Transcript LIFESPAN Home Health, Hospice, and Home Medical Equipment

Informatics and Public Health:
Research Challenges
Bonnie L. Westra, RN, PhD
Assistant Professor, UMN, SON
Robert Wood Johnson Executive Nurse Fellow
Purpose
Explore the Relationship Between Informatics
and Public Health
Discuss the Local/ National Context for
Informatics
Examine Research Challenges
Cognitive
Science
Informatics
Computer
Science
Information
Science
Discipline Science
Nursing Science
Public Health Science
Health Care Problems
Health Care Costs - $1.7 Trillion (CMS Est. $3.6
Trillion Estimated in 2014)
IOM Estimates 44,000 – 98,000 Die Annually Due to
Medical Error
777,000 Injured or Die Annually from Adverse Drug
Events
$300 Billion – Treatments that May Not Improve or
are Redundant or Inappropriate
Administrative Inefficiencies Reduced Through
EHRs/ IS Could Save $78 to $112 Billion Annually
Thompson, T.G., Brailer, D.J. (July 21, 2004). The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care: Framework for
Strategic Action. ONCHIT: http://www.os.dhhs.gov/healthit
NHIN Initiative
1998 National Committee on Vital and
Health Statistics (NCVHS) National Health
Information Initiative (NHII)
2002 Markle Connecting for Health
2003 Consolidated Health Information
(CHI)
2004 - Executive Order
– Office for the National Coordinator for
Health Information Technology (ONCHIT)
– Dr. David Brailer
– E-health Initiative
– Strategic Framework for Action
– Includes PHIN
Clinical
Care
Interconnect
Clinicians
Population/
Health
(PHIN)
Personal
Care
Thompson, T.G., Brailer, D.J. (July 21, 2004). The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care: Framework for
Strategic Action. ONCHIT: http://www.os.dhhs.gov/healthit
Public Health Information Network
(PHIN)
Define And Document The Systems For Public
Health
Identify Industry Standards To Make Systems
Work Together
Develop Specifications To Make Standards
Work For Public Health
Establish Tools And Components That Support
Standards-based Systems
Support Certification For Interoperability
CPHIN Architecture. (n.d.) Center for Disease Control. Retrieved June 1, 2005 from http://www.cdc.gov/phin/architecture/index.html.
Minnesota
E-health Initiative
– Statewide Public-Private
Collaborative
– Improve Health and Safety
– Accelerate Implementation of Health
Technology
– Forming One/More Regional Health
Information Organizations (RHIO’s)
Research/
Policy
Clinical
Consumer
MN-PHIN Strategic Action Plan –
January 2005
– Part of E-health Initiative
– Focus Is On Public Health
Specifically
– Public Health Essential Functions
Public
Health
MN-PHIN
Minnesota Department of Health. (January 2005). MN-PHIN Roadmap & Recommendations for Strategic Action, Retrieved May 31, 2005 from www.health.state.mn.us.
Collect
and assess
Evaluate
data
State
problem
outcome
Individual
problem
Family
Community
Identify interim Population
Disch problem
rating
Plan and
intervene
Identify
admission
problem
rating
Martin, K. Omaha System, 2005
Public Health Nursing Knowledge
Human G&D across the lifespan
Family development
Antepartum /Postpartum
Parenting
Health promotion: All Ages
Chronic disease prevention and
management
Injury prevention
Violence prevention
Chemical health issues and/or
behaviors
Mental Health
Death and dying; grief and loss
Human sexuality
Family planning
Nutrition
Disaster and bioterrorism
response
Disease prevention and control,
Immunizations across the lifespan
Environmental Health and Safety
Technical Nursing Skills
Medication admin/ mngmt
Health determinants
Social and market justice
http://www.health.state.mn.us/divs/chs/phn/HenryStreetProject.htm
Public Health Intervention Wheel
MDH Center for Public Health, 2003
Nursing Data
NMDS
ICNP
Omaha System
CCC
NANDA
NIC
NOC
SNOMED Ct
NMMDS
Patient Care Data Set
Perioperative Nursing Data Set
ABC Codes
LOINC
Public Health Data
Laboratory (LIMS)
Immunization (MIC)
Communicable Disease Reporting (NEDS)
MCH Data (TANF/ MCH Outcomes)
Silos of Data
Essential Functions of Public Health – Omaha
System Proposed
Public Health Information Systems
EHR Vendors
State/ National Efforts
– LIMS, MIC, NEDS
Many Silos
No Specifications for Business Processes to
Adequately Describe Public Health
– PHN
Evidence-Based Practice - PH
Scientific Evidence for Public Health
Synthesize Into Evidence-Based Guidelines
Imbed into Information Systems
– Decision-Support Systems
– Guidelines
– Alerts
Informatics & Knowledge
Development
Existing Scientific Methodologies
– Quantitative
– Qualitative
Newer Methodologies Emerging
– Knowledge Discovery in Databases (KDD)
Decision Trees
Bayesian Networks
Neural Networks
Text Mining
Challenges
Standardized Terminology for Public Health
Identify Business Processes for IS Functional
Requirements
Evidence-Based Practice
Assure Quality Information
Reuse Data for Research