Component 13:

Public Health IT

Component Guide

Health IT Workforce Curriculum

Version 4.0/Spring 2016

This material (Comp 13) was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003. This material was updated in 2016 by Columbia University under Award Number 90WT0004/01-01.

This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit

Component Number: 13

Component Title:

Public Health IT

Component Description:

This component is designed for individuals contemplating careers in public health agencies as well as individuals working in healthcare that may be responsible for reporting to public health agencies. The unit will provide an overview of specialized public health applications such as registries, epidemiological databases, biosurveillance, and situational awareness and emergency response. In addition it will include information exchange issues specific to public health.

Component Objectives:

At the completion of this component, the student will be able to:

  1. Distinguish (draw distinctions) among core functions and essential services of ‘public health’ and ‘clinical care’.
  2. Synthesize the key reasons and current contextual factors for providers in clinical practice to improve public health services and practices using electronic health records (EHRs).
  3. Apply health data definitions and standards, as well as privacy and confidentiality issues, in typical public health scenarios.
  4. Summarize the strategies, features, and systems needed for public health agencies to define and build the necessary connections to EHRs as identified by Meaningful Use legislation.
  5. Describe the roles and functions of existing public health data, health databases, and networks.
  6. Identify the current needs and future directions for EHR biosurveillance, disaster-preparedness, and situational awareness in improving public health.
  7. Summarize/describe the main role, functions, and applications of public health reporting, alerts, and decision support systems.
  8. Summarize the role, functions, and applications of public health IT for health promotion and chronic disease prevention.
  9. Delineate the critical role of advocacy in adoption/use of EHRs and consumer functions for personal health records (PHRs) to improve public health.

Component Files

Each unit within the component includes the following files:

  • Lectures (voiceover PowerPoint in .mp4 format); PowerPoint slides (Microsoft PowerPoint format), lecture transcripts (Microsoft Word format); and audio files (.mp3 format) for each lecture.
  • Application activities (discussion questions, assignments, or projects) with answer keys.
  • Self-assessment questions with answer keys based on identified learning objectives.
  • Some units may also include additional materials as noted in this document.

Component Units with Objectives and Topics

Unit 1: Overview and Contribution to Public Health through EHR Use

Description:

This unit synthesizes the key reasons and current contextual factors for providers in clinical practice to improve public health practice using electronic health records (EHRs).

Objectives:

  1. Explain what is public health.
  2. Discuss what distinguishes public health from the other health sciences.
  3. Explain public health’s unique contributions to the health of the public.
  4. Define Public Health (PH) Information Technology and PH informatics.
  5. Illustrate how innovative IT solutions are being applied to PH practice.
  6. Explain the role of electronic health records and data exchange to clinical care and health care improvement.
  1. Describe PH organizational structure.

Lectures:

  1. Introduction and Historical Context of Public Health(21:24)
  2. Public Health, Health Information Technology, and Public Health Informatics(20:15)

Unit 2: Privacy, Confidentiality and Security of Public Health Information

Description:

This unit will apply health data definitions and standards to typical public health scenarios.

Objectives:

  1. Identify the privacy and security requirements for public health agencies.
  1. Identify when public health agencies can receive identifiable health information to perform public health functions without patient authorization.

Lectures:

  1. Privacy, Confidentiality, and Security of Public Health Information(16:14)

Unit 3: Interoperability Standards in Public Health IT

Description:

This unit summarizes and describes the main role, functions, and applications of public health-enabled electronic health records (EHRs).

Objectives:

  1. Explain and describe the Meaningful Use and MIPS Advancing Care Public Health Objective.
  1. Describe the Public Health Engagement process required for Meaningful Use compliance.
  2. Know the ONC Certified Capabilities of EHRs that support public health capabilities.
  1. List and discuss the public health IT standards used for Meaningful Use and MIPS Advancing Care public health objectives or referred to in the ONC Standards Advisory.

Lectures:

  1. Types of Electronic Public Health Reporting Identified by the EHR Incentive Program(08:25)
  2. Meaningful Use and MIPS Requirements for Public Health(07:18)
  1. ONC certification of public health functions and an overview of the standards employed(16:27)

Unit 4: Public Health Enabled Electronic Health Records, Decision Support, and Their Role in the Meaningful Use of Health Care Technology

Description:

This unit explains how varying types of information technologies have application in public health practice.

Objectives:

  1. Discuss the New York City Department of Health and Mental Hygiene partnership with a commercial EHR vendor and how it created a public health – enabled EHR.
  2. Describe the EHR “meaningful use” movement and how it could transform existing clinical/public health practices.
  3. Demonstrate knowledge of public health – oriented clinical decision support including an integrated strategy using multiple tools such as alerts, order sets, smart forms, and quality reporting.
  4. Describe the strategies, features, and systems needed for public health agencies to define and build the necessary connections to EHRs as identified by the “meaningful use” legislation.
  1. Identify the essential features of four primary public health IT functions including syndromic surveillance, bidirectional immunization registries, public health alerts, ad – hoc reporting, etc.

Lectures:

  1. Primary Care Improvement Projects (PCIP), Meaningful Use Goals, and Population Health (16:07)
  2. Syndromic Surveillance(13:38)
  3. Immunization Registries, Alerts, and Reporting(15:27)

Suggested Readings

Diamond CC, Mostashari F, Shirky C. Collecting and sharing data for population health: a new paradigm. Health Aff (Millwood). 2009 Mar-Apr;28(2):454-66.

Dr. FarzadMostashari is currently serving as Deputy National Coordinator for Programs and Policy

Hripcsak G, Soulakis ND, Li L, Morrison FP, Lai AM, Friedman C, Calman NS, Mostashari F. Syndromic Surveillance Using Ambulatory Electronic Health Records. J Am Med Inform Assoc. 2009 Mar 4. [Epub ahead of print]

Lurio J, Morrison FP, Pichardo M, Berg R, Buck MD, Wu W, Kitson K, Mostashari F, Calman N. Using electronic health record alerts to provide public health situational awareness to providers. J Am Med Inform Assoc. 2010 Mar 1;17(2):217-9.

Mostashari F, Tripathi M, Kendall M. A tale of two large community electronic health record extension projects. Health Aff (Millwood). 2009 Mar-Apr;28(2):345-56.

Unit 5: Epidemiological Databases and Registries

Description:

This unit identifies current needs and future directions for EHR biosurveillance, disaster-preparedness, and situational awareness in improving public health.

Objectives:

  1. Identify the functions and key issues of epidemiology compared to clinical practice.
  2. Define and distinguish among the components that make up epidemiology.
  3. Identify the difference between environmental and mechanistic causes of disease.
  4. Describe the components of epidemiological reasoning.
  5. List the different types of epidemiology.
  6. Define clinical epidemiology and its relationship with evidence – based practice.
  7. Explain the current applications of epidemiology and how the results influence evidence – based practice.
  8. Identify different sources of epidemiological databases and how information is updated and exchanged with clinical entities.
  9. Describe the purpose of a registry, the types of information contained within public health registries and how this information can be used.
  10. Identify the defining characteristics of epidemiological registries.
  11. Identify different entities that operate registries and how information from clinical practice gets imported into these registries.
  1. Identify security and access issues in the information exchange between communities, clinical institutions, public health departments and federal agencies involved in public health prevention and control.

Lectures:

  1. Introduction(19:39)
  1. Databases, Registries, and Exchange(17:03)

Unit 6: Biosurveillance

Description:

This unit summarizes the essential public health services and methods by which they can be improved through the use of EHRs in the context of the clinical care environment.

Objectives:

  1. Describe the traditional means used to monitor and report on disease spread within a community.
  2. Identify current data sources used to track disease.
  3. Describe the typical process of syndromic surveillance.
  4. Identify strengths and weaknesses of using EHRs for biosurveillance.
  5. Describe process for monitoring, reporting, and analyzing EHR biosurveillance data.
  1. Identify how current and future findings from EHR biosurveillance improve public health operations and services.

Lectures:

  1. Biosurveillance (22:04)
  1. Define public health
  2. Role of public health-enabled electronic health records and health information exchange (HIE)
  3. Monitor health
  4. Diagnosis and investigate
  5. Inform, educate, and empower

Unit 7: Monitoring, Investigating, and Empowering Public Health with EHRs

Description:

This unit explains a novel approach to developing and implementing health promotion programs in public health practice.

Objectives:

  1. Describe the role of public health in context of clinical care environment.
  2. Identify and describe the following three essential public health services: Monitor health, Diagnosis and investigate, Inform, educate, empower.
  3. Identify public health practice challenges in these service areas.
  4. Identify opportunities for EHRs and HIEs to address these challenges in: Syndromic Surveillance, Notifiable disease reporting, Public health case investigation.
  1. Describe challenges and limitations of EHRs to address these service areas.

Lectures:

  1. Monitoring, Investigating, and Empowering Public Health with EHRs(28:08)

Unit 8: The Potential of Public Health IT for Health Promotion and Chronic Disease Prevention

Description:

This unit summarizes/describes the main role, functions, and applications of public health reporting, alerts, and decision support systems.

Objectives:

  1. Describe and categorize issues/questions, data sets, and factors (variables) that are used in descriptive epidemiology.
  1. Describe how evidence – based recommendations may be appropriately used in implementing and evaluating health promotion and disease prevention.
  2. Describe different types of health promotion and disease promotion and different methods of enacting health promotion programs.
  3. Identify the steps in the process of implementing and evaluating prevention programs and interventions.
  4. Identify the clinical preventive services that are linked to health promotion and disease prevention.
  5. Describe how informatics can be incorporated into clinical preventive services.
  6. Describe the history and foundation of geographic information systems and explain its role in evidence – based practice.
  7. Identify the barriers to incorporating public health IT into clinical practice and potential methods for resolving these limitations.
  8. Identify the existing and innovative methods for communicating and sharing health information with the public.

Lectures:

  1. The Potential of Public Health IT for Health Promotion and Chronic Disease Prevention(36:12)

Unit 9: Quality Reporting

Description:

Summarize/describe the main role, functions and applications of public health reporting, alerts and decision support systems.

Objectives:

  1. Identify/describe important characteristics and components of useful health care quality measurement systems.
  2. Identify the past and present efforts to transform medical practice through pay – for – performance initiatives.
  3. Identify national group efforts involved in the establishment of quality standards/metrics (NCQA, NQF, etc.) based upon claims and EHR data.
  4. Describe how quality metrics are integrated, tracked, and used in EHRs and describe real – world implementations in eClinicalWorks, EPIC, NextGen.
  5. Describe the use of EHR – based quality metrics in pay – for – performance incentive projects.
  1. Summarize the preliminary findings/conclusions from the EHR pay – for – performance project and possible future directions.

Lectures:

  1. Quality Reporting(32:40)

Component Authors

Component Originally Developed by:

Assigned Institution:

Columbia University

Team Lead(s):

Rita Kukafka, DrPH, MA, FACMI, Columbia University

Michael Buck, PhD, New York City Department of Health and Mental Hygiene

Primary Contributing Authors:

Michael Buck, PhD, New York City Department of Health and Mental Hygiene

Rita Kukafka, Dr. PH, MA, FAMI, Columbia University

Lecture Narration

Voiceover Talent

Joel Richards

Sound Engineer

Michael Deleon

Team Members:

John Allegrante, PhD, Columbia University

Lynda Carlson, PhD, Borough of Manhattan Community College

Madhabi Chatterji, PhD, Columbia University

Sharib Khan, MA, Columbia University

Rita Kukafka, DrPH, MA, FACMI, Principal Investigator, Columbia University

Elizabeth Oliver, MS, Bronx Community College

Marlena Plagianos, MS, New York City Department of Health and Mental Hygiene

Anna Ritko, PhD, Columbia University

Sarah Shih, MPH, New York City Department of Health and Mental Hygiene

Cindy Smalletz, MA, MS, Columbia University

Winfred Wu, MD, New York City Department of Health and Mental Hygiene

John Zimmerman, DDS, Columbia University

Component Updated by:

Assigned Institution:

Columbia University

Team Lead(s):

Rita Kukafka, DrPH, MA, FACMI, Columbia University

Primary Contributing Authors:

Michael Buck, PhD, New York City Department of Health and Mental Hygiene

Rita Kukafka, Dr. PH, MA, FAMI, Columbia University

Lecture Narration

Voiceover Talent

Joel Richards, Ned Boyle

Sound Engineer

Michael Deleon, Ned Boyle

Team Members:

Raven David, MPH, CHTS-PW, Project Manager, Columbia University

Virginia Lorenzi, MS, CPHIMS, FHL7, Columbia University

Vanessa Nguyen, MPH, New York City Department of Health and Mental Hygiene

Jennifer Ringler, MHA, Columbia University

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Health IT Workforce CurriculumPublic Health IT1

Version 4.0