An Informatics Solution for Informing Care Delivery of Immediate Public Health Risks to Their Patients

Abstract

This paper describes a public health alerting approach that has the potential to improve patient care during a public health outbreak and reduce healthcare costs, streamline the process of public health alert management and dissemination, and heighten the crucial feedback loop between public health officials and clinicians. The approach ties public health alerts into the diagnostic process and allows clinicians to more easily determine when an observed medical condition may be related to a more widespread disease outbreak. A prototype Alert Knowledge Repository (AKR) service using this approach was demonstrated within the Health Information and Management Systems Society (HIMSS) and the Public Health Information Network (PHIN) interoperability showcases in April and September 2009, respectively.

Towards public health decision support: a systematic review of bidirectional communication approaches

“…Six articles describe approaches in which knowledge about emerging health threats and population health was disseminated through EHR systems. [28][29][30][31][32][33] Three of the articles focused on describing either how EHR systems might support 28 or the development of a system designed to support 29 The other three articles 30 31 33 describe the development and initial evaluation of bidirectional communication infrastructures wherein clinicians receive public health knowledge through their EHR system or a health information exchange. In Lurio et al, 30 a large ambulatory practice implemented a process by which emerging public health threats trigger the creation and display of CDS alerts.…”

“…26 27 EHR articles described public health alerts that were input into existing CDS systems deployed within the clinical enterprise. In Lombardo et al, 29 a web services architecture was deployed to allow commercial EHR systems to connect to a centralized repository of public health alerts. In Gamache et al, 33 commercial EHR systems already connected to a health information exchange received information through a single connection point at the local health department.…”

“…35 Guidance on semantic interoperability and how best to represent public health knowledge was absent in the discussion of the selected articles. Articles by Garrett and Yasnoff 28 and Lombardo et al 29 described the potential for a repository of public health knowledge. However, neither article discussed standardized knowledge representation within the repository, nor did the articles address how standardized knowledge could be disseminated among various jurisdictions.…”

Beyond information access: Support for complex cognitive activities in public health informatics tools

“…Technology, although essential, is only a means by which users “make best use of information” [5]. Much of the existing PHI literature focuses on the technological structures that facilitate information access [6, 7, 8, 9]. In such contributions, as well as in review papers that consider multiple PHI tools (e.g., [10, 3]), criteria for evaluation generally consist of meeting basic information access needs [11].…”

“…More specifically, we are concerned with public health informatics tools that support, facilitate, and/or enhance complex, unstructured, and/or open-ended cognitive activities. This class of PHI tools would include highly visual tools for epidemiological simulation, analysis, and decision support such as STEM [23], DDSS [24], SOVAT [25], EpiScanGIS [26], MDAST [27], Zeilhofer and colleagues’ component-based tool [28], Epinome [29], and PanViz [30], but exclude simple medical alert notification systems such as those described by Lombardo and colleagues [7] or Gesteland and colleagues [31]. Throughout the paper we refer to this class of tools as PHI tools .…”