Public Health Informatics—New Opportunities for Public

Health Practitioners

Philadelphia Department of Public Health

Caroline C. Johnson, MD

Health Informatics

“…the intersection of information science, computer science, and health care. It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health…”

Communicable Disease Surveillance Data

Systems

Electronic Transmission

Fax, phone, mail

Direct Data Entry

Disease Epidemiology

Outbreak Recognition

Guide Program Activities

Reporting to Other Agencies

Case Tx & Management

Inputs Outputs

2009 – H1N1 Vaccine Administration Reporting

5

Impact of Health Informatics on Public Health Practice

Data processing is quicker and more accurate

High volume diseases can be addressed

New types of data accessible

High-risk events more easily recognized

Public Health Informatics in Action:ELR - Data Managed Quicker

% Cases thru ELR0%

20%

40%

60%

80%

100%

2010 2011 2012 2013

Mean # Days til Action0

3

6

9

12

2010 2011 2012 2013

Public Health Informatics in Action:High Volume Diseases Can Be

Addressed

2010 2011 2012 20130

4,000

8,000

12,000

16,000

20,000

24,000

11,14012,820

14,539

19,785Positive HCV Test Reports

Public Health Informatics in Action:New Types of Data- Syndromic

Surveillance• Growing adoption since 2001 Anthrax attacks• Leverage real-time or near real-time data from ERs• Used for early detection of public health concerns

(bioterrorism, disaster monitoring, outbreaks, trends) Non-traditional disease surveillance• De-identified, pre-diagnostic data • Not intended for notifiable disease surveillance

• PhiladelphiaHome-grown system started in 2002 Transitioning to Pennsylvania Department of Health’s

system, EpiCenter16 of 22 Hospitals with EDs reporting (~2300 daily visits)

Philadelphia ED Surveillance:Opiate Overdoses March 2014

1/1/2

013

1/14/2

013

1/27/2

013

2/9/2

013

2/22/2

013

3/7/2

013

3/20/2

013

4/2/2

013

4/15/2

013

4/28/2

013

5/11/2

013

5/24/2

013

6/6/2

013

6/19/2

013

7/2/2

013

7/15/2

013

7/28/2

013

8/10/2

013

8/23/2

013

9/5/2

013

9/18/2

013

10/1/2

013

10/14/2

013

10/27/2

013

11/9/2

013

11/22/2

013

12/5/2

013

12/18/2

013

12/31/2

013

1/13/2

014

1/26/2

014

2/8/2

014

2/21/2

014

3/6/2

014

3/19/2

0140

5

10

15

20

25

30

35

overdosesmean (u)u+3stdev

Public Health Informatics in Action:

High-risk Events More Easily Recognized

Automated cluster recognition

TimePlacePerson