineering. Pearson Prentice Hall. Upper Saddle River, NJ. 2nd Edition. 1-172.

10. Method 1. Design of repository 2. Search by public-health knowledgeable searchers 3. Categorization by team members 4. Redesign 5. Publication

11. Method 1. Design of repository 2. Search by public-health knowledgeable searchers 3. Categorization by team members 4. Redesign 5. Publication

12. 1. Design: Entity-Relationship Diagram for Resource Database PHDSC Identifying and documenting best practices in HIT adoption in public health

13. Entity-Relationship Diagram for Resource Database PHDSC Identifying and documenting best practices in HIT adoption in public health Educating the public health workforce on public health informatics and HIT standards Identifying and documenting business processes and functional requirements for interoperable EHR-PH systems Developing on-line tools to enable local and state public health participation in the national HIT standardization process

14. Entity-Relationship Diagram for Resource Database: PHDSC

15. Method 1. Design of repository 2. Search by public-health knowledgeable searchers 3. Categorization by team members 4. Redesign 5. Publication

16. 2. Search by Searchers  Students at Johns Hopkins  Staff at HLN  Wide range of domains  Wide range of functions  Mostly domestic  Active Web site  Some documents

17. Method 1. Design of repository 2. Search by public-health knowledgeable searchers 3. Categorization by team members 4. Redesign 5. Publication

18. 3. Categorization  CDC Domain  Public Health Essential Function  Informatics function  Standardization phase  Standardization Activities

20. Domains: CDC +  Bioterrorism  Chronic Disease  Communicable Disease  Dental Health  Emergency Response  Environmental Health  Epidemiology  Global Health  Immunization Injury  Maternal and Child Health  Mental Health  Occupational Health  Public Health Informatics  Vital Statistics  Zoonotic, Vector-Borne, and Enteric

21. Business Processes: Public Health Essential Functions  Assess  Assure  Connect  Develop  Diagnose  Educate  Empower  Enforce  Evaluate  Exchange  Identify  Inform  Investigate  Manage  Mobilize  Monitor  Research

22. Informatics Functions  Analyze Data  Collect Data  Code Data  Generate Reports  Reminders, Notifications, Alerts, Summaries  Integrate Data  Manage Data  Store, Verify

23. Standardization Phases  Needs and Priorities  Standards Development  Standards Harmonization  Standards Trial Implementation (Testing)  Standardized HIT Products Certification  Standardized HIT Products Adoption

24. Standardization Activities  Identify domain need  Establish functional requirement  Develop spec  Identify overlap/gap  Resolve overlap/gap  Select standard  Implement standard  Test standard spec  Deploy standard  Establish compliance  Establish conformance  Certify HIT product

25. Entity-Relationship Diagram for Resource Database PHDSC Identifying and documenting best practices in HIT adoption in public health Educating the public health workforce on public health informatics and HIT standards Identifying and documenting business processes and functional requirements for interoperable EHR-PH systems Developing on-line tools to enable local and state public health participation in the national HIT standardization process

27. 3. Categorization  CDC Domains 15  Public Health Essential Functionx 17  Informatics functionx 6  Standardization phasex 6  Standardization Activitiesx 12  = a lot!

28. Method 1. Design of repository 2. Search by public-health knowledgeable searchers 3. Categorization by team members 4. Redesign 5. Publication

29. 4. Redesign  All systems, as well as those dependent on standards  While not exhaustive, accept multiple examples  Must be active (updated)  Must be interactive (not just a report)  Must be current  Must be accessible (not subscription)  Must have substantive information (not just “brochures”)

30. Method 1. Design of repository 2. Search by public-health knowledgeable searchers 3. Categorization by team members 4. Redesign 5. Publication

31. THE “STORIES” RESOURCE

32. For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.atsdr.cdc.gov