Category Archives: Conference

Public Health Informatics Virtual Event on July 16-18, 2013 – Call for Abstracts!

Connect with colleagues at your own convenience!

ph informatics virtual event

This virtual event provides the opportunity to learn and discuss the latest initiatives in public health informatics with attendees from all over the country and internationally. Call for abstracts is now open and will continue until May 31, 2013. This year’s theme is “Strengthening Public Health – Health Care Collaboration.” Abstract submissions are encouraged in the following areas:

1)  Informatics policy and practice: virtual sessions will focus on national and international policy issues and their implications for public health informatics programs; applied informatics projects for programmatic support; and new initiatives

Examples might include:

  • ICD-10 CM/PCS –deadline for implementations 10/1/2014
  • Meaningful Use & Electronic Health Records
  • Interstate data exchange
  • Data exchange to support ACOs

2)  Research & Innovation: virtual sessions will focus on informatics research and technological innovation to public health and clinical settings.

Examples might include:

  • Applying analytics to new and existing data sources
  • Leveraging Big Data for population and public health
  • Learning health systems to support integration of primary care and public health
  • Novel technologies for population and public health education and communication (mobile, web, social media)

3)  Supporting Public Health Evidence Based through Informatics Practice: virtual sessions will focus on strengthening public health through knowledge sharing, evaluation, visualization and reporting.

Examples might include:

  • Evaluation methodologies and findings
  • Decision support for population health Health status and performance management dashboards
  • Community Health Assessments as part of the community health improvement process
  • Return on Investment (ROI) and Value of Information (VOI) analyses for informatics programs and systems

If any of the items above relate to your area of work, do not miss the opportunity to submit an abstract!

Help us get the word out and share this blog post with your colleagues and friends! And if you’re ready to submit an abstract go straight ahead here.

Meeting sponsors include CDC, NACCHO, and ASTHO.

Health IT at the 2013 Public Health Preparedness Summit

preparedness summit logo

People are always asking, “What is informatics and how does informatics affect me?” or “What does informatics mean to my everyday job?”  At the 2013 Public Health Preparedness Summit, there will be some great examples of how emergency preparedness is supported by innovative technology and is informed by good informatics.  In other words – not just what technology to use, but how to put this technology to good meaningful use.

A number of these sessions will focus on social media, messaging during a disaster, and new tools to reach out to different populations. These presentations highlight how critical informatics has become in preparing for and recovering from disasters.

Some of these sessions are below:

  • Dispense Assist: Online Screening Tool for Mass Dispensing and Vaccination -Implementation/Training Workshop:  This workshop will introduce you to Dispense Assist (DA) a free, online screening tool for mass dispensing and vaccination available for use by any interested jurisdiction.
  • Emergency Messaging for the Electronic Age: This workshop will explore the explosion of social media and how it has changed the way in which those in the public health field must look at risk communication and information sharing, especially in times of emergency.
  • Video-Savvy Crisis Response Workshop: Using YouTube, Skype and uStream for Effective Communication in an Emergency: You’ll learn how to use YouTube, Skype, and UStream to communicate effectively during a crisis using tools you may already have.
  • Innovations in Public Health Emergency Alerting and Notification: Presentations will address the impact of the public health capabilities on emergency alerting and information sharing practices, including the Epidemic Information Exchange and Health Alert Network programs.
  • FluCare: A Mobile Texting Service to Support Antiviral Medication Use during an Influenza Pandemic: This session will highlight the development of a mobile texting service to provide medication information and support for people who are prescribed antivirals during an influenza pandemic.
  • Cell Phone Mapping and Disaster Mental Health Preparedness Planning in Under-Resourced Black Communities: Presenters will discuss cell phone GPS software and computer-based mapping platforms that will allow community groups to easily collect data to inform planning activities. This offers an opportunity to address the digital divide and build resilience in under-resourced black communities.
  • Utilization of Mobile Health (mHealth), Social Media and Emerging Technologies for Public Health and Disaster Preparedness-Lessons Learned and Policy Implications: This sharing session will cover how mobile health, social media, and other emerging technologies offer an opportunity to improve disaster preparedness. The research presented during this session aims to identify notable practices at local health departments in using these platforms for preparedness efforts, identifying barriers to use, and assessing how to increase uptake of these methods. 
  • Effective Use of Social Media in Public Health: Promoting a Practice Exchange in Pandemic and All-Hazards Preparedness and Response: This session will explore how an online compendium of preparedness tools from across the country and a social marketing campaign created an interactive disaster preparedness community for state and local planners.
  • Prototype Tool for Analyzing Email Traffic in Public Health Emergency Operations Centers: This session will solicit input from participants on a prototype tool that CDC and Lockheed Martin have developed to analyze and visualize email traffic within an emergency response center.

We hope that you will join us at this year’s Summit to learn more about the role of ePublic Health & Informatics in emergency preparedness. Are you on Twitter? Follow @prepsummit for the latest information and use the hashtag #phps13 to follow the online conversation. To see what other sessions will be offered at the Summit and to register, please visit http://www.phprep.org/.

Insights from Kansas Information Management and Exchange Workshop

Recently Vanessa Holley and I were asked to facilitate a workshop with local health departments (LHDs) in Kansas.  We were slated to discuss how to help LHDs make two decisions:

  • Do they need an electronic health record (EHR) system?
  • If/how should they connect to the health information exchange (HIE)?

Through the course of the discussions, it quickly became apparent that the decisions to have an EHR or connect to the HIE were only part of the story and in some ways were over emphasized because they are easier to conceptualize.  But the discussions began to broaden and clarify some of the issues.  As it turns out, I think we actually stumbled upon a pretty good road map for ePublic Health.

Let’s look closer at what I mean.

Before you can effectively take advantage of any technology or HIE option:

  • Step 1: develop the future vision for your LHD and clarify both what value and what services you plan to offer your community.  You first need to determine what services your LHD will be focused on in the new world of healthcare.  This is critical because if, for example, your health department is not going to continue to heavily invest in clinical services, then considering a practice management or EHR system may not be a good investment – despite current needs.  On the other hand if you plan to increase your case management and care coordination role in the community, you’ll want to be sure whatever system you purchase or build takes into account those requirements in order to best support your work.
  • Step 2: is to create or update your statewide collaborative Health Information Management Plan and planning body with a wide representation from LHD, state, and program personnel.  Even if this already exists, ensure that representatives are both well informed and doing a complete job of communicating out decisions that are made.  To begin this step you have to begin to coordinate at a heightened level with your state and neighboring LHDs.  In Kansas, they have had a great relationship with their state and a very active LHD association.  However, they still realized that they could benefit by making a more formal body that is charged with coordinating and collaboratively developing the Health Information Management Plan for public health.  This is different from the statewide HIT plan because it is much more than information technology and is solely focused on creating one public health voice for health departments throughout the state.  This is so critical because your partners need to hear a coordinated and unified voice for public health.  Also, most of the Meaningful Use solutions are designed and managed at the state level.  Therefore it is imperative that LHDs are collaborating with the state to understand how their information needs will be met and how these solutions will interact with their local systems.  There has been so much to keep up with in the fast pace of Meaningful Use that many states have not yet formalized this body and its charge.  However states that have recently created such a coordinating body, like Ohio, report huge successes in making decisions and dealing with unforeseen issues related to the changing world of ePublic Health (See CDC Charter Lite Template).
  • Step 3:  gain a clearer appreciation for your LHDs capabilities, needs, and desires. This can often involve an assessment of the systems you have, the needs that are met and the gaps that exist.  It might even be good for the aforementioned Health Information Planning group to survey LHDs and display results.  This will help LHDs identify peers they can work with and peers who can offer peer assistance or advice about vendors.  It is important that this not be done from a standpoint of competition or condemnation, but rather of bettering each health department.
  • Step 4: delineate the benefits of practice management and EHR systems. Though clinical operations and responsibilities for LHDs can vary wildly, most LHDs have some sort of specialty clinics that they run (examples include STD/HIV, TB, Maternal and Child Health, etc).  And though the state is often preparing systems to meet Meaningful Use requirements, LHDs must come up with their own solutions for meeting the demands of these clinics.  Complicating matters, LHDs often have cross over between local clinic information needs and programmatic reporting to state or federal partners.  In our discussions in KS, we discovered that even with smaller programmatic clinics there are good reasons to deploy one or both of these types of systems.  Especially since costs have decreased dramatically in the past 5 years.  Benefits include more efficient programmatic reporting, increasing overall clinic efficiency resulting in a higher volume of visits, increased recovery of costs and billing, decreased need for record space, etc.  Once you have determined that the benefits offered by these systems fit within your LHD vision, conduct a review of specific systems based on your unique requirements, and understand the costs and benefits you can expect, then you can make an informed decision as to which system you should deploy (see NACCHO’s All-Systems-Go tool).
  • Step 5:  know your requirements for exchange and assess/pursue your local HIE options to support those requirements. For this final step, our discussions in KS turned to the HIE options that exist in their state.  Since they have been a leader in Health Information Exchange and LHDs have been heavily involved, they have a couple of really nice options.  In their state, LHDs can get basic HIE services for free, which include direct secure messaging and access to a provider web portal.  And KS LHDs are finding really interesting ways to use these services – like using the web portal for case investigations and sending follow-up testing requests and outbreak summary reports to physicians using direct secure messaging.  The state health department is working to connect their reporting systems to LHDs through the HIE, but work remains to make local and state systems interoperate in this fashion.  It also came to light that there were other exchange requirements that the LHD had that aren’t a part of their “free” set of services, but have enough value that they will want to understand the costs/benefits and pursue those options.  For example, local clinic managers would like to perform clinical assessments on their clients and provide test results and other clinical notes to the referred provider or receive visit summary documents when the referred visit is complete.  Though there is still much work to do, what was clear was that in the not so distant future one could imagine LHDs in KS having an efficient and interoperable connection to the state and other community based systems through their HIE.  In order to have this sort of success, it is critical that your LHD get involved, stay involved, or increase involvement locally with your HIE options.  Be aware of what services your HIEs provide, how these services can benefit your LHDs vision for the future, and see if you can negotiate special rates for LHDs.

If LHDs earnestly and systematically pursue these five steps, I believe they will have a thriving and successful transition into becoming an efficient LHD of the ePublic Health future.  At NACCHO, we’re working with our ePublic Health workgroup to develop more detailed tools that will support LHDs who go through each of these steps – so stay tuned.  I want to give a special thanks to the Kansas Health Foundation, Kansas Association of Local Health Departments, and Kansas Department of Health and Environment for allowing me into their rapidly developing world of ePublic Health.

Summary of WIRED Health Conference by Dr. Pilkington

On October 15-16, in New York City, the WIRED Health Conference in association with the Robert Wood Johnson Foundation convened a conference to explore the challenges and opportunities of data-driven medicine. Featured speakers included geneticist Craig Venter, MIT’s Gig Hirsch, architect Michael Graves, and Intel’s Andy Grove. The subject was “Big Data”. The question was what is Big Data and what does it mean for health care providers and consumers?

The federal government has acknowledged this predicament and recently set aside more than $200 million to fund big data initiatives. Earlier this month, the National Science Foundation and the National Institutes of Health (NIH) awarded about $15 million to fund eight big data research projects. The awards will “ultimately help accelerate research to improve health — by developing methods for extracting important, biomedically relevant information from large amounts of complex data,” said NIH Director, Francis Collins in a press release. Other researchers are mining social media data to monitor the adverse effects of certain medications, and the NIH has also put the data from the 1000 Genomes Project in the cloud for other scientists to use.

The slate of sessions at the live-streamed WIRED conference showcased the many ways data can be deployed to improve health and wellness. Former Intel Chairman and CEO Andy Grove issued a call to arms to free healthcare data, making his case for radical price transparency in medicine. Another session at the conference spotlighted the work of Nicholas Christakis, director of the Human Nature Laboratory at Harvard University who said, “there’s a lot of talk about personal data, but even more important than individuals’ wellness behavior is the way that networks of people affect each other’s health.” Craig Venter imagined a future where you can download software, print a vaccine, inject it, and presto! Contagion averted.

– Dr. William “Phred” Pilkington, Chief Executive Officer & Director of Public Health Cabarrus Health Alliance

Public Health Proposals from ONC’s HIT Policy Committee – October 2012

After Dr. Mostashari’s opening remarks, the HITPC meeting continued with hours of testimony.  Click Here to View October 3, 2012 HITPC Public Health Proposals for Stage 3.

Farzad Addresses ONC’s Health Information Technology Policy Committee (HITPC) Meeting 10-3-12

Dr. Farzad Mostashari, the National Coordinator for Health Information Technology, gave opening remarks at ONC’s Health Information Technology Policy Committee meeting.  He discussed some of the latest happenings since the last HITPC meeting.  This past interim, there were apparently several not so flattering commentaries in the newspapers.  He described it as 3 acts in a play.

Act 1:

There were some opinions that ONC is acting as a cheerleader.  A review of some cost benefit analysis was done on Meaningful Use incentives and said the data has not demonstrated any cost savings or real health benefit.  Further these opinions apparently went on to say that the Meaningful Use effort is misguided and a waste of money.  Another large criticism that came Dr. Mostashari’s way was that the government had not yet set any real standards for Health Information Exchange (HIE).

Dr. Mostashari responded by saying there were actually 31 cost studies done on this topic, and 27 out of 31 actually describe some cost benefit – not exactly the “rare exception” described.  In addition, Dr. Mostashari asked the question, “if we increase A1C measures for diabetics and save 2 amputations – is it worth it?”

What we’re seeing is that health information technology (HIT) is an infrastructure that once in place, you can do any number of studies and improvements.  The question isn’t if we need HIT infrastructure, but really the question is how do we do it and how do we maximize its use?

There are any number of stories of success, like the Minnesota diagnostic imaging scans that went electronic.  Before the electronic infrastructure, the decision to approve a scan was convoluted and took 10 min or more.  They asked the question, “could we use our electronic health record (EHR) for this approval process by coding the approval logic right into the system?”  Once they did, they saw a dramatic decrease in inappropriate and duplicate scans, and it took only 10 seconds for approval. 

As for the assertion that “there are no standards”, Dr. Mostashari pointed out that many use cases are now beginning to arrive at consensus standards precisely because of Meaningful Use.  It has taken some time, but stage 2 will show some really big changes in the near future.  He pointed out that many of the standards are cataloged at the Meaningful Use Stage 2 Standards-Hub.

Act 2:

A series of articles in several news papers around the country came out regarding billing.  They found that the decade before meaningful use (2000 – 2009), there was an association between higher severity codes and payments.  The implication was that this meaningful use government incentive program to encourage adoption of electronic health records may have had an unintended consequence of increasing both the number of requests and cost of severity codes.  Actually, Dr. Mostashari said, it is unclear if many things were simply under coded and now are captured or if there is a great deal of fraud.  It is also not clear what the final and total impact is on cost.  It is entirely possible that admission levels have improved despite these changes in coding.  More substantially, meaningful use was a conscious effort to move systems away from documentation and billing and toward patient centered care coordination and population health.  “If we continue to pay for documentation and more visits, that is exactly what we’ll get.”

Farzad mentioned that 76 percent of plans and medical homes expect to be in an Accountable Care Organization (ACO) pay model.  You simply can’t do a better job of measuring care without access to good information.

In addition, immutable health logs, a byproduct of meaningful use, help to enforce against fraud.  If care is documented that didn’t actually occur, then that is bad care and illegal and we take that very seriously. 

We also just heard about results of the open notes project (sponsored by RWJ).  Something like 99% of consumers and 100% of providers in the project want this practice of secure and full access to medical records for all appropriate parties to continue to be offered.  Again this sort of practice will go a long way to discover out and out fraud. 

With all of that said, it is incumbent upon us the HIT policy committee to take another look at documentation for medical purposes and offer guidelines and policies for what is good medical documentation.  We need to find out what would be good EHR functionality and what is just “over the line”.  Too much documentation just for higher billing codes, bypassing the audit log, or skipping record amendments where we can clarify should be considered in that discussion. 

Act 3:

There is real change beginning to occur on the ground.  But don’t expect this to be a one shot success.  It is and always has been a staged approach.  The first stage is collecting structured data.  The second stage is thinking about population health and data sharing.  The third stage is really getting to the meaningful use of electronic medical records.  One commenter said, “let’s be patient here, you can’t ask a two year old to do six year old tricks.”

The largest ever study of diabetes is underway through electronic EHR data and initial findings indicate remarkable improvement in patient care.  We owe it to practitioners and vendors to set ambitious goals, provide guidance, and maybe even a little bit of cheerleading.

Making Ideas Grow in Every Community – A Brief Summary of the Social Good Summit for Local Public Health

A powerful, engaging, and global conversation took place at the 2012 Social Good Summit in New York City (September 22-24). The deeper message behind the projects, initiatives, and innovations, was to become engaged in something greater than yourself to make a change in this world. Now more than ever before, as local communities within this broader global context, we’re at a better place to engage in innovative solutions for problem solving. The Summit was a collaboration of Mashable, United Nations Foundation, 92Y, United Nations Development Programme, Bill & Melinda Gates Foundation, and Ericsson.

Local health departments need to keep up with today’s technologies but also prepare for the challenges and opportunities that tomorrow brings. Some of these stories show how cost-effective solutions can come about in low resource settings. I hope to inspire you with these stories and move you to develop new initiatives in your community.

While you read these stories, consider how similar ideas can be initiated in your community.

  • What resources are needed?
  • What kind of public-private partnership should you look for? Which organizations should you approach?
  • What kind of business plan should you create?

Unleashing The Power Of Open Innovation In Government
Todd Park, U.S. Chief Technology Officer, the White House

A highly energetic Todd Park, shared his role and responsibility by focusing on these three primary tasks:

  • Make new data available to the public;
  • Take already available but unusable data and make it usable;  and
  • Make entrepreneurs and innovators aware of the government data.

Park said “You take the data that’s already there and jujitsu it, put it in machine-readable form, let entrepreneurs take it and turn it into awesomeness.”

As a result of his initiatives at both HHS and now the White House, Park has inspired developers to create “…products or services helping tens of thousands of people improve their health service experience around the country.”

For more information visit http://www.hdiforum.org.

Video link: http://new.livestream.com/Mashable/SGS/videos/3987528

Can Mobile Phones Eliminate Pediatric AIDS?
Josh Nesbit, CEO, Medic Mobile
Anu Gupta, Director in Corporate Contributions, Johnson & Johnson
Robert Fabricant, Vice President of Creative, Frog Design

The answer to the above question? “No,” said Josh Nesbit, it isn’t the device that will end it but the people using the mobile device that can.

According to Nesbit “A billion people will never see a doctor in their lives, but 90% of the world’s population is covered by mobile.”  He followed to say, “50% of the people in Sub-Saharan Africa own phones.”

His organization’s efforts have already seen results in initiatives in India. Vaccination coverage has gone from 60% to 90% coverage.

An interesting example he shared was of a $15 camera device that can take holographic pictures to remotely analyze blood samples. That in itself shows how far a mobile device can go to support areas with no clinics and health services.

For more information on Nesbit’s organization, http://medicmobile.org.

Video link: http://new.livestream.com/Mashable/SGS/videos/3988840

How Google Earth is Changing the World
Rebecca Moore, Engineering Manager, Google Earth Outreach & Earth Engine Google, Inc.

We all have our preference in search engines, but most people know how far Google has gone to create innovations beyond just simple searches.  Rebecca Moore shared examples of Google Earth Outreach. Now you ask, what is this service? Google Earth Outreach provides tools to nonprofits to help raise awareness, increase decision-making and engage stakeholders.

This service provides free versions of the following tools but advanced, fee-based versions are available as well: Google Earth; Google Earth Engine; Google Maps Engine; Open Data Kit; Spreadsheet Mapper; Custom Maps for Google Maps; Google Fusion Tables; Google Maps API; Google Street View; and Google Map Maker.

How are these services helpful to public health?

Researchers are constantly making discoveries through Google Earth. For instance, scientists discovered a rare type of Coral Reef on the remote shores of Australia. The area was scheduled for oil mining, and once the discovery was made the plans for drilling were stopped. Moore explained how Google Earth enables users to tell a story. For example, the effects of coal mining that includes mountain top removal, which results in debris in communities and subsequent health risks. The localities, especially those indicated sensitive locations on the map, like schools and hospitals can then be mapped to better understand the direct health risk to the community. This Google tool combined with public health knowledge and urban planning can help spur community activism to fight against activity that poses dangerous health risks to the population.

Can your health department use this tool to tell a story?

Video link: http://new.livestream.com/Mashable/SGS/videos/3991619

Shrinking the “Digital Divide”: The Future of Mobile
Larry Irving, Co-Founder, Mobile Alliance for Global Go

Being connected with a purpose was the message that Larry Irving delivered along with needing to focus on outcomes.

Mobile connectivity is changing lives and providing promising solutions to tough problems. Although, as Irving said, “This is the most important device ever for changing the world, but we have to work together to make it work the way we want it to work.” Solutions are hard according to Irving, but his advice was that, “You’re talking about changing business models. You’re talking about changing cultures. You’re talking about changing operational models. And we have to sit down together and figure out how this is going to work.”

His advice for mobile optimization is:

  • Hackathons should focus less on solely about a technology and instead focus on how technology can help fill gaps in society and social needs;
  • Bring investors and entrepreneurs to the table; and
  • Celebrate individuals and groups that are making social good happen with mobile solutions.

Video link: http://new.livestream.com/Mashable/SGS/videos/4025900

Digital Disaster Relief
Wendy Harman, Director of Social Strategy, American Red Cross
David Kobia, Director of Technology Development, Ushahidi
Samantha Murphy, Mashable

Responding and being aware of disastrous situations is indeed a hard job. That’s why the American Red Cross is expanding its services by giving the public a seat at the table. Wendy Harman said this has two components: 1) aggregating big data for situational awareness 2) building a digital volunteer task-force. I recently participated in one of their social media trainings as part of their volunteer task-force and believe that they are moving in the right direction to create a larger digital presence. By leveraging their Digital Operations Center and the use of digital volunteers, they can extend their services through multiple platforms in a new way. To learn more about the American Red Cross’ Digital Operations Center, read here.

Ushahidi stands for “witness” in Swahili. It is an open source project which allows users to crowdsource crisis information to be sent via mobile. David Kobia said that the open source platform allows for data to be visualized on a map, showing stories of different occurrences during crises.  For more information, http://www.ushahidi.com/about-us.

Can local health departments use such tools to visualize important data in their communities?

Video link:  http://new.livestream.com/Mashable/SGS/videos/4026562

Using Mapping Technology to End Polio
Nicole Newnham, Documentary Film Maker & Writer, The Revolutionary Optimists
Linord Moudou, Anchor & Reporter, Voice Of America
Sherine Guirguis, Communications Specialist, UNICEF

Why is it so important now more than ever to end polio? “If we don’t finish polio now, it will come back,” says Sherine Guirguis. Now we’re closer than ever to eradicate this disease and with support of technology, we’re coming closer to ending it.

Map Your World, is a multi-platform project that puts the power of new technologies into the hands of young change agents, enabling them to map, track, and improve the health of their own communities – and then share their stories of change with each other and with the world. A young group of children called the Daredevils of West Bengal, made their mission to increase polio vaccination in their community (due to a personal story of a child they knew who died of polio). Using paper megaphones and going door to door these children advocated for vaccination. Their tracking only went so far, but with the help of documentary film makers they were able to adopt an open source technology that enables them to keep track of their progress.

How can we engage our communities and target major health issues by creating low cost innovative tools?

Video link: http://new.livestream.com/Mashable/SGS/videos/4028200