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Rajamani S, Waterfield KC, Austin R, Singletary V, Odowa Y, Miles-Richardson S, Winters T, Powers B, LaRoche F, Trachet S, Fritz J, Leider JP, Wurtz R, Shah GH. Training in Public Health Informatics and Technology Leveraging a Multi-institutional Partnership Model and Emphasizing Experiential Learning. Appl Clin Inform 2024; 15:668-678. [PMID: 39142641 PMCID: PMC11324355 DOI: 10.1055/s-0044-1787979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/03/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Though public health is an information-intense profession, there is a paucity of workforce with Public Health Informatics and Technology (PHIT) skills, which was evident during the coronavirus disease 2019 (COVID-19) pandemic. This need is addressed through the PHIT workforce program (2021-2025) by the Office of the National Coordinator for training and to increase racial and ethnic diversity in the PHIT workforce. The objective is to share details on the Training in Informatics for Underrepresented Minorities in Public Health (TRIUMPH) consortium, funded by the PHIT workforce program. METHODS The TRIUMPH consortium is a collaboration between academic and practice partners with a commitment to training 879 students in PHIT. The Schools of Public Health and Nursing at the University of Minnesota, Jiann-Ping Hsu College of Public Health at Georgia Southern University, Morehouse School of Medicine, and Public Health Informatics Institute offer PHIT training through various programs. Academic institutions focus on student recruitment, developing courses/curriculum, and granting degrees/certificates, and the role of practice partners is to support experiential learning through internships/practicums. RESULTS The TRIUMPH consortium is progressing toward its goals, with 692 students (79%) already trained in a PHIT modality as of December 2023. The learners comprise diverse race/ethnicity, including White (48%), Black/African American (32%), Asian (10%), White Hispanic (5%), American Indian/Alaska Native (2%), and Black Hispanic (1%). Numerous internships have been completed in settings ranging from state/local public health agencies to health care delivery systems. Diversity initiatives were supported by partnering with existing programs (e.g., the AMIA First Look program and the Nursing Knowledge Big Data Science conference). CONCLUSION This consortium model is an excellent approach to informatics training and sharing expertise across partners. It provides scalability and broader geographic outreach while presenting opportunities to students from underrepresented backgrounds. Lessons learned have implications for overall informatics training (e.g., partnerships models, promoting racial/ethnic diversity).
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Affiliation(s)
- Sripriya Rajamani
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, United States
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, United States
| | - Kristie C. Waterfield
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, United States
| | - Robin Austin
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, United States
| | - Vivian Singletary
- Public Health Informatics Institute, Atlanta, Georgia, United States
| | - Yasmin Odowa
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
| | | | - Tony Winters
- Public Health Informatics Institute, Atlanta, Georgia, United States
| | - Brenton Powers
- Department of Public Health Education, Morehouse School of Medicine, Atlanta, Georgia, United States
| | - Feather LaRoche
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Sarah Trachet
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Jennifer Fritz
- Center for Health Information Policy and Transformation, Minnesota Department of Health, Saint Paul, Minnesota, United States
| | - Jonathon P. Leider
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Rebecca Wurtz
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Gulzar H. Shah
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, United States
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Ensuring Food Safety for Americans: The Role of Local Health Departments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127344. [PMID: 35742588 PMCID: PMC9223748 DOI: 10.3390/ijerph19127344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022]
Abstract
(1) Background: Several agencies in the United States play a primary role in ensuring food safety, yet foodborne illnesses result in about 3000 deaths and cost more than USD 15.6 billion each year. The study objectives included analyzing local health departments’ (LHDs) level of engagement in food safety and other related services, and LHDs’ characteristics associated with those services. (2) Methods: We used data from 1496 LHDs that participated in the 2019 National Profile of Local Health Departments Survey, administered to all 2459 LHDs in the United States. Logistic regression analyses were performed to model multiple dichotomous variables. (3) Results: An estimated 78.9% of LHDs performed food safety inspections, 78.3% provided food safety education, 40.7% provided food processing inspections, and 48.4% engaged in policy and advocacy. The odds for LHDs to directly provide preventive nutrition services were 20 times higher if the LHDs had one or more nutritionists on staff (Adjusted Odds Ratio or AOR = 20.0; Confidence Interval, CI = 12.4−32.2) compared with LHDs with no nutritionists. Other LHD characteristics significantly associated with the provision of nutrition services (p < 0.05) included population size, state governance (rather than local), and LHD having at least one registered, licensed, practical, or vocational nurse. The odds of providing food processing services were lower for locally governed than state-governed LHDs (AOR = 0.5; CI = 0.4−0.7). The odds of performing food safety inspections varied by LHD’s population size, whether a nutritionist was on staff, whether it was state-governed (vs. locally), and whether it completed a community health assessment (CHA) within 5 years. (4) Conclusions: LHDs play a critical role in ensuring safe food for Americans, yet variations exist in their performance based on their specific characteristics. Adequate funding and a competent workforce are essential for LHDs to utilize evidence-based practices and engage in policymaking and advocacy concerning food safety.
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Pendergrass J, Ranganathan C. Institutional factors affecting the electronic health information exchange by ambulatory providers. HEALTH POLICY AND TECHNOLOGY 2021. [DOI: 10.1016/j.hlpt.2021.100569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bosco LJ, Alford AA, Feeser K. Heterogeneity and Interoperability in Local Public Health Information Systems. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:529-533. [PMID: 34292913 DOI: 10.1097/phh.0000000000001404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Laura J Bosco
- National Association of County and City Health Officials, Washington, District of Columbia
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Walker DM, Yeager VA, Lawrence J, McAlearney AS. Identifying Opportunities to Strengthen the Public Health Informatics Infrastructure: Exploring Hospitals' Challenges with Data Exchange. Milbank Q 2021; 99:393-425. [PMID: 33783863 DOI: 10.1111/1468-0009.12511] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Policy Points Even though most hospitals have the technological ability to exchange data with public health agencies, the majority continue to experience challenges. Most challenges are attributable to the general resources of public health agencies, although workforce limitations, technology issues such as a lack of data standards, and policy uncertainty around reporting requirements also remain prominent issues. Ongoing funding to support the adoption of technology and strengthen the development of the health informatics workforce, combined with revising the promotion of the interoperability scoring approach, will likely help improve the exchange of electronic data between hospitals and public health agencies. CONTEXT The novel coronavirus 2019 (COVID-19) pandemic has highlighted significant barriers in the exchange of essential information between hospitals and local public health agencies. Thus it remains important to clarify the specific issues that hospitals may face in reporting to public health agencies to inform focused approaches to improve the information exchange for the current pandemic as well as ongoing public health activities and population health management. METHODS This study uses cross-sectional data of acute-care, nonfederal hospitals from the 2017 American Hospital Association Annual Survey and Information Technology supplement. Guided by the technology-organization-environment framework, we coded the responses to a question regarding the challenges that hospitals face in submitting data to public health agencies by using content analysis according to the type of challenge (i.e., technology, organization, or environment), responsible entity (i.e., hospital, public health agency, vendor, multiple), and the specific issue described. We used multivariable logistic and multinomial regression to identify characteristics of hospitals associated with experiencing the types of challenges. FINDINGS Our findings show that of the 2,794 hospitals in our analysis, 1,696 (61%) reported experiencing at least one challenge in reporting health data to a public health agency. Organizational issues were the most frequently reported type of challenge, noted by 1,455 hospitals. The most common specific issue, reported by 1,117 hospitals, was the general resources of public health agencies. An advanced EHR system and participation in a health information exchange both decreased the likelihood of not reporting experiencing a challenge and increased the likelihood of reporting an organizational challenge. CONCLUSIONS Our findings inform policy recommendations such as improving data standards, increasing funding for public health agencies to improve their technological capabilities, offering workforce training programs, and increasing clarity of policy specifications and reporting. These approaches can improve the exchange of information between hospitals and public health agencies.
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Affiliation(s)
- Daniel M Walker
- College of Medicine, The Ohio State University.,Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University
| | - Valerie A Yeager
- Richard M. Fairbanks School of Public Health, Indiana University
| | - John Lawrence
- Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University
| | - Ann Scheck McAlearney
- College of Medicine, The Ohio State University.,Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University
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Tarabichi Y, Goyden J, Liu R, Lewis S, Sudano J, Kaelber DC. A step closer to nationwide electronic health record-based chronic disease surveillance: characterizing asthma prevalence and emergency department utilization from 100 million patient records through a novel multisite collaboration. J Am Med Inform Assoc 2021; 27:127-135. [PMID: 31592525 DOI: 10.1093/jamia/ocz172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 08/29/2019] [Accepted: 09/05/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The study sought to assess the feasibility of nationwide chronic disease surveillance using data aggregated through a multisite collaboration of customers of the same electronic health record (EHR) platform across the United States. MATERIALS AND METHODS An independent confederation of customers of the same EHR platform proposed and guided the development of a program that leverages native EHR features to allow customers to securely contribute de-identified data regarding the prevalence of asthma and rate of asthma-associated emergency department visits to a vendor-managed repository. Data were stratified by state, age, sex, race, and ethnicity. Results were qualitatively compared with national survey-based estimates. RESULTS The program accumulated information from 100 million health records from over 130 healthcare systems in the United States over its first 14 months. All states were represented, with a median coverage of 22.88% of an estimated state's population (interquartile range, 12.05%-42.24%). The mean monthly prevalence of asthma was 5.27 ± 0.11%. The rate of asthma-associated emergency department visits was 1.39 ± 0.08%. Both measures mirrored national survey-based estimates. DISCUSSION By organizing the program around native features of a shared EHR platform, we were able to rapidly accumulate population level measures from a sizeable cohort of health records, with representation from every state. The resulting data allowed estimates of asthma prevalence that were comparable to data from traditional epidemiologic surveys at both geographic and demographic levels. CONCLUSIONS Our initiative demonstrates the potential of intravendor customer collaboration and highlights an organizational approach that complements other data aggregation efforts seeking to achieve nationwide EHR-based chronic disease surveillance.
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Affiliation(s)
- Yasir Tarabichi
- Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, Ohio, USA.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Internal Medicine, The MetroHealth System, Cleveland, Ohio, USA.,Division of Pulmonary and Critical Care Medicine, The MetroHealth System, Cleveland, Ohio, USA
| | - Jake Goyden
- Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, Ohio, USA.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rujia Liu
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.,Center for Healthcare Research and Policy, The MetroHealth System, Cleveland, Ohio, USA
| | - Steven Lewis
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.,Center for Healthcare Research and Policy, The MetroHealth System, Cleveland, Ohio, USA
| | - Joseph Sudano
- Department of Internal Medicine, The MetroHealth System, Cleveland, Ohio, USA.,Center for Healthcare Research and Policy, The MetroHealth System, Cleveland, Ohio, USA
| | - David C Kaelber
- Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, Ohio, USA.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Internal Medicine, The MetroHealth System, Cleveland, Ohio, USA.,Department of Pediatrics, The MetroHealth System, Cleveland, Ohio, USA.,Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.,Center for Healthcare Research and Policy, The MetroHealth System, Cleveland, Ohio, USA
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Public Health Informatics in Local and State Health Agencies: An Update From the Public Health Workforce Interests and Needs Survey. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 2, Public Health Workforce Interests and Needs Survey 2017:S67-S77. [PMID: 30720619 PMCID: PMC6519871 DOI: 10.1097/phh.0000000000000918] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective: To characterize public health informatics (PHI) specialists and identify the informatics needs of the public health workforce. Design: Cross-sectional study. Setting: US local and state health agencies. Participants: Employees from state health agencies central office (SHA-COs) and local health departments (LHDs) participating in the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). We characterized and compared the job roles for self-reported PHI, “information technology specialist or information system manager” (IT/IS), “public health science” (PHS), and “clinical and laboratory” workers. Main Outcome Measure: Descriptive statistics for demographics, income, education, public health experience, program area, job satisfaction, and workplace environment, as well as data and informatics skills and needs. Results: A total of 17 136 SHA-CO and 26 533 LHD employees participated in the survey. PHI specialist was self-reported as a job role among 1.1% and 0.3% of SHA-CO and LHD employees. The PHI segment most closely resembled PHS employees but had less public health experience and had lower salaries. Overall, fewer than one-third of PHI specialists reported working in an informatics program area, often supporting epidemiology and surveillance, vital records, and communicable disease. Compared with PH WINS 2014, current PHI respondents' satisfaction with their job and workplace environment moved toward more neutral and negative responses, while the IT/IS, PHS, and clinical and laboratory subgroups shifted toward more positive responses. The PHI specialists were less likely than those in IT/IS, PHS, or clinical and laboratory roles to report gaps in needed data and informatics skills. Conclusions: The informatics specialists' role continues to be rare in public health agencies, and those filling that role tend to have less public health experience and be less well compensated than staff in other technically focused positions. Significant data and informatics skills gaps persist among the broader public health workforce.
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Building Informatics Capacity of Local Health Departments to Combat COVID-19: A Call to Action. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 26:322-324. [DOI: 10.1097/phh.0000000000001201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yeung T. Local health department adoption of electronic health records and health information exchanges and its impact on population health. Int J Med Inform 2019; 128:1-6. [DOI: 10.1016/j.ijmedinf.2019.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 02/21/2019] [Accepted: 04/15/2019] [Indexed: 10/26/2022]
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Local Health Departments' Engagement in Addressing Health Disparities: The Effect of Health Informatics. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 25:171-180. [PMID: 29975343 DOI: 10.1097/phh.0000000000000842] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Health disparities and health inequities can lead to poor health outcomes. However, health disparities continue to persist in communities across the United States, presenting a crucial public health challenge. Persisting budget cuts and workforce challenges tend to hinder local health departments' (LHDs') ability to assess and address health disparities. OBJECTIVES To examine the extent to which LHDs' use of informatics effects their engagement in strategies and activities addressing health disparities. METHODS Data from the 2016 Profile of LHDs were used in examining the association of informatics with 9 activities addressing health disparities/inequities. RESULTS Fifty-nine percent of LHDs used data and described health disparities in their jurisdiction, and 12% conducted original research to link health disparities to differences in social or environmental conditions. Less than 40% of LHDs prioritized resources for the reduction of health disparities. LHDs that implemented information systems had increased odds of describing the disparities in their jurisdiction (P < .01) and having prioritized resources for the reduction of disparities (P < .01). Per capita expenditures, participation in a national accreditation program process, and a larger LHD population were also positively associated with 7 of 9 activities for addressing health disparities/inequities. CONCLUSIONS As LHDs advance efforts to reduce health disparities and inequities, leadership will find informatics a useful strategy. National initiatives aimed to boost LHDs' engagement in the reduction of disparities might benefit from our findings, positing a positive influence of informatics.
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Massoudi BL, Chester KG. Public Health, Population Health, and Epidemiology Informatics: Recent Research and Trends in the United States. Yearb Med Inform 2017; 26:241-247. [PMID: 29063572 PMCID: PMC6239230 DOI: 10.15265/iy-2017-035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives: To survey advances in public and population health and epidemiology informatics over the past 18 months. Methods: We conducted a review of English-language research works conducted in the domain of public and population health informatics and published in MEDLINE or Web of Science between January 2015 and June 2016 where information technology or informatics was a primary subject or main component of the study methodology. Selected articles were presented using a thematic analysis based on the 2011 American Medical Informatics Association (AMIA) Public Health Informatics Agenda tracks as a typology. Results: Results are given within the context developed by Dixon et al., (2015) and key themes from the 2011 AMIA Public Health Informatics Agenda. Advances are presented within a socio-technical infrastructure undergirded by a trained, competent public health workforce, systems development to meet the business needs of the practice field, and research that evaluates whether those needs are adequately met. The ability to support and grow the infrastructure depends on financial sustainability. Conclusions: The fields of public health and population health informatics continue to grow, with the most notable developments focused on surveillance, workforce development, and linking to or providing clinical services, which encompassed population health informatics advances. Very few advances addressed the need to improve communication, coordination, and consistency with the field of informatics itself, as identified in the AMIA agenda. This will likely result in the persistence of the silos of public health information systems that currently exist. Future research activities need to aim toward a holistic approach of informatics across the enterprise.
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Affiliation(s)
- B. L. Massoudi
- Public Health Informatics Program, RTI International, Atlanta, GA, USA
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - K. G. Chester
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- C3 Informatics, Milton, GA, USA
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Urgent Challenges for Local Public Health Informatics. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 22 Suppl 6, Public Health Informatics:S6-S8. [PMID: 27684620 PMCID: PMC5049959 DOI: 10.1097/phh.0000000000000479] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This editorial highlights the urgent challenges for local public health informatics and provides solutions to face these challenges.
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