Public Health and Epidemiology Informatics: Recent Research Trends.

OBJECTIVES: To introduce and analyse current trends in Public Health and Epidemiology Informatics. METHODS: PubMed search of 2020 literature on public health and epidemiology informatics was conducted and all retrieved references were reviewed by the two section editors. Then, 15 candidate best papers were selected among the 920 references. These papers were then peer-reviewed by the two section editors, two chief editors, and external reviewers, including at least two senior faculty, to allow the Editorial Committee of the 2021 International Medical Informatics Association (IMIA) Yearbook to make an informed decision regarding the selection of the best papers. RESULTS: Among the 920 references retrieved from PubMed, four were suggested as best papers and the first three were finally selected. The fourth paper was excluded because of reproducibility issues. The first best paper is a very public health focused paper with health informatics and biostatistics methods applied to stratify patients within a cohort in order to identify those at risk of suicide; the second paper describes the use of a randomized design to test the likely impact of fear-based messages, with and without empowering self-management elements, on patient consultations or antibiotic requests for influenza-like illnesses. The third selected paper evaluates the perception among communities of routine use of Whole Genome Sequencing and Big Data technologies to capture more detailed and specific personal information. CONCLUSIONS: The findings from the three studies suggest that using Public Health and Epidemiology Informatics methods could leverage, when combined with Deep Learning, early interventions and appropriate treatments to mitigate suicide risk. Further, they also demonstrate that well informing and empowering patients could help them to be involved more in their care process.

Identifying Opportunities to Strengthen the Public Health Informatics Infrastructure: Exploring Hospitals' Challenges with Data Exchange.

Policy Points Even though most hospitals have the technological ability to exchange data with public health agencies, the majority continue to experience challenges. Most challenges are attributable to the general resources of public health agencies, although workforce limitations, technology issues such as a lack of data standards, and policy uncertainty around reporting requirements also remain prominent issues. Ongoing funding to support the adoption of technology and strengthen the development of the health informatics workforce, combined with revising the promotion of the interoperability scoring approach, will likely help improve the exchange of electronic data between hospitals and public health agencies. CONTEXT: The novel coronavirus 2019 (COVID-19) pandemic has highlighted significant barriers in the exchange of essential information between hospitals and local public health agencies. Thus it remains important to clarify the specific issues that hospitals may face in reporting to public health agencies to inform focused approaches to improve the information exchange for the current pandemic as well as ongoing public health activities and population health management. METHODS: This study uses cross-sectional data of acute-care, nonfederal hospitals from the 2017 American Hospital Association Annual Survey and Information Technology supplement. Guided by the technology-organization-environment framework, we coded the responses to a question regarding the challenges that hospitals face in submitting data to public health agencies by using content analysis according to the type of challenge (i.e., technology, organization, or environment), responsible entity (i.e., hospital, public health agency, vendor, multiple), and the specific issue described. We used multivariable logistic and multinomial regression to identify characteristics of hospitals associated with experiencing the types of challenges. FINDINGS: Our findings show that of the 2,794 hospitals in our analysis, 1,696 (61%) reported experiencing at least one challenge in reporting health data to a public health agency. Organizational issues were the most frequently reported type of challenge, noted by 1,455 hospitals. The most common specific issue, reported by 1,117 hospitals, was the general resources of public health agencies. An advanced EHR system and participation in a health information exchange both decreased the likelihood of not reporting experiencing a challenge and increased the likelihood of reporting an organizational challenge. CONCLUSIONS: Our findings inform policy recommendations such as improving data standards, increasing funding for public health agencies to improve their technological capabilities, offering workforce training programs, and increasing clarity of policy specifications and reporting. These approaches can improve the exchange of information between hospitals and public health agencies.

COVID-19 prevention and treatment information on the internet: a systematic analysis and quality assessment.

OBJECTIVE: To evaluate the quality of information regarding the prevention and treatment of COVID-19 available to the general public from all countries. DESIGN: Systematic analysis using the 'Ensuring Quality Information for Patients' (EQIP) Tool (score 0-36), Journal of American Medical Association (JAMA) benchmark (score 0-4) and the DISCERN Tool (score 16-80) to analyse websites containing information targeted at the general public. DATA SOURCES: Twelve popular search terms, including 'Coronavirus', 'COVID-19 19', 'Wuhan virus', 'How to treat coronavirus' and 'COVID-19 19 Prevention' were identified by 'Google AdWords' and 'Google Trends'. Unique links from the first 10 pages for each search term were identified and evaluated on its quality of information. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: All websites written in the English language, and provides information on prevention or treatment of COVID-19 intended for the general public were considered eligible. Any websites intended for professionals, or specific isolated populations, such as students from one particular school, were excluded, as well as websites with only video content, marketing content, daily caseload update or news dashboard pages with no health information. RESULTS: Of the 1275 identified websites, 321 (25%) were eligible for analysis. The overall EQIP, JAMA and DISCERN scores were 17.8, 2.7 and 38.0, respectively. Websites originated from 34 countries, with the majority from the USA (55%). News Services (50%) and Government/Health Departments (27%) were the most common sources of information and their information quality varied significantly. Majority of websites discuss prevention alone despite popular search trends of COVID-19 treatment. Websites discussing both prevention and treatment (n=73, 23%) score significantly higher across all tools (p<0.001). CONCLUSION: This comprehensive assessment of online COVID-19 information using EQIP, JAMA and DISCERN Tools indicate that most websites were inadequate. This necessitates improvements in online resources to facilitate public health measures during the pandemic.

Accesibilidad web de cita previa por Internet en atención primaria / Web accessibility of Internet appointment scheduling in primary care

Objetivo: Evaluar la accesibilidad del servicio de cita previa por Internet para servicios sanitarios de atención primaria y su adecuación a los requisitos exigidos por la legislación española. Método: Estudio descriptivo de la accesibilidad de 18 sitios web correspondientes a los servicios autonómicos de salud responsables del servicio de cita previa por Internet para servicios sanitarios de atención primaria. El nivel de accesibilidad se evaluó mediante cinco herramientas automáticas. Resultados: Solo seis sitios web declaran un nivel AA conforme con las pautas de accesibilidad WCAG 2.0. El nivel de accesibilidad web, según los requisitos legales en España, es bajo. La evaluación ha identificado los principales errores a solventar. Conclusiones: La mayoría de los servicios autonómicos de salud responsables de la cita previa por Internet deben mejorar el nivel de accesibilidad web y adecuarla a los requisitos de la normativa vigente

Objective: To assess the accessibility level of Internet appointment scheduling in primary care and the fulfilment of the requirements of Spanish legislation. Method: Descriptive study of the accessibility of 18 web sites corresponding to the autonomic health services responsible for Internet appointment scheduling for primary health care services. The level of web accessibility was evaluated by means of five automated tools. Results: Only six websites self-declared to be in compliance with level AA of WCAG 2.0. The level of web accessibility according to the legal requirements in Spain is low. The evaluation tools identified the main errors to be corrected. Conclusions: Most of the autonomic health services responsible for Internet appointment scheduling in primary care need to improve their level of web accessibility and ensure that it complies with Spanish legislation

Distributed Data Networks That Support Public Health Information Needs.

INTRODUCTION: Data networks, consisting of pooled electronic health data assets from health care providers serving different patient populations, promote data sharing, population and disease monitoring, and methods to assess interventions. Better understanding of data networks, and their capacity to support public health objectives, will help foster partnerships, expand resources, and grow learning health systems. METHODS: We conducted semistructured interviews with 16 key informants across the United States, identified as network stakeholders based on their respective experience in advancing health information technology and network functionality. Key informants were asked about their experience with and infrastructure used to develop data networks, including each network's utility to identify and characterize populations, usage, and sustainability. RESULTS: Among 11 identified data networks representing hundreds of thousands of patients, key informants described aggregated health care clinical data contributing to population health measures. Key informant interview responses were thematically grouped to illustrate how networks support public health, including (1) infrastructure and information sharing; (2) population health measures; and (3) network sustainability. CONCLUSION: Collaboration between clinical data networks and public health entities presents an opportunity to leverage infrastructure investments to support public health. Data networks can provide resources to enhance population health information and infrastructure.

PopHR: a knowledge-based platform to support integration, analysis, and visualization of population health data.

Population health decision makers must consider complex relationships between multiple concepts measured with differential accuracy from heterogeneous data sources. Population health information systems are currently limited in their ability to integrate data and present a coherent portrait of population health. Consequentially, these systems can provide only basic support for decision makers. The Population Health Record (PopHR) is a semantic web application that automates the integration and extraction of massive amounts of heterogeneous data from multiple distributed sources (e.g., administrative data, clinical records, and survey responses) to support the measurement and monitoring of population health and health system performance for a defined population. The design of the PopHR draws on the theories of the determinants of health and evidence-based public health to harmonize and explicitly link information about a population with evidence about the epidemiology and control of chronic diseases. Organizing information in this manner and linking it explicitly to evidence is expected to improve decision making related to the planning, implementation, and evaluation of population health and health system interventions. In this paper, we describe the PopHR platform and discuss the architecture, design, key modules, and its implementation and use.

Respuesta de los autores. Errores correlacionados y estimación de la fiabilidad en estudios de validación: comentarios al trabajo validación de la Escala EHealth Literacy (EHEALS) en población universitaria española / No disponible

No disponible

Public Health and Epidemiology Informatics: Recent Research and Trends in the United States.

OBJECTIVES: To survey advances in public health and epidemiology informatics over the past three years. METHODS: We conducted a review of English-language research works conducted in the domain of public health informatics (PHI), and published in MEDLINE between January 2012 and December 2014, where information and communication technology (ICT) was a primary subject, or a main component of the study methodology. Selected articles were synthesized using a thematic analysis using the Essential Services of Public Health as a typology. RESULTS: Based on themes that emerged, we organized the advances into a model where applications that support the Essential Services are, in turn, supported by a socio-technical infrastructure that relies on government policies and ethical principles. That infrastructure, in turn, depends upon education and training of the public health workforce, development that creates novel or adapts existing infrastructure, and research that evaluates the success of the infrastructure. Finally, the persistence and growth of infrastructure depends on financial sustainability. CONCLUSIONS: Public health informatics is a field that is growing in breadth, depth, and complexity. Several Essential Services have benefited from informatics, notably, "Monitor Health," "Diagnose & Investigate," and "Evaluate." Yet many Essential Services still have not yet benefited from advances such as maturing electronic health record systems, interoperability amongst health information systems, analytics for population health management, use of social media among consumers, and educational certification in clinical informatics. There is much work to be done to further advance the science of PHI as well as its impact on public health practice.

Cross-sectional survey on public health informatics workforce in China: issues, developments and the future.

OBJECTIVE: To explore the current situation and issues related to the development of the public health informatics (PHI) workforce in provincial and prefectural centers for disease control and prevention (CDCs) in China, and to describe the corresponding strategies to address these issues for the future. STUDY DESIGN: National cross-sectional study. METHODS: One thousand two hundred and eighty-one respondents were selected at random from provincial and prefectural CDCs. The survey used a self-administered, structured questionnaire with an online data collection tool that integrated data quality control and user management. The questionnaire was divided into seven main categories. Score percentage of satisfaction and proportion in each part were calculated. Descriptive statistics were used to analyse the data, stratifying by country region, CDC level, job role and educational level. RESULTS: One hundred and sixty staff from provincial CDCs and 1121 staff from prefectural CDCs were selected. Only 7.4% (33/445) of prefectural CDCs were not involved in this survey, due to lack of PHI practitioners. CDC staff in the eastern region were predominantly aged 30-39 years (39.5%), which was much younger compared with the other regions (P = 0.0012). Only 34 respondents (2.7%) had academic majors in both health and information technology. More staff had Master's degrees and a higher level of education (18.7%) in the eastern region compared with the other regions (P < 0.0001). Staff in the eastern region in high-level positions and with a higher level of education were more knowledgeable about PHI strategy. Prefectural CDC staff were more satisfied with their work and training than provincial CDC staff. In the eastern region, 34.9% of staff were hired through competitive recruitment, and 57.8% of staff had received a job description with detailed information about their responsibilities, which was higher than in the other regions. Staff in the western region were more likely to leave if a better job became available (37.7%) compared with staff in the other regions (P = 0.0116). CONCLUSION: This study found regional disparities in PHI workforce development, possibly related to disparities in overall regional development. Findings showed a severe shortage of staff with a background in PHI, and occupational development paths were clearly lacking. Based on this study of current workforce issues, a comprehensive strategy for PHI workforce development in China has been described.

Better health intelligence: a new era for civil registration and vital statistics?

The impetus and opportunities for improving birth, death, and cause of death data have never been more propitious. Renewed country commitment to strengthen vital registration systems is clearly evident, supported by nascent regional coalitions of technical and development organisations. The announcement of a major new investment by Bloomberg Philanthropies to strengthen data systems and capacity in selected countries has the potential to catalyse and realise significant improvements in the availability and quality of data for health. This will require technical leadership, strategic intervention choices, strong country partnerships, and efficient delivery and management of multiple technical interventions across participating countries.

The state public health informatics in saudi arabia.

The purpose of this exploratory study is to provide an overview on the state of Public health informatics (PHI) in the Kingdom of Saudi Arabia (KSA). The study defines PHI and discusses the current status and future challenges which face the Saudi health system. Data collection methods included interviews with public health and PHI experts, and database search, using relevant keyword terms in PubMed. Results of this research show that public health information systems (PHIS) are not well-developed to deliver efficient health care in Saudi Arabia. There are several challenges that need to be addressed with the implementation of PHIS such as the need for readiness assessment, resistant to change, integration of systems, and confidentiality and privacy of health information. Future challenges include profiling users, developing a national PHIS and monitoring the impact of PHIS on healthcare outcomes need to be addressed.

Challenges in building health surveillance systems in saudi arabia.

This paper is aiming to briefly discuss the role of health surveillance system in strengthening public health at both the local and global level and the use of health informatics in effectively creating a database of health status for the population of Saudi Arabia. This review will specifically focus on the challenges that face the Kingdom of Saudi Arabia in order to effectively implement surveillance programs making use of advances in health information technology. Data collection was performed through a web-based retrieval of reports and articles and via an interview with an epidemiologist in the Saudi Ministry of Health Surveillance unit. Based on the results of this research, it was found that the use of technology has led to an improvement in communication between various stakeholders (e.g. clinicians, epidemiologists, and decision makers) by providing timely and accurate information needed for informed decision making. However, implementing an ideal model of surveillance systems in Saudi Arabia faces many challenges particularly in training healthcare providers to be qualified and competent enough to ensure the successful implementation of a disease surveillance system.

Infectious disease surveillance in the 21st century: an integrated web-based surveillance and case management system.

The Massachusetts Virtual Epidemiologic Network (MAVEN) was deployed in 2006 by the Massachusetts Department of Public Health, Bureau of Infectious Disease to serve as an integrated, Web-based disease surveillance and case management system. MAVEN replaced program-specific, siloed databases, which were inaccessible to local public health and unable to integrate electronic reporting. Disease events are automatically created without human intervention when a case or laboratory report is received and triaged in real time to state and local public health personnel. Events move through workflows for initial notification, case investigation, and case management. Initial development was completed within 12 months and recent state regulations mandate the use of MAVEN by all 351 jurisdictions. More than 300 local boards of health are using MAVEN, there are approximately one million events, and 70 laboratories report electronically. MAVEN has demonstrated responsiveness and flexibility to emerging diseases while also streamlining routine surveillance processes and improving timeliness of notifications and data completeness, although the long-term resource requirements are significant.

El visado de inspección de medicamentos en España: situación actual desde la perspectiva de los profesionales sanitarios a partir de la introducción de su modalidad electrónica / Validation Inspection of prescription drugs in Spain: Current situation from a health professional perspective after its introduction in electronic form

Objetivo: Conocer la situación actual del visado de inspección de medicamentos (VIM) en España, desde la perspectiva de los profesionales sanitarios a partir de la introducción de su modalidad electrónica. Diseño: Observacional, transversal, en 2 fases, combinando técnicas cualitativas y cuantitativas. Emplazamiento: Sistema sanitario público: atención primaria (AP), especializada (AE) y administración. Participantes: Microgestores, médicos de AP, endocrinólogos; mesogestores, inspectores médicos, farmacéuticos de AP; macrogestores; responsables de direcciones de farmacia de las consejerías de salud de comunidades autónomas (CCAA). Método: Entrevistas telefónicas semiestructuradas; saturación de información (fase 1) y Computer Assisted Telephone Interviewing (CATI) (fase 2). Análisis de contenido, comparación con la literatura médica y normativa. Resultados: El VIM presenta 3 modalidades: manual, electrónica y electrónica vinculada a prescripción electrónica. Los participantes del mismo nivel de gestión perciben de manera similar el fin último del VIM. Existen diferencias en la situación del visado electrónico (VE) entre CCAA. Está más implementado en AP que en AE (63 frente a 37%), con grado similar en ámbitos urbano y rural. Seis de las 17 CCAA presentaron un acceso sencillo y público a la legislación correspondiente. Conclusiones: El VIM se percibe como una herramienta para el control del gasto en medicamentos y como una carga administrativa adicional en AP. El ritmo de implementación del VE difiere entre CCAA así como el acceso a la normativa pertinente(AU)

Aims: To assess the current situation of the inspection validation of prescriptions (IVP) in Spain since the introduction of the electronic procedure (EP) from the healthcare professionals’ perspective. Design: Observational, cross sectional study, in two phases; combining qualitative and quantitative techniques. Setting: Primary Care (PC), Secondary Care (SC) and the health care management sector. Participants: Primary care physicians (PCPs), endocrinologists, medical inspectors, pharmacists and health Authorities of Autonomous Communities (AACC). Method: Semi-structured surveys and Computer Assisted Telephone Interviewing. Results: The IVP presents three modalities in Spain: manual, electronics and electronics linked to electronic prescription. The participants of the same level of management perceive in a similar way the purpose of the IVP, and there exist differences between the different levels of interviewed managers. Differences exist in the situation of EP between AACC. It is more implemented in primary care (PC) than in specialized (63% vs 37%), with similar degree in urban and rural areas. Six of 17 AACC presented a public access to the corresponding legislation. Conclusion: The IVP is perceived as a tool for the economic control in expenditure on drugs and as additional administrative load in PC. The rhythm of implementation of EP differs between AACC as well as the access to the regulation(AU)

PulseNet China, a model for future laboratory-based bacterial infectious disease surveillance in China.

Surveillance is critical for the prevention and control of infectious disease. China's real-time web-based infectious disease reporting system is a distinguished achievement. However, many aspects of the current China Infectious Disease Surveillance System do not yet meet the demand for timely outbreak detection and identification of emerging infectious disease. PulseNet, the national molecular typing network for foodborne disease surveillance was first established by the Centers for Disease Control and Prevention of the United States in 1995 and has proven valuable in the early detection of outbreaks and tracing the pathogen source. Since 2001, the China CDC laboratory for bacterial pathogen analysis has been a member of the PulseNet International family; and has been adapting the idea and methodology of PulseNet to develop a model for a future national laboratory-based surveillance system for all bacterial infectious disease.We summarized the development progress for the PulseNet China system and discussed it as a model for the future of China's national laboratory-based surveillance system.