2. Objectives
• Provide an overview of community and
population health informatics.
• Describe informatics tools for promoting
community and population health.
• Define the roles of federal, state and local
public health agencies in the development
of public health informatics.
3. Using The Foundation of
Knowledge Model
• The collection and processing of
population health data creates the
information that becomes the basis for
knowledge in the field of public health.
• Knowledge about disease trends and other
threats to community health can improve
program planning, decision-making, and
care delivery.
4. Core Public Health Functions
• Assessment and monitoring of the health of
communities and populations at risk to identify
health problems and priorities;
• Formulation of public policies designed to solve
identified local and national health problems and
priorities;
• To assure that all populations have access to
appropriate and cost-effective care, including
health promotion and disease prevention
services, and evaluation of the effectiveness of
that care
5. Public Health Definitions
• The Institute of Medicine of Medicine (IOM)
defines the role of public health as “fulfilling
society’s interest in assuring conditions in which
people can be healthy”(IOM, 1988).
• Functions of public health include prevention of
epidemics and the spread of disease, protection
against environmental hazards, promotion of
health, disaster response and recovery, and
providing access to health care (PHDSC 1, 2006)
6. Community Health Risk
Assessment
• Risk assessment tools have been developed
to identify potentially harmful elements in
the environment also called a "threat and
risk assessment."
– “A "threat" is a harmful act such as the
deployment of a virus or illegal network
penetration.
– A "risk" is the expectation that a threat may
succeed and the potential damage that can
occur” (PCMAG, 2007).
7. Community Health Risk
Assessment, con’t.
• Estimate of current and future
exposures and if exposure will
pose health risks to a broad
populations
– are used to weigh the benefits and costs
of various program alternatives for
reducing exposure to potential hazards.
8. Four Basic Steps of
Risk Assessment
1. Hazard identification-- determine the
types of health problems could be caused
by exposure to a potentially hazardous
material.
2. Exposure assessment-- determine the
length, amount, and pattern of exposure
to the potentially hazardous material.
9. Four Basic Steps of
Risk Assessment, con’t
3. Dose–response assessment-- estimate of
how much exposure to the potential
hazard would cause varying degrees of
health effects.
4. Risk characterization-assessment of the
risk of the hazardous material causing
illness in the population. How much risk is
acceptable?
10. Examples of Risk
Assessment Tools
• Suicide Prevention Community Assessment Tool
(SPRC)
• Youth Risk Behavior Surveillance System (YRBSS)
• The Behavorial Risk Factor Surveillance System
(BRFSS)
• National Health and Nutrition Examination Survey
(NHANES).
11. Agency Support of Epidemiology
and the Monitoring of
Disease Outbreaks
• New technology can provide disease surveillance
for:
– timely investigation and
– identification of data needs to manage the public
health response to an outbreak or terrorist event.
• Surveillance uses health-related data that signal a
sufficient probability of a case or an outbreak that
warrants further public health response.
12. Preparedness in Public Health
• more timely detection of potential health
threats
• situational awareness
• surveillance
• outbreak management
• countermeasures
• response
• communications
13. Syndromic Surveillance
• Typically used to target investigations of
potential infectious cases,
• Can be used to detect possible outbreaks
associated with bioterrorism (CDC, 2007).
• Early detection of possible outbreaks can
be achieved through timely and complete
receipt, review, and investigation of
disease case reports, especially trend
reports.
14. Data Collection and
Interpretation
• Identification of absences from work or
school
• Increased purchases of health-care
products, including specific types of over-
the-counter medications
• Presenting symptoms to health-care
providers
• Laboratory test orders (CDC, 2007).
15. Networked Data Exchange
Systems
• PulseNet USA: A surveillance network for food-
borne infections.
• National Electronic Disease Surveillance System:
Facilitates reporting on approximately 100
diseases with data feeding directly from clinical
laboratories allowing for early detection.
• National Retail Data Monitor (NRDM) system--
collects data on over-the-counter medications and
other health care products from 28,000 stores
16. Data Exchange Systems
• Epidemic Information Exchange: A secure communication
system for practitioners to access and share preliminary
health surveillance information.
• Health Alert Network: A state and nationwide alert
system.
• Biosense: Provides improved real-time biosurveillance and
situational awareness in support of early detection.
• Public Health Information Network: Promotes standards
and software solutions for the rapid flow of public health
information.
17. Agency Support of Epidemiology and the
Monitoring Disease Outbreaks
• Information is vital to public health
programming.
• The data processed into public health
information can be from administrative,
financial and facility sources.
• Data on vital statistics from state and local
governments are also used for public
health purposes.
18. EHRs Promote Public Health
• Generate population-level alerts to be sent
to clinicians through these electronic
record/data exchange systems.
• Allow automated syndromic surveillance of
emergency department records and media
surveillance, promoting early detection of
potential pandemic occurrences.
19. Applying Knowledge to Health Disaster
Planning and Preparation
• The availability of data and speed of data
exchange can have a significant impact on
critical PH functions like disease monitoring
and syndromic surveillance.
• The future of PHI will offer real-time
surveillance data available electronically
and investigations and emergences will be
managed with the tools of informatics.
20. Informatics Tools to Support
Communication and Dissemination
• The revolution in IT has made the capture
and analysis of health data and the
distribution of healthcare information
more achievable and less costly.
• Two-way communication between public
health agencies, community: clinicians and
clinical laboratories can identify clusters of
reportable and unusual diseases.
21. Informatics Tools to Support
Communication and Dissemination
• PH information systems represent a partnership
of federal, state and local public health
professionals.
• Dissemination of prevention guidelines and
communication among PH officials, clinicians and
patients has become a major benefit of PHI.
• IT solutions can be used to provide accurate and
timely information that will guide public health
actions.
22. Using Feedback to Improve
Responses and Promote Readiness
• Improvement of community health status and
population health depends on effective public
and healthcare infrastructures.
• Population health data must be considered an
important part of the infrastructure of all regional
health information exchanges (RHIOs) which are
the building blocks for a national health
information network (NHIN).
23. Using Feedback to Improve
Responses and Promote Readiness
• A RHIO/NHIN can also support public
health goals through broader opportunities
for participation in surveillance and
prevention activities, improved case
management and care coordination, and
increased accuracy and timeliness of
information for disease reporting
(LaVenture, 2005).
24. Using Feedback to Improve Responses
and Promote Readiness
• Public health informatics strives to ensure that
health data systems will meet the data needs of
all organizations interested in population health
as national and international standards are dev
eloped for healthcare data collection.
• This includes standardization of environmental,
socio-cultural, economic and other data that are
relevant to population health (PHDSC, 2007).
25. Prevention Informatics
• Harnessing real-time social data and
aggregating and representing this data in a
meaningful way so that an appropriate
prevention response could be mounted
– Newer software tools to support mapping and
real-time data visualization include Riff and
Ushahidi, each “supporting gathering of
distributed data from the web and other data
streams
26. Crowd Sourcing
• Harnessing data from social media such as
Twitter and Facebook
– to improve response to mass disasters by
helping responders locate people who need
help and identify areas where to send
resources,
– build social capital and
– promote community resilience post-disaster.
27. Thought Provoking Questions
• Imagine that you are a public health informatics specialist
and you and your colleagues have determined that the
threat of a new strain of influenza indicates a need for a
mass inoculation program.
• What public health data would have been used to
determine the need for such a program and
• What data will be collected to determine the
success of such a program?
• What are the advantages and disadvantages of using
crowdsourced Social Media data during disaster
response?
