Public Health Informatics
Overview
Public health informatics is the systematic application of knowledge from multiple disciplines, notably information and computer science, to the data management and reporting requirements of public health. The term encompasses the conceptualization, design, development, implementation, deployment, maintenance and evaluation of information management systems tailored to specific public health functions.
Rapid, accurate and complete communication of health-related information is critical to public health and safety. Public health officials, clinicians and emergency responders rely on this information to diagnose, treat, prevent and control diseases and other health threats. Similarly, the public looks to it for guidance in making health decisions.
Even though public health information is so essential, public health laboratories commonly lack the capacity for electronic reporting and communication. A 2002 APHL survey of 47 state and local public health labs found that more than half could not report a deadly outbreak to state hospitals via email or "blast fax."
To address this issue and many others, the Association of Public Health Labortories is collaborating with many partners including the Centers for Disease Control and Prevention, the Public Health Informatics Institute and other non-profit public health organizations (ASTHO, NACCHO, CSTE, NAHDO, NAPHSIS) in defining data standards, assessing commercial LIMS vendor capabilities and promoting nationwide electronic data systems.
APHL’s Informatics Program aims to move public health laboratories to the cutting edge in the capture, processing and communication of laboratory information vital to public health. The program develops and promotes the use of data standards and LIM systems to streamline these processes and ensure that laboratories keep current with the rapid pace of technological change.
Accomplishments and Activities
PH LIMS Design Document
Building on the success of the comprehensive Requirements for Public Health Laboratory Information Management Systems document, APHL, the Public Health Informatics Institute, and various partners again convened in November 2003 to set in motion the first phase of a logical design for a Public Health Laboratory Information Management System (PHL-LIMS).
This logical design document translates the November 2003 requirements definition into a set of logical design specifications. From these specifications, a physical design can be developed that serves as a blueprint for physical implementation of a PHL-LIMS. The entire logical design, which includes this Phase 1 design document as well as a Phase 2 document to be released at a later date, is based on the 16 business processes identified in the requirements document.
Public Health Laboratories Interoperability Project (PHLIP)
Through PHLIP, participants from public health laboratory work groups in Colorado, Florida, Iowa, Michigan, Nebraska and Virginia focus on vocabulary and messaging among other aspects of information exchange among labs. They work to systematically summarize and categorize tests to improve data quality and information exchange and retrieval, reduce redundant efforts and assist with active surveillance.
On December 5, 2007, APHL consultant John Carroll presented the PHLIP program to the Capitol Hill Steering Committee on Telehealth and Healthcare Informatics. Carroll introduced the interoperability potential of PHLIP in context of the Steering Committee discussion on the new FCC Rural Health Care Pilot Program, an initiative to connect isolated regions with broadband telehealth networks. Read more.
Requirements Document for Public Health Laboratory Information (LIM) Systems
The bioterrorism events of fall 2001 highlighted the critical need of public health laboratories for efficient electronic LIM systems designed to meet their specific requirements.
LIM systems provide the infrastructure for public health laboratories to effectively log and accession specimens; unambiguously associate specimen data with epidemiological, clinical, and test result data; and electronically report findings to public health partners. In addition, a complete LIM system incorporates other business processes essential to internal functioning, such as billing, test quality control and assurance, reagent and kit/forms inventory control, etc.
Sixteen PHLs contributed their laboratory experience to the IT expertise of the Public Health Informatics Institute, while APHL and its Management Information Systems Committee provided coordination and oversight. The Requirements Document for Public Health Laboratory Information Management Systems is the result of that joint effort. To view this document, click here.
In 2007, PHII conducted an evaluation to assess the extent to which the LIMS project was successful in meeting its goals. Read The LIMS Project: Summary of Evaluation Findings.
PHIN
In March of 2000, the CDC invited APHL and other public health partners to co-sponsor a National Stakeholders Meeting on the National Electronic Disease Surveillance System (NEDSS) to advance the concept of integrated and interoperable surveillance systems at the local, state and federal levels. Soon after, the Public Health Information Network (PHIN) took shape to provide a unifying framework for public health informatics initiatives and to define shared data standards for the exchange of public health data.
In this effort, APHL collaborates with the Association of State and Territorial Health Officials (ASTHO), the Council of State and Territorial Epidemiologists (CSTE), the National Association of County and City Health Officials (NACCHO), the National Association of Health Data Organization (NAHDO) and the National Association for Public Health Information Systems (NAPHSIS).
CDC recently launched the Public Health Information Network to develop a single information network that will integrate, functionally and organizationally, public health partners across the nation. PHIN establishes technical and data standards, and work specifications and provides a process for developing and implementing specifications and standards. APHL is working with CDC to:
- Plan the annual Stakeholder’s Conference
- Publish supporting documents such as The Public Health Information Network: A Work in Progress
- Promote PHIN at conferences nationwide
- Train and coordinate with partner organizations.
Commercial Solutions for Public Health LIM Systems
In partnership with the Public Health Informatics Institute, APHL has identified and screened commercial vendor LIM system solutions. The vendor assessment, based on APHL’s Public Health Laboratory Requirements Document, is available as a benefit to APHL members. Over 200 commercial vendors were identified and evaluated via a questionnaire that weighted scores on each of the 500 requirements specifications identified. Vendors graded their products on how well they supported these specifications. Top vendors were selected by matching functional and technical requirements plus a pass/fail analysis of company and product literature.
The 2002 APHL Report on NEDSS
Advancing the National Electronic Disease Surveillance System: An Essential Role for Public Health Laboratories
Click here for the January, 2002, APHL report on NEDSS.
For more information, please contact:
Patina Zarcone, MPH
Director of Strategic Initiatives and Research
240.485.2788 | patina.zarcone@aphl.org
Links of Interest