Introduction to Biomedical Informatics Topic: Public Health Informatics, National Health Information, and Management of Information in HealthCare Organizations Funded by NIH Grant XYZ Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 1
Outline Public Health Public Health Informatics (definition, challenges, examples) National Health Information Infranstructure Management of Information in Healthcare Organizations Discussioni Recommended Reading Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 2
How is Public Health different from other kinds of health care practices? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 3
How is Public Health different from other kinds of health hcare practices? community > individual patient. prevention of disease and injury > acute care and intervention What are some examples of these emphases at work? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 4
Given what public health is, what is public health informatics? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 5
What is public health informatics? Official definition: the systematic application of information and computer scienceand technology to public health practice, research, and learning Yasnoff WA, O'Carroll PW, Koo D, Linkins RW, Kilbourne EM. Public health informatics: improving and transforming public health in the information age. J Public Health Manag Pract. 2000 Nov;6(6):67 75 What do you think that means in practice? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 6
Three focus areas Assessment Policy development Assurance Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 7
Epidemiology: Thescience of publichealth What is it? What is the impact of an emphasis on epidemiology on informatics? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 8
Special Features of Public Health Informatics Systems optimized for retrieval of information from VERY large datasets personal identifiers are limited designed for cross tabulation, statistical analysis, trend tracking and matching, and so on Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 9
Challenges for public health informatics i system Impossible to obtain estimates at certain levels of geographic detail Difficult to handle people with unique characteristics Many of the behavioral indices are patient self reported Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 10
Some examples of public health information systems Video of H1NI tracking system Incidences of cancer (Surveillance Epidemiology and End Results from the National Cancer Institute) http://seer.cancer.gov/ National Disease Surveillance System (>60 diseases nationwide in the US) Immunization Registries (we ll talk about that in depth now ) Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 11
Immunization Registries confidential population based computerized information systems that contain data about children and vaccinations Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 12
National Health InformationInfrastructureInfrastructure Vision: anytime, anywhere health care information at the point of care US lags behind most other industrialized nations in creating nationwidedatabasesandtrackingdatabases and tracking infrastructure What does implementing this vision ii mean in practice? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 13
What are some of the benefits of a national approach to infrastructure? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 14
What are some of the challenges of a national approach to infrastructure? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 15
Approachesto Accelerating NHII Progress in the US Standards Promotion of Collaboration Demonstration Projects (and large scale test beds) Careful Measurement of Progress Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 16
Application Areas for Public Health Informatics Connecting to electronic medical records system Insurers Pharmacy managers Homeland Security What are the risks and benefits of these different uses? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 17
Management of Information in Healthcare Organizations Purpose of healthcare information systems (HCIS): manage information needed by healthcare professionals facilitate communication integrate information coordinate action among healthcare professionals assist in the organization and storage of information supportrecord record keeping andreporting Computerization in organizations is a long term ongoing process Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 18
Factors affectingadoptionanduseadoption and TAM Economic, social, political reasons for adoption Technological considerations Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 19
Intermediate contexts (between person and org); examining workgroups, teams, local communities, communities of practice Environmental factors.. methods of inquiry to attack these issues Assessing the relationship (evolving) between the organization and the technological lsystem Challenges to large scale organizational change Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 20
Particular Issues in Organizational Level HIT System design Implementation Long term survival Unintended consequences Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 21
Discussion How can health informatics researchers resolve differences in concerns over individual care and community/population care? Whatare are the risks of havingsubstantial public health informatics infrastructure and applications? What are the risks of not having it? What are the differences/similarities when considering health informatics at an organizational level vs. national? How can we align the costs and benefits (both financial and other) within hospitals, across the country? Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 22
Recommended Reading Online journal of public health informatics: http://firstmonday.org/htbin/cgiwrap/bin/ojs/index.php/ojphi g p p p jp Public Health Informatics and Information Systems by D.A. Ross, A.R. Hinman, K. Saarlas, and W.H. Foege (Hardcover Oct 16, 2002) The Limits of Privacy. Amitai Etzioni (in particular the chapter on HIV testing) Health data tools and statistics: http://phpartners.org/health_stats.html Chapters 13 & 15 in blue book Baldi/Hayes/Smyth: Introduction to Biomedical Informatics: 23
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