Lecture 2: Data Collection and Informatics Flashcards
Intended use of surveillance systems
- Monitor many determinants of health
- Oldest systems monitor infectious diseases
- increasingly monitoring overall indicators of population health
Systems for monitoring and detecting disease outbreaks
- Traditional reporting (lab reports and disease reporting)
- Professional and personal connections
- Syndromic Surveillance
Four basic tenets of a surveillance system
- incorporating common data elements
- maximizing appropriate timeliness of data collection
- ensure accessibility to appropriate partners
- establishing flexibility for future enhancements
Cooperation is an important aspect of PH surveillance. Who s responsible for providing the reports?
HCPs and Labs
Cooperation is an important aspect of PH surveillance. Who s responsible for processing the reports?
DOH staff
Cooperation is an important aspect of PH surveillance. Who s responsible for using the information for action?
Public health program managers and HCPs
Main areas of surveillance data usage
- Detection (anomalies, outbreaks)
- Periodic data dissemination (to evaluate program efforts)
- Archival information storage (to document evolving health status of population)
- Application of PH protection
Classification of cases by degree of suspicion
- Confirmed
- Probable
- Suspect
- Possible
- Non-case
- Insufficient information
Other Units of surveillance besides case of disease
- test results
- exposure to environmental factor
- practice of certain behavior
- clinical signs and symptoms
- presence of genetic marker
Sentinel surveillance
a specific set of healthcare providers or labs, for example, agree to conduct surveillance for a specific condition for a specific timeframe
Duration of data collection
usually indefinite (ex. influenza data is collected frequently during flu season, but no so much afterward)
Examples of Active surveillance
- review of emergency department logs
- routine queries of labs or review of lab records
Examples of Passive surveillance
- lab reporting
- provider reporting
- ex of when this is used (clinical case reporting of TB by clinicians because no positive lab result is found)
- Passive surveillance ends up being more cost-effective than Active
- Limitations (relies too much on providers, incomplete reporting, not easily enforceable)
Sources of data (Administrative data)
Data generated in the process of administering an activity or providing a service (ex. hospital admission logs , hospital discharge data, pharmacy sales data, or health care claims data)
-More concrete examples are: Medicare, Medicaid, national health care surveys
What is SPARCS?
Statewide planning and Research Cooperative System (a form of hospital discharge data, has info on diagnosis, procedure, age, insurance status, address, race)
-used at DOH to: track priority conditions and program planning, address disparities and neighborhood health profiles, but NOT for monitoring quality of inpatient care.
Sources of data (non-electronic)
- Surveys (assesses prevalence of health conditions and risk, monitors changes over time, assess knowledge, attitudes and practices)
- Person (interview/survey of affected individual)
- Provider (astute clinician calls)
Sources of data (electronic)
-electronic lab info systems
-e health records
-admin data systems
-additional health info systems
-non-traditional electronic data sources
-vital records
disease registries
Issues with e data storage and sharing
- how will data be collected
- where will data be stored (servers)
- how will data be shared with other entities?
Procedures for data access
- data collection occurs at the local level
- data sharing protocols need to be in place
Data quality
- systemic analysis needs to be in place to identify errors caused by data entry
- unique identifiers
- standardized vocabularies
What does HIPPA do?
Protects the privacy of identifiable health information (PH agencies like DOH are exempt, but providers and labs have to report)
What information is confidential?
- Any health or medical information that can identify or be linked to a specific individual
- Privileged information (ex: a specific school where DOH may be conducting investigation)
Sharing Confidential Info
- Info should NOT be shared without patient consent
- Exceptions are: protection of ph, mandated TB control activities, patient access to medical record, sharing with other facilities, criminal activity
- Data transmission (use encrypted emails or secure FTP sites)
What is PH Informatics?
- Focuses on the systematic use of info theories and communication technologies to enhance performance of public health practice
- informatics does not equal information technology (IT)
How can we use informatics to achieve goals of surveillance system?
- Maintain the integrity of original surveillance data
- improve the quality of the surveillance database
- increase availability of surveillance info to yield most valid, useful and timely info to improve ph practice
Terminology: Business process
collection of related activities or tasks that produce a specific service or product for a customer
Terminology: scope document
output expected to be produced by informatics experts
Terminology: functional requirements
what is the system supposed to accomplish
Terminology: Data dictionary
definitions of key variables (looks like codebook)
Maven
Web-based surveillance and management software manufactured by consilience that NY DOH used to look at TB control, STD prevention and control, communicable disease and immunization
CORE Team for Maven (all have different perspectives)
- Health department IT staff (balance interest of program and managing vendor)
- TB control experts (want the system to do exactly what DOH wants efficiently, completely and in a user-friendly manner)
- Consilience (vendor)–> these guys are a business and want to make client happy while minimizing resources and maximizing profit
Steps in setting up a surveillance system
- Business analysis (describe current procedures)
- Functional requirements (ascertain what is needed in new registry system)
- Gap analysis (determine how maven does and does not meet functional requirements)
