New York State Department of Health

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1 Assignment Location: Primary Mentor: Secondary Mentor: Albany, New York Nina Ahmad, MD Medical Director for the Center of Environmental Health Geraldine Johnson, MS Director of Public Health Informatics and Project Management Office Mentor Information Nina Ahmad, MD (family physician, Medical Director for the Center of Environmental Health) will be the primary supervisor. Dr. Ahmad has served as a mentor to students for over a decade. As assistant director and clinical director of a family medicine residency program she supervised staff and students and developed the training program curriculum for the residency program and four medical schools. She received specialized training in informatics and led the integration of health information technology for Patient Centered Medical Home (PCMH) at the residency program. Currently she serves as the Center for Environmental Health medical director. She currently also serves as a mentor to students at the School of Public Health. She will work directly with the fellow to guide their experience across the center, within the different divisions and bureaus. Geraldine Johnson, MS, is the Director of the Public Health Informatics and Project Management Office (PHIPMO), located in the NYSDOH Office of Public Health (OPH), and has oversight of 15 project managers, business analyst, and contractual technology staff. Ms. Johnson manages the OPH information technology project portfolio and is a member of the Agency Review Board which manages the Department s IT project portfolio. She also participates in the State Health Information Network of New York committees as a representative for OPH. PHIPMO staff coordinate informatics project activities, including EHR/HIE interoperability, child health information integration, the New York Early Intervention System, and electronic health emergency preparedness and epidemiology projects, within OPH. Ms. Johnson has over 25 years of public health experience, including epidemiology, informatics projects, and program management, and has worked at the local, regional, and state levels. Ms. Johnson has authored or co authored numerous related publications, including peer reviewed journal articles, national recommendations, textbook chapters, and abstracts, and has presented at national and international conferences. Ms. Johnson participated in the Public Health Accreditation Board Informatics Think Tank and is a member of the International Society for Disease Surveillance, the Council for State and Territorial Epidemiologists, the International Institute of Business Analysis, and a steering committee member of the Association for State and Territorial Health Official s (ASTHO) Informatics Directors Peer Network. Assignment Description

2 is strategically placed in the heart of downtown Albany. Both programs sit within one of four towers. Health may be affected by the air we breathe, the water we drink, the food we eat or the contaminants we touch. Chemicals, radiation, microbes, or anything in the physical world has the potential to affect our health. At the Center for Environmental Health, our scientists, engineers, sanitarians, physicians, educators, researchers and other public health professionals work together to prevent and reduce New Yorkers' health risks at home, work, school and play. The Center level staff provide overall executive direction for environmental health programs. In addition to supervision of central office staff, the office works closely with regional office staff to coordinate the oversight of environmental health program activities implemented by the Department's nine district offices, 36 county health departments, and the New York City Department of Health and Mental Hygiene. Both the Center for Environmental Health and Public Health Informatics and Project Management groups have strong local, state, and federal public health partnerships, as well as partnerships with private sector, community organizations, and universities. The programs have a uniquely strong partnership with the school of public health, and Albany Medical School. Both schools are easily accessible. Dr. Ahmad serves as adjunct faculty at the school of public health and a mentor to students. She also sits on their curriculum board meetings. The fellow will be placed at the executive level where they will be involved in high priority initiatives that are deemed to have a positive public health in the New York State community. Both mentors are at the executive level just under the deputy commissioner and therefore will be able to help navigate the fellow s experience. The fellow will work in multi disciplinary teams with subject matter experts across the center, be a part of building partnerships and help guide the direction of their project. The fellow will also have access to the outreach program to assist in any community engagement efforts and will be part of the executive level decision making. Day to Day Activities When the fellow arrives, they will meet with their mentors to define areas they would like to focus on with an emphasis on the competencies. This will guide the fellow s experience through the year. They will then meet with all supervisors of potential projects to discuss their role and the details of each project. The fellow will be the lead on their own projects within the bureau(s) they select. They will be integrated into the activities of the bureau and their work plan meetings for the selected project. The fellow will work independently and as part of larger teams within the bureau, division, and center levels. On a daily basis, he or she will interact with the staff under the bureau they select, and will have access to all staff under the office of the medical directorship at the executive level. Additionally the fellow will be integrated into high priority assignments in CEH at the executive level. In addition to access to and support from business analysis, project management, and technology professionals, PHIPMO offers the fellow a community of practice that includes informatics training and business requirements elicitation, documentation, traceability, and overall management peer review sessions. Depending on the selected project, the fellow will have an opportunity to participate in any related OPH and Department initiatives or meetings.

3 On a weekly basis, the fellow will work with the mentorship team consisting of the primary and secondary mentors, and the specific project mentor(s). Potential Projects include: 1. Data Quality Assessment of the New York State Child Lead Program: The New York State Child Lead Poisoning Prevention Program receives various types of data from various sources. The types of information collected include laboratory results, demographics, housing, environmental assessment, and nursing services. The data received is crucial to inform the child s provider, as well as state and local health departments for care coordination and follow up services. The information is collected by electronic and manual data transfers, and manual data entry. This project will assess the current data flow and determine data quality indicators for the various types of data collected from multiple sources. The fellow will analyze the various types of data for quality of information received, create measures of data quality to track improvement over time, and design recommendations to improve the flow, collection, and reporting of the data. Public Health impact: This project will assist the Child Lead Program to identify gaps in necessary data for public health interventions quickly and efficiently by creating measures of tracking. This project will also assist in designing interventions and recommendations to correct the issue of data gaps based on user needs and the source of data. 2. Integration of radiation related information systems: The Bureau of Environmental Radiation Protection (BERP) carries out a public health program that addresses hazards associated with various sources of radiation. Bureau activities include the registration, licensure and inspection of regulated facilities, and the oversight of inspection activities carried out by local health department or certified individuals. Program has several stand alone client/server applications to manage these responsibilities: Incident (investigate complaints and exposures), RadCom (Commercial use of radiation), RadInst (installed, medical use of radiation), Radon (environmental exposures) and RadTech (licensing of technicians). Three of these systems should be integrated (RadInst, RadCom and Incident) to provide more comprehensive and efficient system for managing the Department s regulatory functions. There are many programs with data systems that maintain information on facilities, inspections, complaints and enforcement, professional credentials and licensing and

4 electronic payments of fees and fines. The current climate may offer opportunities to consolidate these functions with other initiatives such as elicensing or Lean Management or to other options that may be appropriate. Public Health impact: Develop a plan for the integration of the systems and changes in business rules/process. Integration of at least the three core applications into one system. The system should integrate billing and receivables functions, integrate inspection functions, include new required features, and include a plan for migrating all existing data. The planning phase should take approximately one year depending on the FTE commitment of the development team. 3. Developing the Framework for an Improved Public Health Data System: Specified diseases and conditions are mandated by State laws and regulations to be reported to the by healthcare providers and laboratories. Among the reportable conditions is occupational lung disease. Occupational lung diseases are a group of illnesses that are caused by either repeated, extended workplace exposure or a single, severe workplace exposure to irritating or toxic substances that leads to acute or chronic respiratory ailments. The Occupational Lung Disease Registry (OLDR) was established in 1981 to reduce morbidity and mortality due to exposure to respirable toxic materials in the work environment. Data in the registry comes from a variety of sources including direct reports by physicians, hospitals and other health care providers, and indirect identification of cases through the analysis of poison control center data, emergency department data, and hospitalization data. The methods of acquiring data and its use in public health activities has evolved over time; however, the information system that houses the data has remained unchanged for over a decade. Information from the registry is used in many public health activities. Program staff educate employees and employers about appropriate work practices and protection, and provide guidance on identifying and preventing workplace hazards. Data can be used to identify high risk occupations, industries, or employers and lead to the development of outreach and prevention materials. De identified data is also provided to the Center for Disease Control and Prevention s National Institute for Occupational Safety and Health (NIOSH) for use in their research activities. This project will examine the functions of the OLDR and its various inputs and outputs; identify and take into account the needs of the program and stakeholders; and make recommendations on the elements of a new health information system and work process that will improve the efficiency and effectiveness of the OLDR. Public Health Impact:

5 The OLDR is essential to the surveillance of occupational lung disease in New York State. A comprehensive data system is the foundation of a successful surveillance program. By comprehensively reviewing a programs goals and needs, programs are able to develop and implement appropriate data systems and work processes. These systems are needed to effectively collect, analyze, interpret and disseminate public health data and information.

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