1 CDC in collaboration with CSTE, ASTHO, NACCHO and PHII CLASS I
2 Health Systems Integration The recent push for improved outcomes in population health has called for public health and primary care sectors to collaborate more effectively. The fellows will be placed at state and local health departments, involved in activities that address 1) community epidemiologic surveillance to support community health needs assessments, 2) the public health interface and use of electronic health records, and 3) lessons learned from successful public health and primary care professional partnerships. The Health Systems Integration Program (HSIP) fellowship is designed to build health systems capacity between public health and clinical care partners. HSIP is one of three Project SHINE (Strengthening Health Systems through Interprofessional Education) fellowship programs. Project SHINE is supported by 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), and the Public Health Informatics Institute (PHII), and funded by the Centers for Disease Control and Prevention (CDC). There is an emphasis on Interprofessional Education (IPE) to improve population health through health systems integration. HEALTH SYSTEMS INTEGRATION PROGRAM FELLOWSHIP The goal of the fellowship is to provide a high-quality training experience and to secure long-term career placement for fellows at the state or local level. The fellowship is designed for practitioners with a doctoral degree and two years of experience or at least four years of experience with a master s degree who are interested in the intersection of public health and clinical care. While the program provides rigorous training for its participants, it is also designed with the flexibility to meet the particular interests of the fellow. Fellows are carefully matched to host agencies based on the career interests of the fellow and available opportunities of the host agency. Participants will develop a comprehensive set of core skills through applied competency-based training and experiences.
3 PROGRAM MISSION The HSIP fellowship seeks to facilitate the integration of public health and clinical health systems. The fellowship will focus on these key concepts: Provide an accelerated training experience Work with health systems at state and local health departments as it relates to epidemiologic surveillance and data sharing Create and train a core group of public health workers Interprofessional education in public health TRAINING The HSIP fellowship offers an opportunity to acquire and develop applied epidemiology skills during a high-quality, on-the-job training program in public health practice. Fellows work closely with experienced informaticians, epidemiologists, and public health practitioners at the state and local level, as well as those working at the federal level with the CDC. MENTOR & HOST HEALTH AGENCY Each HSIP fellow is assigned to a designated host health agency and two highly-trained and experienced mentors. Health agencies approved to host a fellow will have demonstrated capacity to provide a fellow with technical training, applied research opportunities, and opportunities to apply epidemiology principles in a practical setting.
4 INTERPROFESSIONAL EDUCATION Interprofessional Education (IPE) is an experience that occurs when students from two or more professions learn about, from, and with each other. 1 The goal of IPE is to prepare health professionals to deliberately work together with the common goal of improving population/community health and patient-centered care within the U.S. health care system. The three aims of IPE are: 1. to achieve better patient care; 2. to achieve better health (outcomes); 3. to achieve more efficient and affordable educational and health care systems. 2 Public health and health care data are critical to achieving these three aims. Applied epidemiologists and infomaticians are uniquely positioned to improve population health by using IPE skills to foster collaboration between public health and primary care partners in the community. 1 World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. Retrieved November 11, 2013, from 2 Institute of Medicine (IOM). (2013). Interprofessional education for collaboration: Learning how to improve health from interprofessional models across the continuum of education to practice: Workshop summary.
5 HEALTH SYSTEMS INTEGRATION PROGRAM ELIGIBILITY To be eligible to be a HSIP Fellow, applicants must meet the following application criteria: 1. Proof of U.S. Citizenship or Permanent Residency 2. Desire to pursue a long-term career at the state or local level of public health 3. Willing to commit to the full-time program (1 year) AND A. Doctoral Degree AND 1. 2 years of public health experience 2. One of the following degrees: Physicians (MD, DO, MBBS, etc) Must have at least one year of clinical training. Doctoral levels scientists with backgrounds (PhD, DrPH, ScD, etc.) in public health or related health fields Medical Professionals (DDS, BSN, MSN, PA, PharmD) Dentists, nurses, physician assistants, doctor of pharmacy, must have a master of public health (MPH) or equivalent degree. Veterinarians (DVM, VMD, etc.) Must have an MPH (or equivalent degree) or relevant public health experience. AND B. Master s Degree OR 1. Minimum 4 years of full time public health work experience at the time of application. 2. Possess a qualifying degree from an accredited academic institution (MPH, MS, etc.) in public health, information sciences or related health fields.
6 Amirah Abdullah, DrPH, MSPH Place of Birth: Loma Linda, CA Highest Degree Obtained: DrPH, Epidemiology, University of Kentucky Certifications: CPH Host Site: Santa Clara County Public Health Department, Santa Clara, CA Primary Mentor: Teeb Al-Samarrai, MD, MS Secondary Mentor: Pamela Stoddard, PhD Future plans after the fellowship: I intend to work at the state or local level as a public health leader and epidemiologist. In this role, I plan to control and reduce the risk factors that impact the population, in addition to developing evidence-based programs to augment the health and well-being of the population. I aspire to use the HSIP training to support my fervor for preventing maladies and promoting health of women, infants, and children. To advance the efforts of state and local health departments, it will require collaborative efforts of health systems to develop effective solutions to reduce risks and adverse health outcomes among the population. My goal is to use systems integration to assist in health department s development of effective solutions to protect the health of the population. Why you chose the HSIP Program: I chose the HSIP program because it utilizes the presence of qualified public health personnel to improve the outcomes of primary and preventative care, through the enhancement of the workforce s capacity, collaborative actions, and effective surveillance. The integration of public health into clinical health systems will augment the creation, recording, and assessment of health information to plan and implement activities to improve the health of the community. I believe that my participation in this program and acquirement of this fundamental education to improving and securing the health of the population, through a comprehensive infrastructure, will shape me into an effective and efficient epidemiologist. Leo Achembong, BDS, MPH Place of Birth: Cameroon Highest Degree Obtained: BDS (Dentistry), University of Benin, Nigeria Certifications: Health Information Technology and Health Information Exchange, Dental Public Health Host Site: Texas Department of State Health Services Primary Mentor: Kalunde Wambua, MPaFF Secondary Mentor: Linda Gaul, PhD, MPH, MS Future Plans after the fellowship: I plan to use the opportunity of the HSIP fellowship to place myself in a position to assume roles in healthcare integration. I am confident that my clinical, public health and health information technology backgrounds combined with the mentorship I will receive while, working in a center that coordinates programs and directs policy in a large public health agency, will provide me with the necessary tools to excel in designing interventions and shaping policy to improve the wellbeing of populations in a holistic manner. Why you chose the HSIP Program: The HSIP program provides on the job training from experienced mentors in epidemiologic surveillance, health information technology, leadership and policy amongst other important aspects in health systems integration. I particularly cherish the chance to be the lead and get very involved in projects that will enhance the collaboration of public health and primary health care. I am most excited to gain data analysis skills in SAS, SQL, Tableau, R and SPSS.
7 Matthew Francis, MS Place of Birth: Oak Creek, WI Highest Degree Obtained: MS, Epidemiology, Michigan State University Host Site: Lane County Health & Human Services, Public Health, Eugene, OR Primary Mentor: Patrick Luedtke, MD, MPH Secondary Mentor: Patrice Korjenek, PhD, MA Future plans after the fellowship: I plan to continue on with my career in public health at the local, state, or federal level. I would like to continue to work with the integration of health systems, especially working on STD, HIV, and Immunization record integration. Why you chose the HSIP Program: I chose the HSIP program because the goal of the program is to facilitate the integration of public and clinical health systems. After working in both the public health and primary care sectors I felt that there was a great need for collaboration between these two pillars of health services. The HSIP fellowship offered me the opportunity to step into leadership positions, work with department and community leaders, and use the skills I have learned to make impacts on public health problems. I feel that there is a great need for individuals that are skilled in both informatics and epidemiology to be contributing members of departments of public health. I feel this fellowship will prepare me to be a better leader in the public health community. Eithne Keelaghan, MD, MS Place of Birth: Los Angeles, CA Highest Degree Obtained: MD, University of Pittsburgh Medical School Host Site: Marion County Public Health Department, Indianapolis, IN Primary Mentor: Joseph Gibson, PhD, MPH Secondary Mentor: Bonny Lewis Van, PhD, FACB Future Plans after the fellowship: I look forward to assuming a leadership role in a public health agency, one that emphasizes the integration of epidemiology and health technology tools in the decision-making and evaluative processes of the healthcare environment. Why you chose the HSIP program: Following my career in information technology, I received medical training, completed a Preventive Medicine residency, and worked in public health epidemiology. I have now chosen the HSIP fellowship to provide me with hands-on training in public health systems integration and management. With its emphasis on interprofessional education in the field of public health, I believe this fellowship will provide the specific training and public health-focused experience that will allow me to participate in a leadership role in the area of public health informatics.
8 Ashley M. Kranz, PhD Place of Birth: Crystal Lake, IL Highest Degree Obtained: PhD, Health Policy and Management, University of North Carolina at Chapel Hill Host Site: County of San Diego, Health and Human Services Agency, Public Health Services, San Diego, CA Primary Mentor: Thomas R. Coleman, MD, MS Secondary Mentor: Deirdre Browner, MPH Future plans after the fellowship: Following the HSIP fellowship, I plan to continue working on projects related to health systems integration. I am eager to use my analytic skills to link existing data sources (e.g., EHR data, personal health data, community health assessments) to conduct studies that can provide local and state governments with more information about access to care and population health outcomes, especially for vulnerable and underserved populations. Why you chose the HSIP Program: I am interested in health systems integration because of its potential to help promote population health through better coordination of existing resources. The HSIP fellowship appealed to me because it provided an opportunity to participate in health systems integration while simultaneously learning about the role and responsibilities of a local health department in promoting community health. I am most excited about the linking of data sources to better measure and promote population health. We are living in the era of big data, but much health data remains isolated and underutilized. I chose to become a HSIP fellow because this program provides me a opportunity to help bring together the public health and primary care sectors in order to identify, link, and analyze some of these data sources. I am excited to gain experience working with EHR data and exploring the strengths and weakness of using it for population health surveillance and targeted health promotion activities. Julianna Lenoch, DVM, MPH Place of Birth: Detroit, MI Highest Degree Obtained: DVM, Colorado State University Certifications: CPH Host Site: Wisconsin Department of Health Services, Department of Public Health, Office of Health Informatics Primary Mentor: Milda Aksamitauskas, MPP Secondary Mentor: Mark Wegner, MD, MPH Future plans after the fellowship: I am hoping to continue training in applied epidemiology and combine my experience of information systems and health system integration into surveillance and practical epidemiology. I plan to use my combined knowledge of veterinary medicine, epidemiology and population systems into an epidemiology career with the CDC or USDA. I also plan to continue working with international agencies to provide veterinary care, immunization and parasite control in rural areas to benefit both animal and human populations. Why you chose the HSIP Program: I chose the HSIP program to give me experience at the state level of health system management. The reputation of CSTE for supporting its fellows drew me into the application cycle, and this new fellowship matched my interests of using data in new ways and pursuing an integrative approach to solve population health problems. I felt the competencies outlined in this fellowship would align with my professional goals and desired training. Health departments have access to large databases that should be utilized and analyzed to improve health care delivery. I believe that linking population health data to apply to individual health is going to be used more frequently in the future, and it s exciting to be on the front end of the solution.
9 Sandhya Swarnavel, BDS, MS Place of Birth: Chennai, India Highest Degree Obtained: Post-Doctoral Residency in General Dentistry, University of Rochester Certifications: General Dentistry Host Site: Michigan Department of Community Health Primary Mentor: Corrine Miller, PhD Secondary Mentor: Jim Collins, MPH Future plans after the fellowship: After the fellowship, my goal is to work for a state or local health department and contribute to solving public health problems. Why you chose the HSIP Program: I chose the HSIP program because it is a great opportunity to add to knowledge I had gained with the Applied Public Health Informatics Fellowship. The HSIP fellowship will give me the opportunity to integrate all my different experiences in the health care setting as a dentist, and the research experience I have as an epidemiologist incorporating informatics. Hands-on training in this fellowship will help me to address a wide range of public health challenges, and enable me to work with public health professionals at the local, state and federal level. Felicia Trembath, MPH Place of Birth: Billings, MT Highest Degree Obtained: MPH, Purdue University Host Site: Maricopa County Department of Public Health, Phoenix, AZ Primary Mentor: Kate Goodin, MPH Secondary Mentor: Mac McCullough, PhD Future plans after the fellowship: After the fellowship, I would like to work for a state or local health department while establishing a relationship with a nearby university in order to facilitate research collaboration. Why you chose the HSIP Program: I chose the HSIP as a way to ease my transition from academics back to public health practice. After practicing in public health at the state and local level for many years, I took an extended leave from the field while I pursued higher education. I selected the HSIP fellowship as a way to experience what was new in the field of public health and health systems while working on projects that I knew I had the skillset to contribute to. The HSIP provides applied epidemiology training, and gives me opportunities for networking, training, and collaboration that I would not have on my own. I believe that the combination of my educational training, professional background, and HSIP fellowship will enable me to contribute to public health at the local, state or national level.
10 Christopher D. Williams, MPH Place of Birth: Monroe, LA Highest Degree Obtained: MPH, Epidemiology, Tulane University School of Public Health & Tropical Medicine Certifications: Graduate Certificate in Public Health Informatics, University of Illinois at Chicago Host Site: Department of Health and Hospitals, Louisiana Office of Public Health Primary Mentor: Tammy A. Hall, Ed.D., M.S. Secondary Mentor: Joseph Foxhood, BA Future plans after the fellowship: I would like to serve in a leadership capacity within a health department, or at a national level. Through interactive trainings, leadership opportunities, expert mentorship from HSIP partners, and practical work experiences at my host site, the HSIP fellowship is equipping me with the requisite skills to become a successful population health integrator. Specifically, through health systems integration my desire is to serve as a nexus between public health and organizations that serve underserved populations to optimize their service capabilities and sustain their work. Why you chose the HSIP Program: The reasons I selected the HSIP fellowship program were multifaceted. 1) As a fellow in the inaugural class of the HSIP fellowship, the fellowship provides insight into promising approaches to leveraging partnerships among health care providers, communities, and hospitals to create a community-wide culture of health. 2) As a fellow, my primary objective is to identify opportunities for collaboration and health systems integration among the state s public health department, health care providers (hospitals and ambulatory), and health disparate communities across the state, with the overarching goal of population health improvement. 3) Lastly, the fellowship presents the incomparable opportunity to put my background in epidemiology, public health informatics, and electronic health record (EHR) implementation to practical use at a public health department. HSIP Class I
11 HEALTH SYSTEMS INTEGRATION PROGRAM COMPETENCIES Fellows will develop a comprehensive set of core skills through competencybased training. These competencies are expected to be fulfilled during the one-year fellowship: Analysis & Assessment Identify public health problems pertinent to the population Determine whether health services adequately address population needs and problems Policy Development & Program Planning Develop, analyze, and advocate for public health policies to improve health service delivery that addresses known population needs Determine the feasibility and expected outcomes of policy options (e.g., health, fiscal, administrative, legal, ethical, social, political) Communication & Cultural Competency Collaborate effectively across organizational, cultural, educational, and community lines Take into consideration the role of cultural, social and behavioral factors of public health and health care agencies/sectors in designing the delivery of health services Apply communication and group dynamic strategies (e.g., principled negotiation, conflict resolution, active listening, risk communication) in interactions with individuals and groups Public Health Sciences Utilize epidemiologic and needs assessment perspectives in design, development, implementation, and evaluation of public health and health care delivery programs Evaluate an existing or developing public health program or surveillance system with a focus on improving health outcomes Health Systems Describe how evidence-based approaches and linking public health and health care perspectives can be used to improve population s health care needs and delivery HSIP CURRENT FELLOW PROJECTS Conduct a feasibility study to better understand how Electronic Health Records can be used to reflect community health Identify best practices in the care of hypertension and hyperlipidemia to reduce heart disease and strokes to improve quality of care Evaluate the reporting system of Hepatitis B and Hepatitis C Prototyping continuity of care documents and data analysis to inform decision making Develop a public health performance accountability dashboard Identify and recommend best practices for development and implementation of electronic health records at local health departments Develop a strategic plan to reduce the burden of disease caused by a recent outbreak of STDs Develop meaningful use guidelines to assist in the integration of diagnosis and treatment codes for tobacco use and cessation Validate HL7 messages with Electronic Medical Records
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