McNabb S.J., Koo D., Pinner R., Seligman J. Informatics ... APHIC... · Web viewThe purpose of this module is to provide students with foundational principles, tools, methodologies,

Applied Public Health Informatics CurriculumOverview of Ten Courses, Released September 2010

Prepared by Public Health Informatics Institute

and Emory University, Rollins School of Public Health

I. Introduction to Public Health Informatics

II. Overview of Data Sources, Standards and Information Systems

III. Interpersonal and Organizational Communication

for the Public Health Informatician

IV. Project Management and System Lifecycle

V. Data Management and Enterprise Architecture

VI. Business Aspects of Public Health Informatics

VII. Information Security and Privacy; Legal and Ethical Issues

VIII. Applied Public Health Informatics Evaluation

IX. Information for Public Health Decision Making

X. Informatics in Support of Public Health Leadership

Public Health Informatics Institute (PHII) and Emory University, Rollins School of Public Health 1

APPLIED PUBLIC HEALTH INFORMATICS CURRICULUM

PRINCIPAL DEVELOPERS

Rollins School of Public Health, Emory University

Kathy Miner, PhD, MPH

Melissa Alperin, MPH, CHES

Public Health Informatics Institute

Claudia W. Brogan, MSEd, Training Manager

Niki Buchanan, MEd, Project Manager

Bill Brand, MPH, CPHIE, Director of Programs

Copyright ©2011 Public Health Informatics Institute. All rights reserved.

We encourage further non-commercial distribution of this report, but all uses in any form, in any quantity, or by any means – electronic, mechanical, photocopying, recording, or otherwise – must include the following attribution on all copies: “From Applied Public Health Informatics Curriculum, Copyright 2011 by Public Health Informatics Institute. All rights reserved.”

About Public Health Informatics Institute

The Public Health Informatics Institute is a program of the Task Force for Global Health, a 501(c)(3) non-profit organization. Our staff is comprised of professionals in the areas of public health, healthcare information systems and communications—all well-versed in the current and emerging issues facing public health. The Institute is known for its expertise as a neutral convener of public health professionals and their stakeholders, transforming health practitioners’ ability to apply information effectively in order to improve health outcomes worldwide.

For More Information

The Public Health Informatics Institute325 Swanton WayDecatur, GA 30030

Claudia W. Brogan: 404-592-1445 Email: [email protected]

Niki Buchanan: 404-687-5638 Email: [email protected]


mailto:[email protected]

mailto:[email protected]

Module I. Introduction to Public Health Informatics

Description: The purpose of this module is to provide students with foundational principles, tools, methodologies, data sources, terminologies, and policy issues as they relate to the emerging field of public health informatics. Current national e-health and health care reform priorities and strategies, and their implications for public health, will be discussed. In addition, students will review the historical and contemporary aspects of public health practice that have required the development of public health informatics.

Competencies for Public Health Informaticians:

Table 1. Competencies and Learning Objectives


Competency Learning Objective(s) Integrate knowledge about informatics into the organization.

Define public health.

Describe the governmental system of public health agencies and how they work together.

Define public health informatics.

Differentiate public health informatics from other health informatics domains (bio-medical, nursing, pharmacy, molecular, etc.).

Describe the historical roots of public health informatics.

Articulate the value of public health informatics to senior leaders within a public health agency and to program managers and staff.

Develop a working vocabulary of public health informatics and information technology terminology.

Review the scientific and grey literature in the public health informatics field.

Support use of informatics to integrate clinical health, environmental risk, and population health.

Identify challenges that can be addressed with public health informatics solutions.

Apply public health informatics principles, tools, and methodologies that can address population health programmatic needs.

Communicate origin and role of standards relevant to informatics projects and information systems.

Describe the various types and purposes of standards relevant to public health informatics; e.g., content exchange, vocabulary, transport, privacy and security.

Describe the role of Standards Development Organizations.

Supports the development of strategic direction for public health informatics within the enterprise.


Describe national e-heath priorities and strategies for improving population health through health IT.

Identify the local/state implications and opportunities for public health of national e-health priorities and initiatives.


Organizing Themes:

Definition of public health informatics (PHI)Integration of public health informatics into the public health systemHistorical overviewIntroduction to common PHI terms, tools, and methodologiesKey partnerships and stakeholdersCommon problems and needs that PHI helps to addressNational e-health agenda and how that impacts local/state public health agencies and the development and success of PHI

Possible Text/Readings/Resources:

Centers for Disease Control and Prevention. (1997). Principles of community engagement. Available at http://www.cdc.gov/phppo/pce/)

Department of Health and Human Services. The ONC-Coordinated Federal Health Information Technology Strategic Plan: 2008-2012. Synopsis. June 3, 2008. Available at: http://healthit.hhs.gov. (Note: Periodic updates to the plan are anticipated.)

Identifying/analyzing food borne outbreaks. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/foodnet/

Informatics at Local Health Departments: Findings from the 2010 National Profile of Local Health Departments”, published by NACCHO July 2010. Available at www.naccho.org

Institute of Medicine. (2003). Who will keep the public healthy? Educating public health professionals for the 21st century. Washington, DC: National Academies Press.

Institute of Medicine. (2003). The future of the public’s health in the 21st century. Washington, DC: National Academies Press.

Koo D., O’Carroll P., LaVenture M. Public Health 101 for informaticians. J Am Med Inform Assoc 2001; 8:585-597.


http://healthit.hhs.gov/

http://www.cdc.gov/phppo/pce/

McNabb S.J., Koo D., Pinner R., Seligman J. Informatics and Public Health at CDC. MMWR 2006; 55(Suppl 02):25-28.

National Center for Health Statistics. (2009). Health, United States, 2008. Hyattsville, MD: U.S. Government Printing Office.

O’Carroll, P.W., Yasnoff, W.A., Ward, M.E., Ripp, L.H., & Martin, E.L. (Eds.). (2003). Public health informatics and information systems. New York: Springer-Verlag.

Scutchfield, F.D., & Keck, W. (2003). Principles of public health practice. Florence, KY: Cengage Learning.

State Alliance for e-Health. Preparing to Implement HITECH: A State Guide for Electronic Health Information Exchange. August, 2009. Available at http://www.nga.org/Files/pdf/0908ehealthhitech.pdf

Yasnoff W.A., O’Carroll P.W., Koo D., Linkins R.W., Kilbourne E.M. Public health informatics: improving and transforming public health in the information age. J Public Health Management Practice 2000; 6:67-75.

Portfolio:

The student will identify 1-2 public health issues/challenges, identify appropriate informatics tools and/or approaches for addressing these issue(s), and describe how the tools and/or approaches would be applied. This provides the opportunity for the student to demonstrate mastery of basic public health informatics vocabulary, concepts and theory. The example chosen by the student can be use and built upon in later modules.

Considerations for Faculty:

If you have not identified pre-requisites for the students, you will likely have to present the material from Module I to students with either no or little public health background (e.g., IT staff), as well as to students with no or little IT background. Ensuring that students clearly understand the foundational information in this module will help ensure an effective learning situation for subsequent modules.

When defining informatics, make sure students can describe the ways in which informatics is distinct from but supports both information technology and public health programs.


http://www.nga.org/Files/pdf/0908ehealthhitech.pdf

Module II. Overview of Data Sources, Standards, and Information Systems

Module Description:

The purpose of this module is to provide students with an overview of current public health data sources, standards and information systems. The students will learn to identify types and sources of data, as well as their utility to public health. The student will be able to identify the characteristics and features of applications and information systems that support point of service, surveillance, response and population health activities. The student will learn the features of effective public health information system design and best practices in integrating and exchanging information across systems. Finally, students will learn to determine the role of standards in enabling information exchange, interoperability, and basic architecture.

Recommended Pre-requisites:

Module I: Introduction to Public Health Informatics Some familiarity with qualitative and quantitative data collection methods (e.g., surveys,

focus groups, interviews) Competencies for Public Health Informaticians:


Competency Learning Objective(s)

Analyze user and stakeholder information, knowledge, and data needs.

Differentiate among the various types of data, data sources, applications and information systems at the local, state, national, and international levels.

Articulate the informatics aspects of some common business processes used in public health; e.g., case management, surveillance, client registration, case investigation.

Identify stakeholder and user needs and goals related to information and knowledge management.

Explain the informatics aspects of integrating Assess uses and value of different types of data Public Health Informatics Institute (PHII) and Emory University, Rollins School of Public Health 7

and exchanging data among clinical health, environmental, public health and other sources to improve population health.

to answer public health questions.

Articulate the different uses of data for public health, including anonymized, de-identified, research, clinical, and secondary.

Differentiate among the various types of public health applications and information systems that operate at local, state, national, and international levels and how they support and advance public health programs.

Explain the need for interoperability of different public health information systems at all programmatic levels.

Use informatics standards. Describe the role of standards in achieving integration and interoperability.

Define the categories of standards identified by the Office of the National Coordinator for Health IT (content exchange; vocabulary; transport; privacy & security), and list examples of standards for each.

Identify informatics standards in use in various projects, applications and information systems, including where appropriate standards do not exist.

Identify interoperability successes and barriers when standards have been used in projects/ systems.

Implement selected standards according to


approved implementation guides.

Identify gaps in standards development and articulate how systems can be designed to be adaptable as new standards emerge.

Contribute to development of public health information systems that are interoperable with other relevant information systems.

Define integration and interoperability.

Describe the requirements for exchanging and integrating information across public health programs and with other organizations.

Identify challenges in achieving interoperability across systems.

Organizing Themes:

Types of public health data and data sources Types of public health information systems Public health data standards Requirements and approaches to achieving system integration and interoperability


Centers for Disease Control and Prevention. Updated guidelines for evaluating public health surveillance systems: recommendations from the guidelines working group. MMWR 2001: 50 (No. RR-13).

Chute, C.G., Koo, D. Public health, data standards, and vocabulary: Crucial infrastructure for reliable public health surveillance. J Public Health Management Practice 2002; 8:11-17.

Friedman, D., Parrish, R.G., & Hunter, E. (Eds.). (2005). Health statistics: Shaping policy and practice to improve the population’s health, New York: Oxford University Press.

Health Information Technology Standards Committee. The official federal advisory body on health standards. www.healthit.hhs.gov


http://www.healthit.hhs.gov/

Health Information Technology Standards Panel. The Panel was formed for the purpose of harmonizing and integrating standards to meet clinical and business needs for sharing information among organizations and systems. www.hitsp.org

O’Carroll, P.W., Yasnoff, W.A., Ward, M.E., Ripp, L.H., & Martin, E.L. (Eds.). (2003). Public health informatics and information systems. New York: Springer-Verlag.

Public Health Data Standards Consortium. Various publications and other resources on standards used in public health. www.phdsc.org

Standards for Certification of Interoperable Electronic Health Records. www.healthit.hhs.gov

Teutsch, S.M., & Churchill, R.E. (Eds.). (2000). Principles and practice of public health surveillance (2nd edition). New York: Oxford University Press.

Portfolio:

For an identified public health need, the student will write a descriptive analysis of a public health information system, including the identification of data sources, actual or potential uses of the data, relevant standards, any known privacy issues, and issues of interoperability with other systems.


Standards are a rapidly evolving domain. It would be important for students to be encouraged to keep current from both a systems perspective as well as from the perspective of their particular work environment. Many of the Resources listed above are good sources for staying current.



http://www.phdsc.org/

Module III. Interpersonal and Organizational Communication for the Public Health Informatician

Course Description:

The purpose of this course is to provide students with essential social interaction and communication techniques. Students will learn to write, present, and convey public health informatics content. Students will learn to communicate technical information, as well as the added value of improving information management in public health practice. In addition, students will learn the principles of mentorship, and be prepared to perform as a mentor or a protégé. This course will focus on the communication skills to teach the Informatician how to be the liaison among the program, scientific, and technical stakeholders so they can succeed in understanding and using informatics.

Recommended Pre-requisite: Module I: Introduction to Public Health Informatics

Competencies for Public Health Informaticians: Table 1. Competencies and Learning Objectives

Competency Learning Objective(s) Communicate with cross-disciplinary leaders and team members.

Apply communication strategies in interactions with individuals and groups.

Communicate numeric and visual information orally and through electronic means, with linguistic and cultural proficiency.

Summarize information that addresses the audience using multiple modalities.

Illustrate complex concepts using diagrams, illustrations and pictures.

Present demographic, statistical, programmatic, and scientific information for use by professional and lay audiences.

Apply user-centered design techniques to determine information needs.

Solicit input from individuals and organizations incorporating user centered design and techniques.


Maintain public health informatics communication partnerships with key stakeholders.

Conduct education and training in public health informatics.

Develop informational and persuasive briefs/presentations that translate public health needs into informatics strategies and recommendations.

Present public health informatics information to lay and scientific audiences, regardless of the information source.

Integrate knowledge about informatics into the organization through theory-driven educational approaches.

Advance personal knowledge of public health informatics by staying current with the literature, attending conferences, and participating in continuing education activities.

Ensure that knowledge, information, and data needs of project or program users and stakeholders are met.

Establish linkages with key stakeholders.

Analyze user and stakeholder information, knowledge, and data needs.

Identify strategies for engaging stakeholders in defining informatics needs and solutions related to addressing community health problems.

Reconcile differences among stakeholders in the development, implementation, and operations of public health informatics systems.

Advance the profession and practice of public health informatics through leadership and mentorship.

Establish mentoring, peer advising, coaching or other personal development opportunities for the public health workforce.

Contribute to the measuring, reporting and continuous improvement of organizational performance.

Modify organizational practices in consideration of changes in the public health system, and the larger social, political, and economic environment.


Organizing Themes:

CommunicationEducation and trainingStakeholder assessment and engagementProfessional development


Alley, M. (2008). The craft of scientific presentations. New York: Springer-Verlag.

Collins, J. (2001). Good to great: Why some companies make the leap … and others don’t. New York: HarperCollins Publishers.

Fisher, R. and Ury, W. (1991). Getting to yes. New York: Penguin Group.

Lorenzi, N. (2004). Managing technological change. New York: Springer-Verlag.

Ury, W. (1991). Getting past no. New York: Bantam Books.

Portfolio:

The student will develop a stakeholder engagement strategy that defines the information needed to assess and/or intervene on a public health problem. This strategy will include the identification of a community-based public health problem in need of an informatics solution, identification of primary and secondary stakeholders, and recommended action steps to engage the stakeholders in remediating the problem.

The student will select a public health informatics topic and develop a presentation (oral or poster) for either a professional or lay audience.

The student will develop a lesson plan on a public health informatics topic.

Based on a personal experience in a mentoring relationship, the student will develop a case study of how the experience advanced an individual’s career.



A variety of resources can be acquired to supplement the considerations listed here. According to the faculty member’s determination of student learning needs, additional course-time can be spent on important topics such as group dynamics and managing effective meetings. Studying the “SBAR Technique” may be useful (clearly communicating “Situation—Background – Assessment—Recommendation”), a framework for coordination among members of a health care team. Concept maps are helpful techniques to include as well, explaining methods of information management. The tool of Mind Mapping can help to visualize, structure and classify ideas, and may be useful for informaticians when illustrating a set of related ideas.

The competencies for this type of course are project based, which typically require out of class time to prepare and in-class time to present.


Module IV. Project Management and Information System Lifecycle

Course Description:

The purpose of this course is to provide students with information about the frameworks and methods used in the design, management, and evaluation of information system lifecycles and projects. Students will learn about ways to ensure that the milestones, change management, and quality assurance procedures are in place to deliver the solutions to meet public health needs. Students will learn techniques, resources, and tools that assist in the analyses and documentation of workflows and business processes, which can be translated into requirements for public health information systems.

Recommended Pre-requisite:

Module I: Introduction to Public Health Informatics




Ensure that knowledge, information, and data needs of a project or program users and stakeholders are met.

Articulate the business case/need for a public health information system.

Analyze user and other stakeholder information, knowledge, and data needs

Implement workflow analysis, business process analysis and redesign, and other techniques and methodologies to capture and translate the needs of a public health program into system requirements.

Establish ongoing structure and methods for effectively engaging stakeholders in design, implementation and enhancement decisions.

Support information system development, Assess the needs and requirements of public


procurement, and implementation that meet public health program needs.

health stakeholders and end users to incorporate in the system design.

Integrate public health system requirements into information systems development, procurement, and implementation.

Implement project management tools or processes consistent with information system needs.

Apply project and program management frameworks and methods to public health informatics initiatives.

Manage IT operations related to project or program.

Manage project or program resources

Manage risks to information systems and applications

Manage the budget, scope, schedule, and human resources of a project.

Implement quality assurance controls to ensure the successful IT adoption to meet the needs of the public health stakeholders.

Apply techniques and controls within a software development lifecycle to ensure the success of a public health solution.

Organizing Themes:

Project managementBusiness processesIT operations

Possible Textbooks/Reading/Resources: Public Health Informatics Institute (PHII) and Emory University, Rollins School of Public Health 16

Centers for Disease Control and Prevention, Unified Process for Project Management. Available at http://www2.cdc.gov/cdcup/

Taking Care of Business, Public Health Informatics Institute, 2009. Available at www.phii.org.

Microsoft Project book and time in a lab to practice it (or some other software with this functionality)

Portfolio:

The student will develop a business case or a request for proposal, define the best practices and business processes and data needs; translate into functional and other requirements; develop an RFP that vendors could respond to.

The student will identify and develop an informatics project for users and stakeholders, to gain experience using basic informatics tools, such as: work flow process, business process analysis, describing project and system requirements, identifying stakeholders (data, best practices, and quality improvement).

The student will develop a project charter, project plan, and communications plan for a defined informatics project.


The informatician needs to be able to explain the principles, methodologies and tools of a project manager. Some of this information may be found in disciples beyond public health informatics.


http://www.phii.org/

http://www2.cdc.gov/cdcup/

Module V. Data Management and Enterprise Architecture

Module Description:

The purpose of this module is to provide students with key data terminology, concepts, and models and principles for data management, knowledge management, and enterprise architecture within the context of public health. Students will learn to apply data design methodologies. They will also learn to aggregate, normalize, integrate and analyze data from multiple health environments. Finally, students will learn best practices and methodologies that are used to architect interoperable or integrated public health information systems based on use of standards and enterprise architecture.


Module II: Survey of Data Sources, Standards, and Information Systems Module IV: Project Management and Information System Lifecycle



Competency Learning Objective(s) Support information system development, procurement, and implementation that meet public health program needs.

Participate/lead in development of knowledge management tools for the enterprise.

Ensure that knowledge, information, and data needs of project or program users and stakeholders are met.

Identify the strengths and challenges associated with qualitative and quantitative data.

Evaluate the characteristics and limitations of data sources.

Describe the difference among and between data management, information management, and knowledge management

Apply key data management information models and principles.

Incorporate data governance concepts and principles into the management operations and enterprise architecture

Monitor the use of concepts and principles of data architecture, analysis and design.

Monitor the use of key database management concepts and principles.


Monitor the use of data security management concepts and principles.

Monitor the use of concepts and principles of data quality.

Monitor the use concepts and principles of data warehousing and data mining.

Contribute to development of public health information systems that are interoperable with other relevant information systems.

Apply formal data design methodology to assure useable, useful, and sustainable public health systems.

Identify interoperability concerns

Explain the best practices and methodologies of to architect interoperable or integrated public health systems.

Differentiate among the various types of data and data sources at the local, state, national, and international levels and how they support and advance (or at times inhibit integration of) public health programs.


Explain the key concepts in aggregating, normalizing, integrating, and analyzing data from multiple health environments including national datasets, clinical information systems, and laboratories.

Organizing Themes:

Data governance in public healthData architecture, analysis and designDatabase managementData security managementData quality managementData warehousing and miningEnterprise architecture



DAMA Guide to the Data Management Body of Knowledge (DMBOK), www.dama.org.

Institute for Enterprise Architecture Developments, Enterprise Architecture Overview, available at http://www.enterprise-architecture.info/EA_Standards.htm

The Open Group Architecture Forum, available at http://www.opengroup.org/architecture/.

Portfolio:

For a selected public health information system (preferably working directly with a local or state health department), analyze and document the current status and any concerns around data design and architecture, data quality (e.g., completeness, accuracy, timeliness), and data security (e.g., appropriate privacy protections, authentication, levels of access rights, audit logs). Some of the data quality and types, standards, are covered in the Module II called Data Sources, Standards, and Information Systems.


The student need only be introduced to knowledge management in this module, in order to understand how it fits with data management and enterprise architecture. A fuller exploration and application of knowledge management will occur in Module IX called Information for Public Health Decision Making. Keep in mind that the informatician Is not typically called upon to be a system architect, database designer or security specialist, so the focus on your modules should be around familiarizing the student with the key concepts and vocabulary so that the person becomes an effective “bridge” between IT and programmatic staff.


http://www.opengroup.org/architecture/

http://www.enterprise-architecture.info/EA_Standards.htm

http://www.dama.org/

Course VI. Business Aspects of Public Health Informatics

Course Description:

The purpose of this course is to provide students with an introduction to business practices associated with public health informatics. Students will learn to plan for and manage fiscal and operational resources in the midst of shifting budgetary environments. Students will learn the various processes of resource acquisition, allocation, business case development, and business plans. In addition, students will learn to procure information technology services in order to purchase, develop, modify, and maintain public health information systems using systematic decision-making methods.


Module I: Introduction to Public Health Informatics Module IV: Project Management and Information System Lifecycle



Competency Learning Objective(s) Manage information system projects supporting public health programs.

Develop business plan which specifies resource allocation, staffing, and sustainability for an informatics system.

Integrate public health system requirements into information systems development, procurement, and implementation.

Incorporate into existing public health informatics systems recent changes in information standards, technologies, and product support to enhance effectiveness and maximize cost-effectiveness and lifespan of acquisitions or builds.

Develop strategies for adapting systems to anticipated changes in informatics systems.

Calculate future cost estimates for expected enhancements for system updates.

Adhere to agency policies and procedures on procurement, purchase and development of public health informatics systems.

Follow best practices and agency/ jurisdictional policies for developing a request for information (RFI), request for proposal (RFP), grant, contract, cooperative agreement, and other fiscal arrangements.

Follow agency/jurisdiction’s policies for issuing and making decisions regarding RFPs for information systems and


technology.

Perform research on potential vendors to understand history, performance record, capacity, ongoing commitment to and development of the product line, and feedback from other users.

Document all aspects of the acquisition process and makes them transparent to the public.

Award RFP, contract or cooperative agreement for information systems and technology.

Write Statements of Work (SOW) that adhere to legal, contract, and performance terms.

Identify how change management principles and methods contribute to cost-control and system stability.

Estimate cost for various types of technology projects.

Articulate typical reasons for IT project failures.

Manage vendor relationships and contracts.Evaluate IT operation’s performance management techniques.

Implement evaluation parameters for the management of internal IT operations.

Implement evaluation parameters for the management of IT operations by subcontracted entities, recognizing deviations from or need to amend contracts.

Operate project within scope of allotted resources (e.g., fiscal, human).


Organizing Themes:

Statements of Work and/or Requests for ProposalsVendor managementIT evaluation


CDC Unified Project Management, available at http://www2.cdc.gov/cdcup/.

Batteries Not Included: Understanding the total cost of ownership for a commercial off-the shelf public health laboratory information management system available at www.phii.org/resources.

Portfolio:

Develop a business plan which specifies resource allocation, staffing, and sustainability for an informatics system.

Develop request for proposal (RFP), grant contract, or cooperative agreement.

Respond to request for proposal (RFP), grant contract, or cooperative agreement.

Critique submitted responses to request for proposal (RFP), grant contract, or cooperative agreement.

Create a library of sample charters, business processes, and RFP’s that users can pull from and contribute toward.

Develop business plan for public health informatics solution.


This course lends itself to a critique of a SOW or RFP currently in use by a public health agency. The various IT programs within your institution undoubtedly have many excellent resources around effectively writing and evaluating RFPs and proposals.


http://www.phii.org/resources

http://www2.cdc.gov/cdcup/

Module VII. Information Security and Privacy; Legal, and Ethical Issues

Module Description:

The purpose of the module is to provide students with the ability to identify and apply information privacy and security policies and practices to public health information systems. Students will learn legal and ethical requirements necessary for protecting the privacy of individuals and populations. In addition, students will learn legal issues around secure health information exchange among disparate organizations.


Module I: Introduction to Public Health Informatics Module II: Survey of Data Sources, Standards, and Information Systems



Competency Learning Objective(s) Implement solutions that ensure confidentiality, security, and integrity while maximizing availability of information for public health.

Describe legal issues around secure health information exchange among disparate organizations.

Describe the legal and regulatory requirements necessary for protecting the privacy of individuals and populations. (Ex. HIPAA security standards, breach notification rules)

Compare security and privacy options to best meet specific public health informatics systems.

Identify the most likely information security threats in public health systems, and appropriate remediation strategies.


Apply security practices to prevent and mitigate risks associated with public health informatics systems.

Differentiate between and among security risks to public health informatics systems.

Describe the procedures that reduce security risks to public health Informatics systems.

Develop strategies for keeping current on the security procedures.

Ensure the integrity, confidentiality, and reliability of informatics systems and data.

Apply ethical and legal considerations in the evaluation of information security controls and technologies.

Organizing Themes:

Privacy and Confidentiality Information SecurityLaws and RegulationsEthics


Office of the National Coordinator for Health Information Technology. Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information. www.healthit . hhs.gov

Office of the National Coordinator for Health Information Technology. HIPAA Privacy Rule. www.healthit.hhs.gov

Office of the National Coordinator for Health Information Technology. HIPAA Security Rule. www.healthit.hhs.gov

Office of the National Coordinator for Health Information Technology. Health Information Security and Privacy Collaboration. www.healthit.hhs.gov

U.S. Department of Health and Human Services. HITECH Breach Notification Interim Final Rule. http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/breachnotificationifr.html

Public Health Data Standards Consortium. PRISM, a privacy toolkit for public health professionals. http://www.phdsc.org/privacy_security/prism.asp

Centers for Disease Control and Prevention. HIPAA Privacy Rule and public health: guidance from CDC and the U.S. Department of Health and Human Services. MMWR 2003; 52 (suppl). Public Health Informatics Institute (PHII) and Emory University, Rollins School of Public Health 25

http://www.phdsc.org/privacy_security/prism.asp

http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/




http://www.healthit/

Collaborative Institutional Training Initiative (CITI). https://www.citiprogram.org/Default.asp.

Goodman, R.A. (2006). Law in public health practice. New York: Oxford University Press.

Stoll, C. (2000). Cuckoo’s egg. New York: Simon & Shuster.

Portfolio:

For a given public health information system, the student will identify security, privacy, legal, and ethical issues.

The student will research a historical event where information security and/or privacy was compromised and develop a plan for remediation of the situation.

Conduct a needs assessment, using quantitative (e.g., survey, technology observation) and/or qualitative methods (e.g., focus groups, interviews), of security threats to an agency's system.


Be sure the student can differentiate between privacy and security laws and regulations that apply to healthcare entities and those that apply to public health, since they are different. These differences can require surprisingly complex and nuanced policy analysis and implementation. Since and security issues are widely seen as the Achilles Heel of health IT and health information exchange, the instructor must ensure a deep appreciation in the student for the importance and complexity of these issues in American culture.

Be sure that the student can explain privacy and security laws, as well as being able to differentiate between regulations that apply to healthcare entities and those that apply to public health. Distinguish these items with practical examples. These differences can require surprisingly complex and nuanced policy analysis and implementation. Since privacy and security issues are widely seen as the Achilles Health of health information technology and health information exchange, the instructor must ensure a deep appreciation in the student for the importance and complexity of these issues in the landscape of important issues today.


https://www.citiprogram.org/Default.asp

Module VIII. Applied Public Health Informatics Evaluation and Research

Module Description:

The purpose of this module is to provide students with a foundation in the methods and techniques for evidence-based practice of public health informatics. Students will learn to critique the scientific and grey literature and to apply scientific evidence in the solution of public health informatics challenges. Students will develop evaluation and research skills that will allow them to use authoritative sources for information management strategies and to apply established frameworks for the evaluation of public health information systems.


Module I: Introduction to Public Health Informatics Module II: Survey of Data Sources Standards, and Information Systems Module V: Data Management and Enterprise Architecture Module VII: Information Security, Privacy, Legal and Ethical Issues



Competency Learning Objective(s) Evaluate information systems according to the established frameworks.

Define the various types of applicable research (action, applied, epidemiologic, evaluation, qualitative, quantitative and others), and when each is most appropriate.

Assess the usability of an information system including improved effectiveness, efficiency and satisfaction

Solicit feedback on technical solution implementation to ensure results are satisfactory to the data producer and public health organization.


Participate in applied public health informatics research for new insights and innovative solutions to health problems.

Participate in applied public health informatics research.

Apply informatics research to determine how IT can change and improve public health practice.

Contribute to local, national, and international public health informatics research agendas and participates in revising and setting these.

Disseminate findings and contributes to science.

Collaborate with an interdisciplinary team to develop evaluation or research questions.

Critique public health informatics literature.

Conduct public health informatics evaluation or research project.

Identify key informatics research issues, including IRB, conflict of interest, data storage and management, and reporting requirements.

Translate evaluation or research findings to a public health informatics issue.

Describe the importance of leveraging information from other systems for public health.

Describe the importance of leveraging information to improve healthcare, personal health, and other systems.

Use research findings to evaluate an existing information system, data management plan, and/or enterprise architecture. Recommend changes based on research and evaluation findings.

Advance personal knowledge of public health informatics by staying current with lay and professional literature.

Identify the major health-related informatics journals, conferences, and web sites.

Organizing Themes:

Translation of science into practiceRole of information systems in the management of research data



Charles P Friedman, Jeremy C Wyatt. Evaluation Methods in Medical Informatics. 1997Healthcare Information and Management Systems Society. Sections on research, professional development, public policy, and topics and tools. State chapters provide networking opportunities for students. www.himss.org. (Student memberships available at discounted rate.)

American Medical Informatics Association. Various publications and training programs; public policy resources. www.amia.org (Student membership available at discounted rate.)

Michael Hammer. The Process Audit. Harvard Business Review. http://hbr.org/2007/04/the-process-audit/ar/1

Craig Symons. Measuring the Business Value of IT. (2006) Forrester Research, Inc. http://www.cornerstone1.com/SAP/SAP_Forrester_Measuring_the_Business_Value_of_IT.pdf

Portfolio:

The student will write a critical review of literature on a public health informatics topic.

The student will develop a research proposal suitable for submission to the university’s Institutional Review Board.

The student will evaluate a public health information system based on a pre-defined framework, and recommend policy, data management, architecture or other changes.


This module is an opportunity to introduce students to the professional literature within public health informatics and many students are unfamiliar by this type of reading material. The learning objectives around using and critiquing the informatics literature can, of course, be imbedded in any or all of the other modules. This module lends itself to being co-taught by research faculty and a practitioner.

As with all the modules, an emphasis should be maintained on clarifying how data, information, information systems and research findings can be applied to improve public health practice.


http://www.cornerstone1.com/SAP/SAP_Forrester_Measuring_the_Business_Value_of_IT.pdf

http://hbr.org/2007/04/the-process-audit/ar/1

http://hbr.org/2007/04/the-process-audit/ar/1

http://www.amia.org/

http://www.himss.org/

Module IX. Information for Public Health Decision Making

Module Description:

The purpose of this module is to provide students with the basics of knowledge management and decision support systems in public health. Students will learn how to categorize the different types of decisions that are made in the practice of public health; that is, policy, management, clinical, epidemiologic, etc. Students will also identify informatics tools needed to support different decision types. In addition, students will learn about knowledge repositories, data mining and visualization techniques that aid in decision support.


Module I: Introduction to Public Health Informatics Module II: Survey of Data Sources, Standards, and Information Systems Module V: Data Management and Enterprise Architecture Module VI: Applied Public Health Informatics Evaluation and Research



Competency Learning Objective(s) Analyze user and stakeholder information, knowledge, and data needs.

Discuss the value and importance of stakeholder participation.

Provide examples of how the routine use of data can improve data quality (accuracy, completeness) and improve public health program effectiveness.

Analyze information needs relevant to specific public health policy decisions.

Develop use cases for potential decision support applications or systems.


Participate in development of knowledge management tools for the enterprise.

Describe the different types of decisions made in the practice and administration of public health and public health informatics.

Describe a decision support system in terms of the classic data, information, and knowledge hierarchy.

Describe how the choice of data indicators impact the health outcome or decision point for a public health problem

Identify gaps in data sources for decision support.

Identify existing public health knowledge management and decision support systems.

Differentiate between data-driven and knowledge-driven decision support systems, and identify what types of public health decisions are supported by each.

Explain how data visualization and complex reporting drive the decision process.

Evaluate tools that are designed to enable exchange and integration of structured and non-structured data to create reports and support decision making.

Assist in identifying solutions for information access.

Apply data mining techniques and applications.

Support decision analysis for policy development and program planning.


Use informatics to integrate clinical health, environmental risk, and population health for public health and personal health decision making.

Model the information flow, access, and retention needs within, into, and out of projects or programs associated with one or more decision processes.

Describe options for consistent approach for all agency (program) information systems and data sources.

Describe an integration strategy and architecture that could unify disparate data sets that cross health, public health and/or environmental domains to support decision making.

Display data to support public health informatics decision making.

Identify the range of reporting, visualization and analysis needs.

Identify message to be conveyed by data display.

Select optimal method(s) of conveying data message.

Create data display and any supporting narrative.

Organizing Themes:Decision typesKnowledge managementData miningAnalysis, visualization and reporting in public health


Possible Text/Readings/Resources: Books and white papers regarding use of GIS and Public Health. Available for purchase at http://www.esri.com/industries/health/business/literature.htmlFoldy Seth, MD. ] Knowledge Management: Primer for Public Health (source document available upon request)Hammer, Michael (2007) The Process Audit. Harvard Business Review

Foldy Seth, MD. Knowledge Management: Primer for Public Health (source document available upon request)

Hammer, Michael (2007) The Process Audit. Harvard Business Review HIMSS Clinical Decision Support Guidebook Series. www.himss.org

Haddix, A.C., Teutsch, S.M., and Corso, P.S. (Eds.). (2003). Prevention effectiveness: A guide to decision analysis and economic evaluation. New York: Oxford University Press.

Teutsch, S.M., & Churchill, R.E. (Eds.). (2000). Principles and practice of public health surveillance. New York: Oxford University Press.

Edward R. Tufte: Tufte, E.R. (2006). Beautiful evidence. Cheshire, CT: Graphics Press. Tufte, E.R. (1990). Envisioning information. Cheshire, CT: Graphics Press. Tufte, E.R. (2001). The visual display of quantitative information (2nd ed). Cheshire, CT:

Graphics Press. Tufte, E.R. (1997). Visual explanations: Images and quantities, evidence and narrative.

Cheshire, CT: Graphics Press.

Zaruhi R. Mnatsakanyan and Joseph S. Lombardo . Decision Support Models for Public Health Informatics. www.jhuapl.edu/techdigest/td2704/Mnatsakanyan.pdf


This module should be an integrative experience that can be tailored to fit the individual or to a particular agency/public health issue.

It is important to remind students that Decision Support Systems do not make decisions but only provide information to inform the decision making process.


http://www.jhuapl.edu/techdigest/td2704/Mnatsakanyan.pdf

Module X. Informatics in Support of Public Health Leadership and Management

Module Description:

The purpose of this module is to provide students with a more autonomous learning experience that integrates the knowledge and experience of the previous nine modules in practical application to real world experiences. Students will learn the skills to ensure that the strategic direction of informatics aligns with the public health mission and goals of an organization, as well as broader e-Health priorities in the community. Students will be able to describe the drivers for and approaches to integration of data within an agency, interoperability across internal information systems within an agency, and interoperability with systems outside of the agency. Students will learn how to critique policies that influence public health informatics and how to assess the impact of these policies on informatics priorities within their organizations.


Module I: Introduction to Public Health Informatics Module II: Survey of Data Sources, Standards, and Information Systems Module III: Interpersonal and Organizational Communication for the Public Health

Informatician Module IV: Project Management and Information System Lifecycle Module V: Data Management and Enterprise Architecture Module VI: Business Aspects of Public Health Informatics Module VII: Information Security, Privacy, Legal and Ethical Issues Module VIII: Applied Public Health Informatics Evaluation and Research Module IX: Information for Public Health Decision Making




Support development of strategic direction for public health informatics within the enterprise.

Describe concepts of enterprise architecture and governance as they relate to organizational mission, internal integration of data, internal interoperability across information systems, and interoperability with external systems, such as hospitals systems or a Health Information Exchange entity.


Apply design concepts to assure usable, useful, and sustainable public health information systems.

Conduct analysis of alternatives in order to recommend public health informatics strategic decisions for an agency, program or project.

Conduct analysis of alternatives in order to recommend public health informatics strategic decisions for an agency, program or project.

Analyze informatics case studies to identify successes and failures, describing the generalizable lessons learned.

Demonstrate skills in providing informatics consultation, policy analysis and meeting facilitation to support decision making.

Critique implications of public health informatics policies on practice.

Interpret a jurisdictional policy regarding the uses of public health information, and the implications for information system design and use.

Write a public health informatics policy for a defined jurisdiction or agency, such as a data sharing agreement, privacy policy or security policy.

Suggest advocacy strategies to affect public health policy. Include ways that public health data repositories effectively influence active


exchange partnerships that ultimately improve population health.

Promote the profession of public health informatics.

Describe characteristics of organizational leadership, change management, and principles of negotiation, as they relate to informatics issues and decisions.

Develop a professional career plan.

Organizing Themes:

Systems thinkingPolicy analysisProfessional career plan


Office of the National Coordinator for Health IT. Federal Health IT Strategic Plan. www.healthit.hhs.gov

State health information exchange strategic and operational plans. See state-specific web sites for copies of plans and contact individuals.

National Association of County and City Health Officials. Informatics Toolbox. http://naccho.org/toolbox/

Public Health Data Standards Consortium. Resources on health information exchange. http://phdsc.org/products/default.asp

Kingdon, J. (2003). Agendas, alternatives, and public policies (2nd ed.). New York: Addison-Wesley Educational Publishers.

Rowitz, L. (2008). Public health leadership: Putting principles into practice. Sudbury, MA: Jones & Bartlett Publishers, Inc.

Sabatier, P. (Ed.). (1999). Theories of the policy process. Colorado: Westview Press.


http://phdsc.org/products/default.asp

http://naccho.org/toolbox/


Portfolio Project:

For a given public health policy, the student will identify stakeholders (at all levels) and evaluate both the intended and unintended consequences of the policy and potential resolutions.

The student will develop a three-minute “elevator presentation” to address a politician or key policy maker on the importance of an informatics project for their agency/organization.

Given a hypothetical situation, the student will describe how to mitigate technical disasters/failures and communicate effectively. (e.g., It’s your first day on the job and the information system crashes. How do you handle the situation?)

The student will write a plan (business, communications, data) for different key stakeholders that addresses stakeholder needs (multi-level, multi-stakeholder), synthesizing the different needs for the various stakeholders.

Document the necessary infrastructure needed to integrate with/support health information exchange within and outside the agency. Include the necessary strategic direction, policy and infrastructure to achieve internal integration, internal interoperability, and external interoperability.


This module is designed to provide students with senior level skill in the professional public health informatics field. They should be expected to perform with a degree of autonomy and capacity for leadership exhibiting both a depth of knowledge of the breadth of practice and depth of the science in public health informatics.


Documents

McNabb S.J., Koo D., Pinner R., Seligman J. Informatics ... APHIC... · Web viewThe purpose of this module is to provide students with foundational principles, tools, methodologies,