Public Health – Seattle & King County Implements Certified EHR

CDC/ Debora Cartagena

According to the 2009 Status of Local Health Departments Informatics, over half (55%) of LHDs providing primary care and 39 percent of LHDs providing dentistry services use an electronic, or part electronic, health record. Given the increase in EHR use by LHDs and funding to help EHR users, LHDs are becoming more aware of the importance of electronic health records.

Let’s take a look at Public Health – Seattle & King County and their recent efforts of implementing a certified EHR:

Public Health – Seattle & King County is implementing a new federally certified electronic health record (EHR) integrated with a patient management system through OCHIN/Epic. The new EHR will serve 14 sites, including public health centers, STD/HIV and Tuberculosis clinics, field nursing services, and jail health services.

“Our EHR project is a huge step forward for Public Health’s efforts to advance improvements in individual and public health outcomes while increasing efficiencies,” said Ben Leifer, Chief Administrative Officer for Public Health – Seattle & King County.

Public Health will launch the new EHR system in its primary care clinics beginning in June 2013. The project is expected to be completed by 2015.

“We have been actively planning for the new system since 2009, and our thorough work to date has laid the groundwork for a successful implementation,” said Kristi Korolak, Project Manager.

“OCHIN/Epic will provide us with better tools, in real time, to assess our patients’ needs and improve how we deliver care,” said Dr. Charissa Fotinos, Chief Medical Officer for Public Health. “Further, it will enable better patient coordination with local and regional partners, while supporting broader population-based health promotion and disease control.”

For LHDs who want to learn more information about EHRs, check out these useful resources:

• HIMSS highlight several tools that can be used to assist in the adoption and implementation of EHR: http://www.himss.org/ASP/topics_ehr.asp
• The Agency for Healthcare Research and Quality (AHRQ) Knowledge Library includes an implementation checklist to help address potential barriers and challenges to EHR implementation: http://1.usa.gov/cSyYlB
• The Public Health Data Standards Consortium (PHDSC) Electronic Health Record Public Health Task Force provides information on standards and EHRs: http://www.phdsc.org/health_info/ehr-task-force.asp
• The Office of the National Coordinator (ONC) for Health Information Technology provides information on the certification programs for EHRs: http://1.usa.gov/bhanF3

For more information on the Public Health – Seattle & King County EHR project, please contact Kristi Koralak.

Many thanks to Kathryn Ross from Public Health – Seattle & King County for contributing to the blog post.

Integrating Technology into the WIC Experience – ‘Anna’ the Avatar by Dr. Phred Pilkington

By Dr. Phred Pilkington Chief Executive Officer & Director of Public Health Cabarrus Health Alliance

With funding through the Beacon Community Program, Cabarrus Health Alliance and the North Carolina Institute for Public Health (NCIPH) collaborated to adapt a Virtual Character or avatar to the Women, Infants and Children (WIC) environment. The avatar, ‘Anna,’ leverages Embodied Conversational Agent (ECA) technology from Engineered Care. ‘Anna’ was designed to introduce WIC to new participants.

The first module of the avatar is an overview of the WIC Program which teaches participants how to effectively use their benefits. ‘Anna’ is a pregnant WIC participant excited to share with her peers. She uses teach-back questions and answers to ensure user comprehension.

An additional component of the first phase of the project was to assess satisfaction with and effectiveness of the avatar technology in the WIC programs. The Southern Piedmont Beacon Community includes the counties of Cabarrus, Stanly, and Rowan and each of their local WIC Departments. This cross-section of counties allows us to study the effectiveness in rural, rural-urban, and urban health departments. The study assessed the resources and time required to implement a digital health education solution. Touch-screen tablets were provided to two WIC Programs and small computer systems were provided to the third. Paper surveys were provided to WIC clients following the interaction to assess client satisfaction, knowledge and confidence.

At this time, the evaluation is still in process; however, preliminary findings suggest that WIC participants find the ‘Anna’ experience to be an engaging one. Anecdotally, participants offered that “This was better than face-to-face cause I have a tendency to zone out when someone talks to me” and “I liked her.” In addition, ‘Anna’ appears to be an effective learning option with participants noting that “Anna is …better than a DVD” and “this was better than someone talking to you.”

Effectively this project is a pilot intended to collect some preliminary findings about the efficacy of a computer avatar as a health educator. Assuming positive results with WIC clients, we plan to expand the role of ‘Anna’ to include health education in other public health clinical services and for community-based interventions.

For a five minute demo of ‘Anna,’ please click here [wmv file].

Social Media Supporting a Public Health Emergency by the Boston Public Health Commission

Written by:

• Anita Barry, MD, MPH, Director, Infectious Disease Bureau at Boston Public Health Commission
• Craig Regis, MPH, Project Manager, Infectious Disease Bureau at Boston Public Health Commission

Effective and timely communication with the public has always been a critical function of local public health departments.  Whether it be alerting citizens to recent health events or distributing informative materials on disease prevention, risk communication requires public health practitioners to be on the forefront of the communication revolution.

Since the advent of the Internet, social media has revolutionized the way the public obtains information.  Though certain populations still rely heavily on traditional media such as television, radio, and print, the technological advances have caused new information services to emerge.  Social networking services such as Twitter and Facebook are widely used throughout the world, and more and more people are relying on them as their primary source for information.  Smartphones are providing immediate, on-demand access to social networking services.  As smartphone usage is higher among Black and Hispanic mobile phone users, social media also presents an opportunity to reach some vulnerable populations.¹  In this new era of instant, crowd-sourced, mass communication, public health departments are using these new tools to quickly and effectively disseminate important information, especially in urgent situations where time is of the essence.

The Boston Public Health Commission (BPHC) was faced with such a situation in early 2013.  By early January, Boston had seen over ten times as many reported influenza cases than in all of the 2011-12 season.  The number of people going to emergency rooms and other healthcare sites for influenza like illness also markedly exceeded the prior season, creating a large burden on the healthcare system in the city, particularly the hospitals.  The Mayor of Boston declared a public health emergency on Wednesday, January 9, 2013, in order to raise awareness and to mobilize the city’s resources, including encouraging health centers to hold free influenza vaccination clinics that following weekend (January 12-13, 2013).

BPHC was faced with the task of not only keeping an anxious public informed about best practices for influenza care and prevention, but also constantly assembling and circulating a rapidly changing schedule of free influenza vaccination clinics at neighborhood health centers in response to the emergency.  No sooner was the interactive “flu calendar” updated than newly scheduled clinics required additional postings to BPHC’s public website.  The dynamic, real-time nature of social media platforms made them the best method to keep the public adequately informed about a constantly evolving situation.

BPHC’s communication infrastructure includes Twitter with tweets in both English and Spanish, Facebook, YouTube, and a blog.  BPHC’s twitter handle, @HealthyBoston, constantly tweeted updates, linked to factsheets, directed the public to the online calendar for vaccination clinics, and encouraged residents to be vaccinated.  The campaign extended to BPHC’s Facebook page, which also provided a direct link to the clinic calendar.  These platforms allowed for the swift response required during a public health crisis, and facilitated a surge in visitors to the BPHC website.  The influenza section received over 20,000 hits in less than two weeks during the emergency.  Over 80% of these hits were from new visitors, and over 16,000 were to check the clinic calendar.  The response also resulted in an increase in Twitter followers.  In weeks leading up to the flu emergency, @HealthyBoston averaged about 60 new followers per week, but gained over 600 new followers over the next month.

Social media played a pivotal role in keeping the public up to date about an ever-evolving situation with timely and accurate information.  Currently, @HealthyBoston has nearly 11,000 Twitter followers, and over 3,000 Facebook “likes.”  Recognizing the potential of social media to reach a younger audience, the BPHC Communications team launched a youth-oriented twitter handle last month called @WhatheHealth.  Though it takes a dedicated staff and time to build momentum, utilizing social media in public health communications is worth the investment.  It has the potential to increase the presence of an organization, broaden its audience, and revolutionize public health campaigns.

¹Kellogg, Don. “Among Mobile Phone Users, Hispanics, Asians Are Most-Likely Smartphone Owners in the U.S.” Nielsenwire.com. N.p., 1 Feb. 2011. Web. 25 Feb. 2013.

http://blog.nielsen.com/nielsenwire/consumer/among-mobile-phone-users-hispanics-asians-are-most-likely-smartphone-owners-in-the-u-s/

Follow BPHC on Twitter @HealthyBoston and Facebook