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Public and Population Health Informatics: The Bridging of Big Data to…
Public and Population Health Informatics: The Bridging of Big Data to Benefit Communities
Introduction
The current US healthcare’s electronic data infrastructure has been designed primarily to meet the needs of medical providers’ health insurance billing, internal organizational management, and regulatory reporting
Until the last few years, most clinicians in the US had little interest and few incentives to advance population health applications by linking their data across these silos
This trend has recently started to be reinforced and supported by changes in policy, alignment of incentives, and wider adoption of data-sharing protocols and infrastructure
Value-based policies
of commercial and government insurance companies have begun to shift the focus of clinical organizations from individual patient visits to managing larger populations and improving their overall health outcomes while maintaining cost efficiency
State and federal policies introduced increased financial risk-sharing and fixed budgets for provider organizations
Several health information technology (IT) solutions, such as health information exchanges (HIEs) and population or community-level analytics have propelled the collaboration of health systems and public health departments to manage their overlapping “community better” denominators to integrate across many different digital silos
Methods
Literature Search: the literature review focused on articles published from July 1, 2016 - September 30, 2017 and included additional relevant articles from scientific venues
2 more items...
Results
Socio-Technical Infrastructure and Research
The definition of “Big Data” varies depending on the author and context, but it includes a diverse health-related data sources. Public health organizations increasingly use unstructured data to improve event detection, such as injury surveillance
US public health agencies are increasingly developing agreements to use social services data collected by government agencies, outside of public health, to help track areas of risk in the population. Enhanced methods for communicable disease surveillance are being developed to improve timeliness and reduce clinician burden.
Use of near real-time syndromic surveillance systems is growing to monitor environmental triggers and other health threats
Telehealth is a clinical service enhancement, and also serves as a safety net provider for vulnerable populations. The Pan American Health Organization and the Centers for Disease Control and Prevention have developed interactive visualization platforms to aid in injury prevention in the US
Workforce develpment
Public health agencies recognize the need for competency updates in response to evolving data sources, with training needs varying by department size
Sustainability
strategic partnerships should not only lay out digitally supported plans for the improvement of the health status of the community, but they should also encourage stakeholders from outside traditional public health agencies to understand and to be involved in these processes
Sustainable funding models are essential for maintaining fundamental public health services, and integrating population health activities with governmental services
Governace, Ethics, and Confidentiality
Ethical concerns regarding the use of digital data for public health research are paramount, emphasizing the balance between community benefits and individual privacy
Discussion
Public Health Informatics 3.0: Public health leadership has an opportunity to expand the business case for public health and population health information systems.
Collaboration with various providers is becoming crucial for effective community health strategies
SDH data systems should define the community environment, including digital metrics describing features such as crime, housing stock, social networking, measures of pollution, and toxic substance exposure
Alignment of Population and Public Health Informatics Aims and Outcomes: shift towards “value-based” delivery models, such as accountable care organizations and patient-centered medical homes, where clinicians receive higher payment for delivering better and more efficient care
Increased collaboration between healthcare systems and public health departments is evident, driven by the integration of data from electronic health records (EHRs)
Future Dirctions
New financial and regulatory infrastructures, as well as shifts in the care paradigm, has crated increased attention among US medical care providers in popu-lation-based prevention activities intended to reduce readmissions and other avoidable (and expensive) medical events
Ongoing scientific evaluations are needed to assess the impact of SDH-focused interventions on health outcomes
A concerted effort is required to integrate medical and public health data systems, acknowledging and measuring non-medical determinants to achieve comprehensive health and well-being in communities
Social Determinants of Health: is an increased acknowledgment of the importance of considering a broad array of “non-medical” factors generally termed as social determi- nants of health. Along with this recognition has come a surge of interest in data, metrics, IT systems, and advanced analytics that allow for the appropriate inclusion of SDH information into a broad array of health and medical applications and use cases
advances in technology enable better data sharing across public health, population health, and social services, facilitating a more holistic approach to health management