A%20Practical%20Roadmap%20to%20Integrating%20Public%20Health%20(Surveillance)%20IT%20Systems

1
A Practical Roadmap to Integrating Public Health
(Surveillance) IT Systems

• Massimo Mirabito, Kumar Batra, Priscilla Chu
• Sharon R. Burks, William D. Correll, Thomas
  Sukalac

2
Presenter Disclosures

• Max Mirabito, Kumar Batra, Sharon Burks
• Employed by Northrop Grumman
• Own Northrop Grumman Stocks
• Currently working on the CDC CIMS Contract
  supporting CDC/NCHHSTP
• Thomas Sukalac, William D. Correll
• Employed by the Centers for Disease Control and
  Prevention
• Currently support CDC/NCHHSTP
• Priscilla Chu
• Employed by the San Francisco Department of
  Public Health
• Currently supporting the Population Health
  Division

3
The State of Public Health IT Systems

• Public health systems are becoming increasingly
  integrated
• 2011 MMWR report State Electronic Disease
  Surveillance Systems United States, 2007 -2010
• 22 increase in integrated systems
• 211 increase in interoperable systems
• NCHHSTP is encouraging data integration and
  harmonization
• Surveillance Systems Consultation recommendations
• Leadership is involved in standardizing public
  health data
• Build systems that will break down silos
• Increase interoperability and harmonize data
  submission
• Facilitate collaboration between public health
  partners
• Provide guidance and facilitate information
  exchange
• Develop Public Health informatics workforce

4
The Importance of Integration

• Collecting and aggregating
• Deliver efficient and effective services
• Shifting from disease specific to integrated
  systems
• Unified offering across disease domains
• Benefits
• Improved data sharing and data quality
• Increase agility and ability to delivery services
• Detect, monitor, track, identify and correlate

5
Roadmap to Public Health IT System Integration
6
Roadmap Key Factors
7
Factors Influencing Integration

• Leadership priorities
• Aligned with mission, integrate all diseases, one
  system, privacy and confidentiality, efficiencies
• Public Health Programs and Initiatives
• Critical, guide and shape
• System Design and Architecture
• Design, resources, security, support,
  expandability
• Integration
• Data exchange, interoperability, Application
  Program Interfaces (APIs)

Four areas to Focus
8
Roadmap Organization
9
Organizational Factors

• Look Inside
• Strengths EPI, surveillance, research,
  creativity
• Weaknesses IT fragmentation, knowledge, siloes,
  policies and practices
• Look externally
• Opportunities Healthcare reform, liberating
  data, increase collaboration
• Threats/Challenges Constrained budgets,
  categorical funding, policies

Look closely at your organization
10
Roadmap IT Environment
11
IT Landscape

• Current landscape
• Invested considerable resources
• Duplicative systems and outdated technology
• Systems collect similar data in different formats
• IT is burdened more and more to support and
  maintain
• Upcoming landscape
• Technology has created new expectations
• New ways of socializing and discovering data
• Mobility is pressuring IT
• Its harder to keep up

IT is more complex than 20 years ago
12
Roadmap Integration Challenges
13
Integration is Difficult

• People
• Communicate vision
• Balance needs
• Complexity
• Compartmentalization, unique needs
• Rushing to integrate, lack of requirements
• Resources
• Funding, Infrastructure, Sustainability
• Harmonization
• Concept vs. operationalization

Risk is not your enemy
14
Roadmap Recommendations
15
Recommendations

• Align integration to Executive priorities, Public
  Health programs, Architecture, Integration
• Develop your unique blueprint
• Involve IT Informatics early and often
• Identify ways to liberate data to increase
  collaboration

Align your solution to your focus areas
16
Roadmap The San Francisco Blueprint
17
Roadmap San Francisco Department of Public
Health (SFDPH) Population Health Division

• Background
• Process
• Key factors influencing integration
• Organization
• IT environment and information systems
• Lessons learned from integration

18
Background

• Program Collaboration and Systems Integration
  (PCSI) initiative
• Syndemic analysis
• 65 separate data systems
• Decision made by Local Health Officer to move to
  integrated system

Winchester Mystery House
Roadmap The SFDPH Population Health Division
19
Process

• Stakeholder engagement
• Informatics assessment
• Conducted 14 focus group interviews
• Synthesized information into an informatics
  report
• Market solutions report
• Specific to local criteria
• Business case
• Software system demonstrations
• Software system selection

Roadmap The SFDPH Population Health Division
20
Key Factors Influencing Integration

• Strategic Map Build an integrated information
  and knowledge management infrastructure
• Ability to share data for client-centered
  holistic and syndemic approach

• Increase efficiency
• More collaboration
• Less paper
• Less duplicate data entry

Roadmap The SFDPH Population Health Division
21
Organization
Roadmap The SFDPH Population Health Division
22
IT Environment Information Systems

• ITs support of systems
• IT focused on clinical systems
• Public healths outdated systems
• Lack of investment in IT
• Infrastructure, capacity and bandwidth
• Workforce development look at future needs

Roadmap The SFDPH Population Health Division
23
Lessons Learned from Integration

• Stakeholder engagement is important
• Change is everywhere
• Population Health Division reorganization
• New Chief Informatics Officer - IT reorganization
  (4x)
• Clinical side reorganization
• Change management
• Too much change at once is difficult
• Speak to the elephant

Roadmap The SFDPH Population Health Division
24
Conclusion

• Develop a customized informatics blueprint
• Invest in IT (infrastructure and human capital)
  and increase public health informatics
  capacity
• Consider working with Informatics
  resources at CDC

Integration
Integration is lifestyle Integration is a
marathon Integration is a team sport
25
Acknowledgments

• US Centers for Disease Control and Prevention
• Gustavo Aquino NCHHSTP Associate Director for
  Program Integration
• San Francisco Department of Public Health
• Israel Nieves Director, Office of Equity and
  Quality Improvement, Population Health Division,
  San Francisco Department of Public Health