As public health departments around the state scramble to react to the Zika virus outbreak, they’re faced with a stark reality: their systems confront health IT obstacles that stop the effective use and sharing of information to combat epidemics.
Seamless data sharing between public health authorities and physicians on the front lines is crucial to enable actionable insights essential for victory, claims Kenyon Crowley, deputy director of the Center for Health Information and Decision Systems (CHIDS) at the institute of University of Maryland’s Robert H. Smith School of Business.
Although, public health departments nationwide basically are challenged by health IT obstacles that involve the complication and usability of the software, the inability of software to motivate the few distinctive public health reporting requirements, as well as the deficiency of standards for effective information exchange.
“One of the big issues right now in being capable to combat Zika is getting information from the community and being capable to share that information rapidly with partners in case to evaluate where to contribute resources and support,” Crowley states. “Public health departments that have not done a great job of executing electronic health records (EHRs) and surveillance networks in ways to exchange information across the different stakeholders are going to have a much tougher time combating Zika in contrast to those that can rapidly recognize hotspots of trouble through information from the field and provide triage.”
To assist these departments to overcome these health IT obstacles, Crowley and a team of researchers at the institute of University of Maryland, have established a new tool—called the Public Health Information Technology (PHIT) Maturity Index—to better approach their IT abilities and to counter shortcomings.
By leveraging the proposed PHIT Maturity Index, public health authorities can measure their departments’ growth in utilizing IT to support their respective missions. PHIT systems involve electronic health records (EHRs), public health reporting data networks like surveillance systems, and ancillary systems like health information exchanges (HIE).
“A public health department has a huge range of duties in the communities they serve,” states Crowley. “There are ten important services of public health. Each of these tasks has a number of data and information requirements associated with it and IT to be utilized to support the more effective and efficient achievements of those services.”
The PHIT Maturity Index involves 4 measurement categories—scale and scope of use, PHIT quality, policy and resources, PHIT human capital, and PHIT community infrastructure—along with fourteen sub-dimensions linked with 55 queries, utilized to establish a score based on which public health departments can prove benchmark themselves. The index is created to assist departments “gauge their roles in relation to a set of stages that progressively and incrementally detail better utilization of IT” to effectively and efficiently acquire their public health missions.
“These departments can utilize the PHIT Maturity Index to recognize where their gaps are and plan suitably,” adds Crowley.
With investment from the Robert Wood Johnson Foundation, UMD researchers took a 2-year study of the adoption and execution of a NextGen electronic health record (EHR) system by the Montgomery County Department of Health and Human Services in the state of Maryland and a regional primary care coalition, which works with hospitals and clinics to offer safety net services utilizing a separate eClinicalWorks EHR. Based on their research, recently issued in Frontiers in Public Health Services and Systems Research, they established the PHIT Maturity Index.
“We evaluated the systems being utilized within Montgomery County to accomplish their different targets, and worked closely with the department to comprehend how they were or were not serving the information requirements of those services,” states Crowley. “There has not been a lot of research done on the utilization of EHRs in public health departments.”
One of the health IT obstacles confronted by public health departments is that they utilize commercial-off-the-shelf EHR systems made for huge, multi-specialty practices for typical clinical care.
“The nuances and distinctive requirements and customizations that these departments require aren’t always conveniently present to them,” in accordance to Crowley, who nevertheless notes that syndromic surveillance is a primary requirement of the Meaningful Use program.
“We expect that public health departments nationwide will utilize the index,” he states. “The worth of the index increases with the size of the networks utilizing it. As more departments use it, they have a better capability to benchmark their growth.”
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