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PubMed2006

Web GIS in practice IV: publishing your health maps and connecting to remote WMS sources using the Open Source UMN MapServer and DM Solutions MapLab.

Open Source Web GIS software systems have reached a stage of maturity, sophistication, robustness and stability, and usability and user friendliness rivalling that of commercial, proprietary GIS and Web GIS server products. The Open Source Web GIS community is also actively embracing OGC (Open Geospatial Consortium) standards, including WMS (Web Map Service). WMS enables the creation of Web maps that have layers coming from multiple different remote servers/sources. In this article we present one easy to implement Web GIS server solution that is based on the Open Source University of Minnesota (UMN) MapServer. By following the accompanying step-by-step tutorial instructions, interested readers running mainstream Microsoft(R) Windows machines and with no prior technical experience in Web GIS or Internet map servers will be able to publish their own health maps on the Web and add to those maps additional layers retrieved from remote WMS servers. The 'digital Asia' and 2004 Indian Ocean tsunami experiences in using free Open Source Web GIS software are also briefly described.

Geographic Information Systems↗
PubMed2003

ArrayTrack--supporting toxicogenomic research at the U.S. Food and Drug Administration National Center for Toxicological Research.

The mapping of the human genome and the determination of corresponding gene functions, pathways, and biological mechanisms are driving the emergence of the new research fields of toxicogenomics and systems toxicology. Many technological advances such as microarrays are enabling this paradigm shift that indicates an unprecedented advancement in the methods of understanding the expression of toxicity at the molecular level. At the National Center for Toxicological Research (NCTR) of the U.S. Food and Drug Administration, core facilities for genomic, proteomic, and metabonomic technologies have been established that use standardized experimental procedures to support centerwide toxicogenomic research. Collectively, these facilities are continuously producing an unprecedented volume of data. NCTR plans to develop a toxicoinformatics integrated system (TIS) for the purpose of fully integrating genomic, proteomic, and metabonomic data with the data in public repositories as well as conventional (Italic)in vitro(/Italic) and (Italic)in vivo(/Italic) toxicology data. The TIS will enable data curation in accordance with standard ontology and provide or interface a rich collection of tools for data analysis and knowledge mining. In this article the design, practical issues, and functions of the TIS are discussed through presenting its prototype version, ArrayTrack, for the management and analysis of DNA microarray data. ArrayTrack is logically constructed of three linked components: a) a library (LIB) that mirrors critical data in public databases; b) a database (MicroarrayDB) that stores microarray experiment information that is Minimal Information About a Microarray Experiment (MIAME) compliant; and c) tools (TOOL) that operate on experimental and public data for knowledge discovery. Using ArrayTrack, we can select an analysis method from the TOOL and apply the method to selected microarray data stored in the MicroarrayDB; the analysis results can be linked directly to gene information in the LIB.

Databases, Factual↗
PubMedDate not supplied

The healthcare cost and utilization project: an overview.

DATABASE: . Healthcare Cost and Utilization Project (HCUP)-a family of databases including the State Inpatient Databases (SID), the Nationwide Inpatient Sample (NIS), the Kids' Inpatient Database (KID), and the outpatient databases State Ambulatory Surgery Data (SASD) and State Emergency Department Data (SEDD). DESCRIPTION: Multistate, inpatient (SID, NIS, KID) and outpatient (SASD, SEDD) discharge records on insured and uninsured patients. SOURCE: Partnership between the Agency for Healthcare Research and Quality (AHRQ) and public and private statewide data organizations. AVAILABLE DATA: Selected data elements from inpatient and outpatient discharge records, including patient demographic, clinical, disposition and diagnostic/procedural information; hospital identification (ID); facility charges; and other facility information. DATA YEARS AVAILABLE: Varies by database: NIS 1988-2000; SID 1995-2000; KID 1997 and 2000; SASD 1995-2000; and SEDD in pilot phase. Future data years anticipated for all datasets and back years for SID and SASD. UNITS OF ANALYSIS: Patient (in states with encrypted patient identification), physician, market, and state. RESEARCH QUESTIONS: Quality assessment, use and cost of hospital services, medical treatment variations, use of ambulatory surgery services, diffusion of medical technology, impact of health policy changes, access to care (inference), study of rare illness or procedures, small area variations, and care of special populations. STRENGTHS: Largest collection of all-payer, uniform, state-based inpatient and ambulatory surgery administrative data. LIMITATIONS: Lacks clinical detail (e.g., stage of disease, vital statistics) and laboratory and pharmacy data. Ability to track patients across time and setting varies by state. ACCESS TO DATA: Access available to all users who sign and abide by the Data Use Agreement. Application kits available at www.ahrq.gov/data/hcup. HCUPnet, an on-line interactive query tool, allows access to data without purchase (www.ahrq. gov/data/hcup/hcupnet.htm).

Ambulatory Care↗
PubMed2003

Modeling interventions to improve access to public health information.

In a Robert Wood Johnson funded project, we established a model-based means for automatically analyzing and representing grey literature that reports on public health (PH) interventions. We summarize the development of an intervention model for public health documents and provide a project update on the implementation of natural language technology to improve access to difficult to find public health information.

Algorithms↗
PubMed2005

Connecting health departments and providers: syndromic surveillance's last mile.

INTRODUCTION: A critical need exists for mechanisms to identify and report acute illness clusters to health departments. The Massachusetts Department of Public Health (MDPH) works with partner organizations to conduct syndromic surveillance. This effort is based on CDC's Health Alert Network program and includes automated generation and notification of signals and a mechanism to obtain detailed clinical information when needed. METHODS: Syndromic surveillance partners collect emergency department and ambulatory care data. The principal communications platform between syndromic surveillance partners and MDPH is the Massachusetts Homeland and Health Alert Network (HHAN). This Internet-based application serves as a portal for communication and collaboration and alerts predefined groups of users involved in emergency response. Syndromic surveillance partners' systems report to HHAN by using Public Health Information Network Messaging System events that meet thresholds selected by MDPH. Cluster summaries are automatically posted into a document library. HHAN notifies users by electronic mail, alphanumeric pager, facsimile, or voice communications; users decide how they want to be notified for each level of alert. Discussion threads permit real-time communication among all parties. RESULTS: This automated alert system became operational in July 2004. During July-December 2004, HHAN facilitated communication and streamlined investigation of 15 alerts. CONCLUSION: The system allows rapid, efficient alerting and bidirectional communication among public health and private-sector partners and might be applicable to other public health agencies.

Disaster Planning↗
PubMed2005

Electronic health record - public health (EHR-PH) system prototype for interoperability in 21st century healthcare systems.

Information exchange, enabled by computable interoperability, is the key to many of the initiatives underway including the development of Regional Health Information Exchanges, Regional Health Information Organizations, and the National Health Information Network. These initiatives must include public health as a full partner in the emerging transformation of our nation's healthcare system through the adoption and use of information technology. An electronic health record - public health (EHR-PH)system prototype was developed to demonstrate the feasibility of electronic data transfer from a health care provider, i.e. hospital or ambulatory care settings, to multiple customized public health systems which include a Newborn Metabolic Screening Registry, a Newborn Hearing Screening Registry, an Immunization Registry and a Communicable Disease Registry, using HL7 messaging standards. Our EHR-PH system prototype can be considered a distributed EHR-based RHIE/RHIO model - a principal element for a potential technical architecture for a NHIN.

Computer Communication Networks↗
PubMed2003

Benchmarking information needs and use in the Tennessee public health community.

OBJECTIVE: The objective is to provide insight to understanding public health officials' needs and promote access to data repositories and communication tools. METHODS: Survey questions were identified by a focus group with members drawn from the fields of librarianship, public health, and informatics. The resulting comprehensive information needs survey, organized in five distinct broad categories, was distributed to 775 Tennessee public health workers from ninety-five counties in 1999 as part of the National Library of Medicine-funded Partners in Information Access contract. RESULTS: The assessment pooled responses from 571 public health workers (73% return rate) representing seventy-two of ninety-five counties (53.4% urban and 46.6% rural) about their information-seeking behaviors, frequency of resources used, computer skills, and level of Internet access. Sixty-four percent of urban and 43% of rural respondents had email access at work and more than 50% of both urban and rural respondents had email at home (N = 289). Approximately 70% of urban and 78% of rural public health officials never or seldom used or needed the Centers for Disease Control (CDC) Website. Frequency data pooled from eleven job categories representing a subgroup of 232 health care professionals showed 72% never or seldom used or needed MEDLINE. Electronic resources used daily or weekly were email, Internet search engines, internal databases and mailing lists, and the Tennessee Department of Health Website. CONCLUSIONS: While, due to the small sample size, data cannot be generalized to the larger population, a clear trend of significant barriers to computer and Internet access can be identified across the public health community. This contributes to an overall limited use of existing electronic resources that inhibits evidence-based practice.

Attitude to Computers↗
PubMed1990

[The concept of informatics applied to Soviet public health].

Development of integrated medical information systems (IMIS) was proposed as a main direction of health care informatization in this country. The IMIS are meant to function both on the out- and in-patient basis covering a region (city) with a population amounting to two hundred thousand. They are aimed primarily at providing information supply continuity for the prevention, diagnosis, and the treatment of diseases, and at establishing intercommunications between institutions, departments, physicians, and specialists. The IMIS may serve a data base to give objective information to higher administrative levels, and a basis for creating autonomous information systems intended to automate the work of a separate establishment (department, or physician). The IMIS may also be used to develop medical educational systems (teaching systems, biomedical data banks and data base for medical workers, reference-information service for the population), medical expert systems, and systems of scientific work provision. Expenses on the development and establishment of IMIS are estimated, and possible social sequelae of health care informatization are assessed.

Costs and Cost Analysis↗
PubMed2006

Evidence-based healthcare and health informatics: derivations and extension of epidemiology.

Epidemiology provides extremely valid information and evidence regarding human health. Epidemiologic findings with regard to major illnesses must be amassed, enhanced, and expanded further into related areas as a foundation for evidence-based medicine that is based on clinical practice, as well as for evidence-based healthcare that includes public health-related issues. Epidemiology should be recognized not only by epidemiologists but also by a variety of people, including specialists in other areas for healthcare and medicine, people in law and media, policy makers, and the general public. A system is needed that can create information for facilitating appropriate decision-making with issues related to clinical medicine and public health. The principles and methodology of epidemiology are used as a base for developing a field of health informatics. The objective of health informatics is to establish a system for facilitating the flow and circulation of health and medical information. Health informatics has potential applications for the creation, communication, and use of information, and the discipline is being expanded as a practical applied science in search of solutions. This report represents an effort to expand the scope of health informatics and extend the applications of epidemiology by working with individuals in other disciplines and the public.

Decision Support Techniques↗
PubMed2004

A convocation of wizards: synergies at the intersection of child health care, public health, and information technology.

Although great opportunities for synergies exist, experts in children's health care, public health, and informatics often practice in silos--unaware of advances in related fields. The conference "A Vision for Child Health Information Systems: Developing Child Health Information Systems to Meet Medical Care and Public Health Needs," was held in Atlanta, Georgia, December 3-4, 2003 in an effort to break down barriers. Issues--germane to each group and bridging the boundaries between them--are presented. A vision of health care with obstacles removed is described. Experts should work to diminish the insularity that interferes with effective collaboration, focus on the intersections of child health, public health and information technology, and recognize and promulgate the message that one-size technology solutions that are designed for adult medicine don't fit this area of practice.

Adolescent↗
PubMed2004

A local department of public health and the geospatial data infrastructure.

Local health departments (LHD) are the most widely distributed aspect of the United States public health infrastructure. The role of LHDs has changed since the terrorist attacks of September 11, 2001, and an increased concern about bioterrorism. This concern resulted in more emphasis on disease surveillance and the need for new institutional linkages of LHDs with other entities for effective response. These changes coincide with technological changes in spatial data integration and the growth of medical informatics in public health. The integration of GIS into the daily work of an LHD holds promise of improving not only bioterrorism response capabilities, but also the management of emerging infectious diseases, such as West Nile Virus or food borne illness, as well as longstanding programs focused on nutrition and safety. Still, the impediments to using GIS at an LHD remain strong as funding decisions and a complex technology continue to challenge implementation efforts.

Bioterrorism↗
PubMed2000

Information needs and uses of the public health workforce--Washington, 1997-1998.

Substantial efforts have been made to ensure that state and local public health agencies have the information technology and training needed for public health communications, information access, and data exchange. Numerous public health-related data and information resources are available on the World-Wide Web (e.g., MEDLINE, MMWR, CDC Prevention Guidelines Database, and Emerging Infectious Diseases); however, little systematic work has been done to understand the information needs of the public health workforce. To identify these needs and patterns of use and to set priorities for developing new online public health information resources, the University of Washington School of Public Health and Community Medicine (UW SPHCM) and the Washington State Department of Health (WSDoH) held structured and facilitated discussions with segments of the local public health workforce in Washington during 1997-1998. This report summarizes the results of those discussions, which indicate that different segments of the public health workforce have different information needs.

Congresses as Topic↗
PubMed2004

Population health technologies: emerging innovations for the health of the public.

At the beginning of the 21st century, we are at the dawn of a possibly unprecedented era of scientific discovery and promise. Emerging technologies, including information and communication technologies, genomics, microelectromechanical systems, robotics, sensors, and nanotechnologies, provide enormous opportunities for population health improvement. Population health technology refers to the application of an emerging technology to improve the health of populations. Emerging technologies present an opportunity for addressing global health challenges-in both developed and developing countries. Health issues ripe for the application of new technologies include disease surveillance and control, environmental monitoring and pollution prevention, food safety, health behavior change, self-care, population screening, and chronic disease and injury prevention and control. If appropriately applied, population health technologies may greatly enhance existing health intervention models. However, potential adverse consequences could arise related to privacy, confidentiality, and security; quality and effectiveness; sustainability; and the technology divide. To ensure the optimal development and diffusion of population health technologies will require balancing these risks and benefits while simultaneously adopting new mechanisms of public and private support for research and development in this potentially important new domain of public health.

Biomedical Technology↗
PubMed2001

An inventory of information on blindness and visual impairment in Canada.

BACKGROUND: Several health databases contain information on blindness and visual impairment in Canada. Such databases may permit studies of the outcomes, predictors, economic costs and meta-analysis of ocular health problems and visual disability. In this paper we summarize the existing public health information on blindness and visual impairment in Canada. METHODS: A systematic search was performed to find the information in three areas: health administrative databases, health surveys and registries. Both literature searching and Internet searching were performed. The institutions were notified by email or telephone that information pertaining to vision and blindness was desired. When necessary, we visited the institution to obtain the information. RESULTS: Health administrative databases contain information on a wide cross-section of diagnoses but are usually limited in detail and seldom provide longitudinal information. Health surveys have a limited amount of systematic information on vision-related questions and rely exclusively on self-reporting. Registries exist on a wide range of visual topics. The Canadian National Institute for the Blind (CNIB) has the most comprehensive registry. INTERPRETATION: This is the first attempt at summarizing all the public health information on blindness and visual impairment in Canada. The present population-based ocular information has numerous shortcomings. More comprehensive validation of large registries, such as that of the CNIB, is needed to provide the foundation for a longitudinal ocular surveillance system. Such a system could guide research on risk factors and the effect of treatment, economic analyses, and public policy for ocular research and service allocation.

Blindness↗