scholarly journals A Meaningful Journey to Onboard Syndromic Data through a Local HIE

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Jeffrey Johnson ◽  
Jessica Yen ◽  
Brit Colanter ◽  
Eric McDonald
Keyword(s):  
Public Health ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Agency ◽  
Meaningful Use ◽  
The United States ◽  
Lessons Learned ◽  
Local Health ◽  
Local Public Health ◽  
Public Health Agencies

This presentation aims to highlight key activities, technical approaches, data discoveries, lessons learned and outcomes achieved while onboarding local hospitals for syndromic Meaningful Use Stage 2 through a local health information exchange. The federal meaningful use initiative is currently a major driver to enable greater establishment of syndromic surveillance capacity across the United States. The role and efforts by local and state public health agencies in the syndromic onboarding process varies greatly. We describe efforts from a local public health agency to onboard, validate and integrate meaningful use syndromic information.

scholarly journals Leveraging public health's participation in a Health Information Exchange to improve communicable disease reporting

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Ian Painter ◽  
Debra Revere ◽  
P. Joseph Gibson ◽  
Janet Baseman
Keyword(s):  
Public Health ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Communicable Disease ◽  
Health Agency ◽  
Public Health Agency ◽  
Public Health Agencies ◽  
The Public ◽  
The Mean

Background: Infectious diseases can appear and spread rapidly. Timely information about disease patterns and trends allows public health agencies to quickly investigate and efficiently contain those diseases. But disease case reporting to public health has traditionally been paper-based, resulting in somewhat slow, burdensome processes. Fortunately, the expanding use of electronic health records and health information exchanges has created opportunities for more rapid, complete, and easily managed case reporting and investigation. To assess how this new service might impact the efficiency and quality of a public health agency's case investigations, we compared the timeliness of usual case investigation to that of case investigations based on case report forms that were partially pre-populated with electronic data. Intervention: Between September 2013-March 2014, chlamydia disease report forms for certain clinics in Indianapolis were electronically pre-populated with clinical, lab and patient data available through the Indiana Health Information Exchange, then provided to the patient’s doctor. Doctors could then sign the form and deliver it to public health for investigation and population-level disease tracking. Methods: We utilized a novel matched case analysis of timeliness changes in receipt and processing of communicable disease report forms. Each Chlamydia cases reported with the pre-populated form were matched to cases reported in usual ways. We assessed the time from receipt of the case at the public health agency: 1) inclusion of the case into the public health surveillance system and 2) to close to case. A hierarchical random effects model was used to compare mean difference in each outcome between the target cases and the matched cases, with random intercepts for case. Results: Twenty-one Chlamydia cases were reported to the public health agency using the pre-populated form. Sixteen of these pre-populated form cases were matched to at least one other case, with a mean of 23 matches per case. The mean Reporting Lag for the pre-populated form cases was 2.5 days, which was 2.7 days shorter than the mean Reporting Lag for the matched controls (p = <0.001). The mean time to close a pre-populated form case was 4.7 days, which was 0.2 days shorter than time to close for the matched controls (p = 0.792). Conclusions: Use of pre-populated forms significantly decreased the time it took for the local public health agency to begin documenting and closing chlamydia case investigations. Thoughtful use of electronic health data for case reporting may decrease the per-case workload of public health agencies, and improve the timeliness of information about the pattern and spread of disease.

scholarly journals Containing COVID-19 Through Contact Tracing

2020 ◽  
Vol 136 (1) ◽  
pp. 32-38
Author(s):  
Nilesh Kalyanaraman ◽  
Michael R. Fraser
Keyword(s):  
Public Health ◽  
Health Agency ◽  
The United States ◽  
Lessons Learned ◽  
Local State ◽  
Contact Tracing ◽  
Public Health Agencies ◽  
Incident Command ◽  
Department Of Health

Containing coronavirus disease 2019 (COVID-19) through case investigation and contact tracing is a crucial strategy for governmental public health agencies to control the spread of COVID-19 infection in the United States. Because of the recency of the pandemic, few examples of COVID-19 contact-tracing models have been shared among local, state, and federal public health officials to date. This case study of the Anne Arundel County Department of Health (Maryland) illustrates one model of contact-tracing activity developed early in the outbreak. We describe the contact-tracing effort’s place within the broader county health agency Incident Command System, as well as the capabilities needed, team composition, special considerations, and major lessons learned by county health officials. Other local, state, tribal, territorial, and federal health officials and policy makers can use this case study to innovate, iterate, and further refine contact-tracing efforts to prevent the spread of COVID-19 infection and support community members in isolation or quarantine.

A System-Level Intervention to Encourage Collaboration Between Juvenile Justice and Public Health Agencies to Promote HIV/STI Testing

2020 ◽  
Vol 32 (4) ◽  
pp. 337-355 ◽  
Author(s):  
Katherine S. Elkington ◽  
Anne Spaulding ◽  
Sheena Gardner ◽  
Danica Knight ◽  
Steven Belenko ◽  
...  
Keyword(s):  
Public Health ◽  
Juvenile Justice ◽  
Health Agency ◽  
The United States ◽  
Practice Change ◽  
System Level ◽  
Public Health Agencies ◽  
Treatment Services ◽  
Sti Testing ◽  
Health Agencies

Justice-involved youth are at high risk for HIV and STIs, and justice agencies are uniquely poised to offer HIV/STI testing. However, testing in these settings is not routine and represents a missed opportunity. This study describes a system-level implementation intervention designed to increase access to HIV/STI testing through juvenile justice (JJ) and public health agency collaboration across six counties in six states in the United States. Local change teams, active facilitation, and training were utilized to facilitate agency partnerships and development of HIV/STI practice change protocols. Five counties established health and JJ partnerships and four counties successfully implemented their protocols. Sites with HIV/STI education and testing protocols behaviorally screened 98.5% of youth and tested 41.2% of those youth; 0% were HIV+ and 43.2% had an STI. The intervention provides a feasible, scalable solution, through promoting partnerships between JJ and health agencies, to link youth to testing and treatment services.

scholarly journals Intent to Vaccinate Children against COVID-19: Low levels of trust in public health agencies trust across rural communities

2021 ◽  
Author(s):  
Enbal Shacham ◽  
Germysha Little ◽  
Steve Scroggins ◽  
Avery Fredman ◽  
Ricardo Wray ◽  
...  
Keyword(s):  
Public Health ◽  
Rural Communities ◽  
Online Survey ◽  
Health Agency ◽  
Special Focus ◽  
Cross Sectional ◽  
Local Public Health ◽  
Public Health Agencies ◽  
Health Agencies ◽  
State And Local

Background: A COVID-19 vaccination for children is positioned to be a critical resource in the pandemic-prevention effort. However, studies have shown hesitation towards COVID-19 vaccination uptake and a lack of trust in government agencies; putting children at risk for not receiving preventative medical care. The purpose of this study was to determine the association between trust in public health agencies and parental intention to vaccinate their children against COVID-19. Methods: Residents of a Midwestern state who reported being parent/guardian of one or more child, aged &lt;18 living at home, were recruited to participate in a cross-sectional online survey conducted during September-October 2020 (n=238). Participants were asked their level of trust in both state and local public health departments and if they planned on vaccinating their children against COVID-19. Resident geography, rural, suburban, and urban, was categorized using definitions from the Health Resource Services Administration (HRSA) and matched to participant county of residence. Descriptive and binomial logistic regression analyses were conducted to predict probability of vaccine intent for children.Results:. Among participants, 132 (55.5%) reported intention to vaccinate their children against COVID-19. Factors that were found to significantly decrease probability of vaccinating child were being a rural resident and lower level of trust in both state and local public health agencies. Discussion: Results from this study highlight the importance of addressing public health agency mistrust among individuals, regardless of geography, to assure more equitable vaccine delivery. Further, special focus may be needed for those living in more isolated, less populated areas, where a higher level of trust may be needed before parents vaccinate their children.

Journaling among home care workers during the COVID-19 pandemic: A promising method for qualitative data collection

2021 ◽  
pp. 147332502110648
Author(s):  
Julia I Bandini ◽  
Julia Rollison ◽  
Jason Etchegaray
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Home Care ◽  
Lived Experiences ◽  
Health Agency ◽  
The United States ◽  
Lessons Learned ◽  
Future Research ◽  
Care Workers ◽  
Home Care Workers

Qualitative methods that capture individual lived experiences throughout rapidly changing circumstances are particularly important during public health emergencies. The COVID-19 pandemic has put home care workers at risk as they provide vital services in homes to individuals with chronic conditions or disabilities. Using a 6-week journaling process in which we enrolled participants at different points, we sought to examine experiences of home care workers ( n = 47) in the United States in New York and Michigan during April–July 2020 of the COVID-19 pandemic. Our methods for data collection and analysis were guided by a general qualitative approach as we aimed to examine the weekly perspectives and lived experiences of home care workers. We asked individuals to respond to our journaling prompts weekly to capture their reflections in “real time.” To better understand home care workers’ perspectives on journaling and the broader external context in which they provided care, we triangulated our data with interviews with home care workers ( n = 19) and home health agency representatives ( n = 9). We explored the feasibility of a rolling journaling process during an unprecedented public health emergency, characterized by rapid changes and uncertainty in day-to-day life, and reflect on lessons learned to guide future research on journaling for data collection, particularly for marginalized workers during public health crises, when events are evolving rapidly.

scholarly journals Development of a Climate Change Vulnerability Assessment Using a Public Health Lens to Determine Local Health Vulnerabilities: An Ontario Health Unit Experience

2018 ◽  
Vol 15 (10) ◽  
pp. 2237 ◽  
Author(s):  
Morgan Levison ◽  
Ainslie Butler ◽  
Steven Rebellato ◽  
Brenda Armstrong ◽  
Marina Whelan ◽  
...  
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Vulnerability Assessment ◽  
Action Plan ◽  
Local Level ◽  
Health Agency ◽  
Health Impacts ◽  
Research Approach ◽  
Local Health ◽  
Local Public Health

Climate change is negatively impacting the health of Canadians and is accordingly expected to have a significant impact on public health agencies and their response to these health impacts throughout the twenty-first century. While national and international research and assessments have explored the potential human health impacts of climate change, few assessments have explored the implications of climate change from a local public health perspective. An applied research approach to expand local knowledge and action of health vulnerabilities through a climate change action plan and vulnerability assessment was utilized by a local public health agency. Adoption and adaptation of the approach used may be valuable for public health organizations to assist their communities. Through completing a vulnerability assessment, an evidentiary base was generated for public health to inform adaptation actions to reduce negative health impacts and increase resiliency. Challenges in completing vulnerability assessments at the local level include the framing and scoping of health impacts and associated indicators, as well as access to internal expertise surrounding the analysis of data. While access to quantitative data may be limiting at the local level, qualitative data can enhance knowledge of local impacts, while also supporting the creation of key partnerships with community stakeholders which can ensure climate action continues beyond the scope of the vulnerability assessment.

scholarly journals Surveillance of Stillbirth and Syphilis Screening Using Electronic Health Records

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Brian E Dixon ◽  
Jane Wang ◽  
Timothy E O'Connor ◽  
Janet N Arno
Keyword(s):  
Public Health ◽  
Electronic Health Records ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Congenital Syphilis ◽  
The United States ◽  
Health Records ◽  
Syphilis Testing ◽  
Electronic Health

Objective: To measure stillbirth delivery rates and syphilis screening rates among women with a stillbirth delivery using electronic health record data available in a health information exchange.Introduction: Reports of infants born with congenital syphilis have increased in the United States every year since 2012. Prevention depends on high performing surveillance systems and compliance with the U.S. Centers for Disease Control and Prevention (CDC) recommendations to perform syphilis testing early in pregnancy, in the third trimester and at delivery if a woman is at high risk, and following a stillbirth delivery. These guidelines exist, because untreated syphilis is associated with adverse fetal outcomes including central nervous system infection and death.Surveillance of congenital syphilis and stillbirth is challenging because available data sources are limited. Assessment of compliance with testing guidelines is particularly challenging, since public health agencies often lack access to comprehensive cohorts of tested individuals as most public health laws only require reporting of positive disease case information.Methods: Using integrated electronic health records available in a community-based health information exchange, we examined syphilis testing patterns for women with a stillbirth delivery in Indiana between 2010-2016. The cohort was examined to determine whether the women received syphilis testing in accordance with the CDC recommendations. During this time period, Indiana recorded around 84,000 live births per year.Data were extracted from electronic health records, including encounter data, laboratory test results and procedure data, captured by the Indiana Network for Patient Care (INPC), one of the largest community-based HIE networks in the United States. The INPC connects over 90 health care facilities, including hospitals, physicians’ practices, pharmacy networks, long-term post-acute care facilities, laboratories, and radiology centers. In addition to clinical care, the INPC supports surveillance of STIs1.Women with a stillbirth delivery were identified using International Classification of Disease (ICD) Clinical Modification (CM) codes from the 9thand 10th editions (ICD-CM-9 and ICD-CM-10). Inclusion codes: ICD-CM-9 codes 656.4, 779.9, V27.1, V27.3, V27.4, V27.6, V27.7, V32.01, V32.1, V32.2, V36.1; and ICD-CM-10 codes P95, P96.9, O36.4, Z37.1, Z37.3, Z37.4, Z37.9.Using the master person index for the INPC, we linked stillbirth deliveries with pregnancy encounters and laboratory testing data. We analyzed documentation of syphilis testing during the pregnancy (up to 270 days prior to the stillbirth delivery) as well as after the stillbirth delivery (up to 30 days). Broad time ranges were utilized to account for potential delays in reporting of either the stillbirth delivery or the syphilis test results. Documentation could include either presence of a result from a laboratory test for syphilis or a CPT code (80055, 86780, 86781, 86592, 86593) indicating performance of a syphilis test.Results: A total of 4,361 stillbirth deliveries attributable to 4,265 unique women were identified in the INPC between 2010-2016; representing a rate of 7.44 stillbirths per 1,000 live births during the same time period. Of the stillbirth deliveries, syphilis testing occurred within 270 days prior to or 30 days after delivery for 2,763 (63.4%) cases. Figure 1 displays the number of stillbirth cases observed each year and the number of cases in which syphilis testing occurred during the pregnancy or after delivery.Conclusions: Using integrated electronic health records data, we discovered that fetal deaths occurred more frequently (7.44 versus 4.09 per 1,000) than previously estimated2 through fetal death reporting mechanisms in Indiana. Furthermore, we observed increasing rates of stillbirth within Indiana in recent years. Integrated data further enabled measurement of syphilis testing rates for stillbirth cases, which were similar to those reported by Patel et al.3using a large, national administrative data set. Testing rates in Indiana are well below the targets set by national and international public health organizations. Accessing more complete data on populations using a health information exchange is valuable, although doing so may uncover a more negative picture of health in one’s community. Deeper analysis of these trends is warranted to explore factors related to increasing rates as well as limited testing in this population.

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