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From Numbers to Outcomes: Data Resources for Public Health- PCCM/MH

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by Meg Harris on 15 November 2013

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Transcript of From Numbers to Outcomes: Data Resources for Public Health- PCCM/MH

From Numbers to Outcomes: Data Resources for Public Health
Creating a Common Understanding
Dataset: A dataset is a collection of records, electronic or paper-based, organized for a particular purpose. Some small datasets could logically be grouped together. For example, several datasets about food-borne outbreaks could be grouped together because, even though each dataset tracks an independent outbreak, all of the datasets contain essentially the same kind of information.
Making the Transition


What system changes are needed for public health agencies to meet effectively the information needs of its community partners?

How do we keep pace with the growing demands to electronically exchange information with physicians, hospitals, and other public health agencies?

And how do we, within the public health agency, ensure we are
maximally collecting and utilizing data to provide our best community service?
Iowa Department of Public Health
Data Management
Meg Harris, MPH, MPA
515-725-2179
meghan.harris@idph.iowa.gov
Informatics in the Public Sector
IDSS
IRIS
CAReS
Stellar
Trauma
Registry
Newborn
screening
Birth
Registry
Death
Registry
EHDI
IRCID
I-Smart
CAREWare
Brain, Spinal,
Farm Injury
PRAMS
PNSS
SHR/SEER
WHIS
e-HARS
HIV/AIDS
CFY
EMS Patient
Registry
IWIN
IDSS
IRIS
CAReS
Stellar
Trauma
Registry
Newborn
screening
Birth
Registry
Death
Registry
CDR
EHDI
IRCID
I-Smart
CAREWare
Brain, Spinal,
Farm Injury
Inpatient/Outpatient
Database
PRAMS
PNSS
SHR/SEER
WHIS
e-HARS
HIV/AIDS
CFY
EMS
Registry
IWIN
Child Death
Registry
Birth
Death
BRFSS
Census
What we had in the warehouse
SID
Child Blood Lead
Cancer
Birth Defects
Poverty
Housing
Water Quality
Air Quality
Birth Death BRFSS
SID Census
What we have in the Public Health Tracking Portal
Public Health Informatics
The systematic application of information and
computer science and technology to public health
practice, research, and learning.

Information System
This term refers to a business application of the computer. It is made up of the database, application programs, as well as manual and machine procedures. It also encompasses the computer systems that do the processing. The database stores the subjects of the business (master files) and its activities (transaction files). Application programs provide the data entry, updating, query, and report processing. Examples of public health information systems include cancer surveillance, immunization registries, disease surveillance, and vital records.
Interoperability
The ability of information technology systems from various programs and software applications to communicate, to exchange data accurately, effectively, and consistently, and to
What about Healthcare?
Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 established funding for sharing specified EHR data with public health authorities (part of AARA)
Health Insurance Portability and Accountability Act of 1996 (HIPAA) Standards for Privacy of Individually Identifiable Health Information (Privacy Rule) established national legal authority permitting, though not requiring,
“covered entities” to transmit individually identifiable health information from EHRs and health care transactions to public health authorities
1) Population coverage
What is Needed from Healthcare?
1) Requires new legal authority
What is Needed from Public Health?
Develop a nationwide interoperable health information technology infrastructure that:
(a) Ensures that appropriate information to guide medical decisions is available at the time and place of care;
(b) Improves health care quality, reduces medical errors, and advances the delivery of appropriate, evidence-based medical care;
(c) Reduces health care costs resulting from inefficiency, medical errors, inappropriate care, and incomplete information;
(d) Promotes a more effective marketplace, greater competition, and increased choice through the wider availability of accurate information on health care costs, quality, and outcomes;
(e) Improves the coordination of care and information among hospitals, laboratories, physician offices, and other ambulatory care providers through an effective infrastructure for the secure and authorized exchange of health
care information; and
(f) Ensures that patients’ individually identifiable health information is secure and protected.
Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator 2004
IDPH Taking Steps Forward
Dataset catalog
Applications catalog
Disaster recovery
Policies and procedures
Significant potential exists to better assess healthcare utilization, community health, tracking of medical treatments and interventions, the burden of disease, as well as to support substantial improvements in healthcare and in identifying cost-effective treatments through the use of data available through the IHIN.
In the next several years, efforts should be focused on enrollment in the IHIN and use of IHIN data for purposes of improving clinical healthcare for individual Iowans.
In the meantime, stakeholders and policymakers should monitor the use of the IHIN data for clinical improvement of healthcare at both the system and community level to ensure that the system is positively contributing to population-based improvements in the local delivery healthcare delivery system.
Once the IHIN approaches a completely functioning exchange with a sufficient majority of the State’s population and providers invested in the technology, system, and processes, policymakers should conduct a thorough evaluation of the
feasibility of developing either a centralized query or repository system to enable access to IHIN data for research, and the costs associated with its development and ongoing operation.
Intersections- Iowa Health Information Network
"Let the
dataset
change your
mindset
."- Hans Rosling

"Several scientific and medical investigators eventually concluded that one of the likely sources of the outbreak was sewage leaking from a U.N. base housing Nepalese peacekeepers. The base was perched above a tributary stream leading into the Artibonite River near the town of Meille."
U.N. sued for 'bringing cholera to Haiti,' causing outbreak that killed thousands
By Ivan Watson and Joe Vaccarello, CNN
updated 11:36 AM EDT, Thu October 10, 2013
U.N. sued for “bringing cholera to Haiti,” causing outbreak that killed thousands. (n.d.). CNN. Retrieved October 29, 2013, from http://www.cnn.com/2013/10/09/world/americas/haiti-un-cholera-lawsuit/index.html
BBC. (2010). The Joy of Stats. Wingspan Productions.
Calman, N. (2012). Strengthening Public Health and Primary Care Collaboration Through Electronic Health Records. American Journal of Public Health, 102(11), e13. doi:10.2105/AJPH.2012.301000
Ellsworth Fritz, J., Rajamani, P., & LaVenture, M. (2009). Minnesota Public Health Informatics Planning Toolkit. Public Health Informatics Institute.
Public Health Data Standards Consortium. (n.d.). Retrieved from http://www.phdsc.org/
Office of the National Coordinator for Health Information Technology. (2013). Adoption of electronic health record systems among U.S. non-federal acute care hospitals: 2008-2012 (No. 9). Retrieved from http://www.healthit.gov/sites/default/files/oncdatabrief9final.pdf
Friedman, D. J., Parrish, R. G., & Ross, D. A. (2013). Electronic health records and US public health: Current realities and future promise. American journal of public health, 103(9), 1560–1567.
Lenert, L., & Sundwall, D. N. (2012). Public health surveillance and meaningful use regulations: A crisis of opportunity. American Journal of Public Health, 102(3), e1–e7. doi:10.2105/AJPH.2011.300542
Rosling, H. (2006). Making sense of too much data. TED. Retrieved from http://www.ted.com/playlists/56/making_sense_of_too_much_data.html
Hsiao, C.-J., & Hing, E. (2012). Use and characteristics of electronic health record systems among office-based physician practices, United States, 2001-2012. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Retrieved from http://198.246.124.29/nchs/data/databriefs/db111.pdf

References
Inpatient/ Outpatient
Database
CDR
Child Death
Registry
Public Health Tracking
2) Reporting standardization
3) Reporting on individuals over life course
4) Standard measures of factors influencing population health must exist
2) Data and transmission standards
3) Public and political acceptance of new uses of electronic health records
4) Capacity to receive and analyze data
Data Steward: responsible for providing data content, context, and associated rules for interpretation of each data source. The data steward(s) serves as an intermediary between the data owner and data custodian. Data stewards have the responsibility of ensuring that the appropriate steps are taken to protect the data and that respective policies and guidelines are being properly implemented. Data Owner and Steward might be the same person.
Data Custodian: Responsible for the technical environment and database structure that hosts data. The custodian for IDPH data may be indicated by statute (i.e., State Registrar of Vital Records); however, the physical custodian for the majority of IDPH data is the Bureau of Information Management and Bureau of Health Statistics.
Data Owner: The data owner may authorize or deny access to certain data within IDPH, and is responsible for accuracy and integrity of the data and timely response to data inquiries.
Information Consumer
Information Broker
Public Health Tracking
Iowa Health Information Network
Iowa Health Information Network
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