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Acharya JC, Staes C, Allen KS, Hartsell J, Cullen TA, Lenert L, Rucker DW, Lehmann HP, Dixon BE. Strengths, weaknesses, opportunities, and threats for the nation's public health information systems infrastructure: synthesis of discussions from the 2022 ACMI Symposium. J Am Med Inform Assoc 2023; 30:ocad059. [PMID: 37146228 PMCID: PMC10198524 DOI: 10.1093/jamia/ocad059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/03/2023] [Accepted: 04/04/2023] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVE The annual American College of Medical Informatics (ACMI) symposium focused discussion on the national public health information systems (PHIS) infrastructure to support public health goals. The objective of this article is to present the strengths, weaknesses, threats, and opportunities (SWOT) identified by public health and informatics leaders in attendance. MATERIALS AND METHODS The Symposium provided a venue for experts in biomedical informatics and public health to brainstorm, identify, and discuss top PHIS challenges. Two conceptual frameworks, SWOT and the Informatics Stack, guided discussion and were used to organize factors and themes identified through a qualitative approach. RESULTS A total of 57 unique factors related to the current PHIS were identified, including 9 strengths, 22 weaknesses, 14 opportunities, and 14 threats, which were consolidated into 22 themes according to the Stack. Most themes (68%) clustered at the top of the Stack. Three overarching opportunities were especially prominent: (1) addressing the needs for sustainable funding, (2) leveraging existing infrastructure and processes for information exchange and system development that meets public health goals, and (3) preparing the public health workforce to benefit from available resources. DISCUSSION The PHIS is unarguably overdue for a strategically designed, technology-enabled, information infrastructure for delivering day-to-day essential public health services and to respond effectively to public health emergencies. CONCLUSION Most of the themes identified concerned context, people, and processes rather than technical elements. We recommend that public health leadership consider the possible actions and leverage informatics expertise as we collectively prepare for the future.
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Affiliation(s)
- Jessica C Acharya
- Healthy Policy & Management, Informatics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Catherine Staes
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Katie S Allen
- Department of Health Policy & Management, Richard M. Fairbanks School of Public Health, IUPUI, Indianapolis, Indiana, USA
- Center for Biomedical Informatics, Regenstrief Institute, Inc., Indianapolis, Indiana, USA
| | - Joel Hartsell
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
- Epi-Vant, LLC., Salt Lake City, Utah, USA
| | - Theresa A Cullen
- Center for Biomedical Informatics, Regenstrief Institute, Inc., Indianapolis, Indiana, USA
- Pima County Public Health Department, Tucson, Arizona, USA
| | - Leslie Lenert
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
- Health Sciences South Carolina, Charleston, South Carolina, USA
| | - Donald W Rucker
- 1upHealth, Boston, Massachusetts, USA
- Department of Emergency Medicine, Ohio State University, Columbus, Ohio, USA
| | - Harold P Lehmann
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Brian E Dixon
- Department of Health Policy & Management, Richard M. Fairbanks School of Public Health, IUPUI, Indianapolis, Indiana, USA
- Center for Biomedical Informatics, Regenstrief Institute, Inc., Indianapolis, Indiana, USA
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Dada AO, Lee CT, Elisha A, Oyebanji O, Danjuma JS, Sagir K, Eteng W, Abubakar A, Dalhat M, Kamateeka M, Aderinola O, Oladejo J, Agogo E, Ihekweazu C. Impact of a Newly Established Revolving Outbreak Investigation Fund on Timeliness of Response to Public Health Emergencies in Nigeria. Health Secur 2022; 20:147-153. [PMID: 35404146 DOI: 10.1089/hs.2021.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Timely access to emergency funding has been identified as a bottleneck for outbreak response in Nigeria. In February 2019, a new revolving outbreak investigation fund (ROIF) was established by the Nigeria Centre for Disease Control (NCDC). We abstracted the date of NCDC notification, date of verification, and date of response for 25 events that occurred prior to establishing the fund (April 2017 to August 2019) and for 8 events that occurred after establishing the fund (February to October 2019). The median time to notification (1 day) and to verification (0 days) did not change after establishing the ROIF, but the median time to response significantly decreased, from 6 days to 2 days (P = .003). Response to disease outbreaks was accelerated by access to emergency funding with a clear approval process. We recommend that the ROIF should be financed by the national government through budget allocation. Finally, development partners can provide financial support for the existing fund and technical assistance for protocol development toward financial accountability and sustainability.
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Affiliation(s)
- Augustine Olajide Dada
- Augustine Olajide Dada, MD, MPH, is a Technical Advisor, National Action Plan for Health Security/Regional Disease Surveillance Systems Enhancement Implementation Support Unit
| | - Christopher T Lee
- Christopher T. Lee, MD, MSc, MPH, is Director of Global Epidemic Preparedness and Response, Resolve to Save Lives, New York, NY
| | - Ande Elisha
- Ande Elisha, MD, MSc, is a Senior Technical Assistant, Office of the Director General
| | | | - Jenom S Danjuma
- Jenom S. Danjuma, MD, MPH, is a Technical Officer for Prevent Epidemics
| | - Khadijah Sagir
- Khadijah Sagir are Technical Assistants, Office of the Director General
| | - Womi Eteng
- Womi Eteng, MSc, Emergency Preparedness Officers, Department of Health Emergency Preparedness and Response
| | - Anwar Abubakar
- Anwar Abubakar are Emergency Preparedness Officers, Department of Health Emergency Preparedness and Response
| | - Mahmood Dalhat
- Mahmood Dalhat, MD, MPH, is a Senior Technical Advisor, African Field Epidemiology Network, Abuja, Nigeria
| | - Moreen Kamateeka
- Moreen Kamateeka, MD, MPH, is a Field Coordinator and Business Development Officer, African Field Epidemiology Network, Abuja, Nigeria
| | - Olaolu Aderinola
- Olaolu Aderinola is Head, Emergency Response Unit, Department of Health Emergency Preparedness and Response, MBBS, MPH
| | - John Oladejo
- John Oladejo, PhD, is Director, Department of Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Emmanuel Agogo
- Emmanuel Agogo, MD, MPH, is Nigeria Country Representative; both at Resolve to Save Lives, Abuja, Nigeria
| | - Chikwe Ihekweazu
- Chikwe Ihekweazu, FFPH, is Director General, Office of the Director General, Nigeria Centre for Disease Control, Abuja, Nigeria
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Hurst D, Sharpe S, Yeager VA. Administrative Preparedness Strategies: Expediting Procurement and Contracting Cycle Times During an Emergency. Public Health Rep 2017; 132:294-297. [PMID: 28394699 DOI: 10.1177/0033354917698131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We assessed whether administrative preparedness processes that were intended to expedite the acquisition of goods and services during a public health emergency affect estimated procurement and contracting cycle times. We obtained data from 2014-2015 applications to the Hospital Preparedness Program and Public Health Emergency Preparedness (HPP-PHEP) cooperative agreements. We compared the estimated procurement and contracting cycle times of 61 HPP-PHEP awardees that did and did not have certain administrative processes in place. Certain processes, such as statutes allowing for procuring and contracting on the open market, had an effect on reducing the estimated cycle times for obtaining goods and services. Other processes, such as cooperative purchasing agreements, also had an effect on estimated procurement time. For example, awardees with statutes that permitted them to obtain goods and services in the open market had an average procurement cycle time of 6 days; those without such statutes had a cycle time of 17 days ( P = .04). PHEP awardees should consider adopting these or similar processes in an effort to reduce cycle times.
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Affiliation(s)
- David Hurst
- 1 Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sharon Sharpe
- 1 Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Valerie A Yeager
- 2 Department of Global Health Management and Policy, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
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Martini L, Presley D, Klieger S, Burris S. A Scan of CDC-Authored Articles on Legal Epidemiology, 2011-2015. Public Health Rep 2016; 131:809-815. [PMID: 28123227 DOI: 10.1177/0033354916669497] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The Centers for Disease Control and Prevention (CDC) conducts research on legal epidemiology, the scientific study of law as a factor in the cause, distribution, and prevention of disease. This study describes a scan of articles written by CDC staff members to characterize the frequency and key features of legal epidemiology articles and their distribution across CDC departments and divisions. METHODS CDC librarians searched an internal repository for journal articles by CDC staff published from January 1, 2011, to May 31, 2015. Researchers reviewed and coded the abstracts to produce data on key features of the articles. RESULTS Researchers identified 158 CDC-authored legal epidemiology articles published in 83 journals, most frequently in Preventing Chronic Disease (14 publications), Journal of Public Health Management Practice (10 publications), and Morbidity and Mortality Weekly Report (9 publications). Most articles concerned the use and impact of law as a deliberate tool of intervention. Thirteen articles addressed the legal infrastructure of public health, and 3 assessed the incidental or unintended effects of nonhealth laws. CDC-authored articles encompassed policy making, implementation, and impact. Literature reviews and studies mapping laws across multiple jurisdictions constituted one-quarter of all publications. Studies addressed laws at the international, national, state, local, and organizational levels. CONCLUSION Results of the scan can be used to identify opportunities for the agency to better support research, professional development, networking, publication, and tracking of publication in this emerging field.
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Affiliation(s)
- Leila Martini
- Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA, USA
| | - David Presley
- Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA, USA
| | - Sarah Klieger
- Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA, USA
| | - Scott Burris
- Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, PA, USA
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Marks-Sultan G, Tsai FJ, Anderson E, Kastler F, Sprumont D, Burris S. National public health law: a role for WHO in capacity-building and promoting transparency. Bull World Health Organ 2016; 94:534-9. [PMID: 27429492 PMCID: PMC4933143 DOI: 10.2471/blt.15.164749] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 02/02/2016] [Accepted: 02/10/2016] [Indexed: 11/27/2022] Open
Abstract
A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries' legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law - from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a public health law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in public health law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance.
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Affiliation(s)
- Géraldine Marks-Sultan
- Institut de Droit de la Santé, Université de Neuchâtel, Avenue du 1er-Mars 26, 2000 Neuchâtel, Switzerland
| | - Feng-Jen Tsai
- Masters Program in Global Health and Development, Taipei Medical University, Taiwan, China
| | - Evan Anderson
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, United States of America (USA)
| | - Florian Kastler
- Health and Law Institute, University of Paris Descartes, Paris, France
| | - Dominique Sprumont
- Institut de Droit de la Santé, Université de Neuchâtel, Avenue du 1er-Mars 26, 2000 Neuchâtel, Switzerland
| | - Scott Burris
- Beasley School of Law, Temple University, Philadelphia, USA
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