scholarly journals Public Health Practice within a Health Information Exchange: Information Needs and Barriers to Disease Surveillance

Author(s):  
Blaine Reeder ◽  
Debra Revere ◽  
Rebecca A. Hills ◽  
Janet G. Baseman ◽  
William B. Lober
2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Janelle Kibler ◽  
Scott McNabb ◽  
James Lavery ◽  
Ziad Memish ◽  
Affan Shaikh ◽  
...  

ObjectiveThe goal of this editorial is to shed light on the lack of transparency that exists in the sharing of Public Health data and to reverse this presumption in favour of open public health information properly vetted and openly accessible. Open public health information is a critical step to revitalize public health practice and is a human right.IntroductionPublic health practice that prevents, detects, and responds to communicable and noncommunicable disease threats is hindered by poor access to public health data and information. This includes timely sharing of case-based information, respecting patent and publication rights, and the ethical sharing of specimens. Disagreements about information shared and under what circumstances plus who has right to the data, clinical specimens, and their derivative products impede research and countermeasures. Delayed or inaction by public health authorities undermines trust and exacerbates the crisis. Evident in 2014 by the delayed Public Health Emergency of International Concern declaration of the Ebola virus outbreak in West Africa by the World Health Organization, the governing presumption is that access to public health information should be restricted, constrained, or even hoarded; this is a failed approach. This lack of transparency prevents information availability when and where it is needed and obstructs public health efforts to efficiently and ethically prevent, detect, and respond to emerging threats. A better way forward is to reverse this presumption in favour of open public health information properly vetted and openly accessible. Open public health information is a critical step to revitalize public health practice and is a human right.While there is limited global consensus among scientists and public health practitioners on best practices to guide national health authorities, researchers, NGOs, and industry as they navigate the ethical, political, technical, and economic challenges associated with the sharing of essential public health information (e.g., pathogen isolates, clinical specimens, and patient-related data), grounding this discussion on the guiding principles of open public health information can help navigate the complex privacy, security, communication, and access needs, and ensure that collaboration and sharing occur in a manner that is ethically and socially just, efficient, and equitable. Built on existing governance frameworks such as the International Health Regulations (IHRs) and the Pandemic Influenza Preparedness Framework (PIP), open public health can transform public health surveillance, allowing for the rapid sharing of data and products during outbreaks for mutual benefit and enhanced global health security.MethodsThis abstract represents a larger editorial style manuscript, thus no methods were developed in the abstract.ResultsThis editorial style manuscript aims to reverse the presumption that public health data is damaging to one in favour of open public health information properly vetted and openly accessible.ConclusionsSimilar to other open movements (i.e., open data, open government, open development, and open science) that seek to address the world’s greatest challenges through transparency, collaboration, reuse of and free access to ideas, open public health offers an ideal solution to overcome the challenges in the 21st century.


2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Joseph Sharp ◽  
Christine D Angert ◽  
Tyania Mcconnell ◽  
Pascale Wortley ◽  
Eugene Pennisi ◽  
...  

Abstract Background Public health information exchanges (HIEs) link real-time surveillance and clinical data and can help to re-engage out-of-care people with HIV (PWH). Methods We conducted a retrospective cohort study of out-of-care PWH who generated an HIE alert in the Grady Health System (GHS) Emergency Department (ED) between January 2017 and February 2018. Alerts were generated for PWH who registered in the GHS ED without Georgia Department of Public Health (GDPH) CD4 or HIV-1 RNA in the prior 14 months. The alert triggered a social work (SW)–led re-linkage effort. Multivariate logistic regression analyses used HIE-informed SW re-linkage efforts as the independent variable, and linkage to care and 3- and 6-month viral suppression (HIV-1 RNA < 200 c/mL) as primary outcomes. Patients admitted to the hospital were excluded from primary analysis. Results One hundred forty-seven out-of-care patients generated an alert. Ninety-eight were included in the primary analysis (mean age [SD], 41 ± 12 years; 70% male; 93% African American), and 20 received the HIE-informed SW intervention. Sixty percent of patients receiving the intervention linked to care in 6 months, compared with 35% who did not. Patients receiving the intervention were more likely to link to care (adjusted risk ratio [aRR], 1.63; 95% confidence interval [CI], 0.99–2.68) and no more likely to achieve viral suppression (aRR, 1.49; 95% CI, 0.50–4.46) than those who did not receive the intervention. Conclusions An HIE-informed, SW-led intervention systematically identified out-of-care PWH and may increase linkage to care for this important population. HIEs create an opportunity to intervene with linkage and retention strategies.


2020 ◽  
Vol 41 (S1) ◽  
pp. s423-s423
Author(s):  
Alana Cilwick ◽  
Alexis Burakoff ◽  
Wendy Bamberg ◽  
Geoffrey Brousseau ◽  
Nisha Alden ◽  
...  

Background: Healthcare-associated group A Streptococcus (GAS) infections can cause severe morbidity and death. Invasive GAS is a reportable condition in the 5-county metropolitan area of Denver, Colorado. Prior to August 2018, methodology to identify long-term care facility (LTCF) residency among reported GAS cases was accomplished by reviewing addresses reported electronically, and identification of postsurgical cases and outbreaks relied on reporting by healthcare facilities. We evaluated whether the use of a health information exchange (HIE) to identify healthcare exposures improved our ability to detect and rapidly respond to these events. Methods: In August 2018, we implemented a review of health records available in the HIE accessible by the Colorado Department of Public Health and Environment for all incoming reports of GAS for selected healthcare exposures: LTCF residency, surgery, delivery, wound care, and other relevant exposures. We defined an LTCF-related case as GAS in a current or recent resident (ie, in the 14 days prior to the positive culture) of an LTCF. Postpartum and postsurgical cases were defined as GAS isolated from a sterile site or wound during the inpatient stay or within 7 days of discharge following a delivery or surgical procedure. Outbreaks in each of these settings were defined as 2 or more cases within a 3-month period. We compared the number of cases and outbreaks identified in each category during a 1-year period before and after implementation of the use of the HIE in the case ascertainment process. Results: During August 2017 through July 2018, prior to implementation of the HIE process, we detected 45 LTCF cases and conducted outbreak investigations in 9 facilities. Moreover, 1 postsurgical case and 1 postpartum outbreak were reported by healthcare facilities; none were detected via surveillance. During August 2018 through July 2019, after the implementation of HIE process, we identified 70 LTCF cases and conducted outbreak investigations in 13 LTCFs. We detected 5 postsurgical cases and 3 postpartum cases, which resulted in 2 outbreak investigations. Conclusions: Enhanced GAS surveillance through use of a HIE resulted in detection of more healthcare-associated GAS infections and outbreaks. Timely identification of healthcare-associated GAS infections can allow for prompt response to outbreaks and promotion of proper infection control practices to prevent further cases. Jurisdictions in which GAS is a reportable condition should consider the use of HIEs as part of routine surveillance to identify GAS outbreaks in high-risk settings. HIEs should be made available to public health agencies for case ascertainment and outbreak identification.Funding: NoneDisclosures: None


Sign in / Sign up

Export Citation Format

Share Document