The Rising Need for Digital Public Health Surveillance
As the Digital Revolution continues to unfold, public health faces fresh challenges related to data and technology. Historically, public health has relied on paper records — think manila file folders sitting on a shelf in a doctor’s office — generated by healthcare and transmitted through manual means to conduct its crucial disease surveillance efforts. But as the clinical world has digitized and transformed the way it does record-keeping, these manila folders have vanished and given way to automated processes, and unfortunately, public health has not quite kept pace. This technological lag impedes the ability of public health to do its work. In order to receive the timely information needed to anticipate and stop disease outbreaks, public health must permanently let go of our lingering attachments to those paper forms and physicians’ scrawls of yesteryear and evolve to connect with these new clinical systems.
At the Public Health Informatics Institute (PHII), we believe that informatics is a key part of this needed evolution. PHII is a program of the Emory University-affiliated nonprofit The Task Force for Global Health and, as part of The Task Force’s health systems strengthening sector, operates under the mission of transforming health practitioners’ ability to use information effectively. A major component of our work is helping public health practitioners understand what informatics is and how it can improve their ability to do their work. At its base, informatics is the information science that guides the design of the complex data systems that keep information secure, usable and responsive to the user’s needs. We often say at PHII that informaticians act as knowledge architects — the information systems they build account for function, user needs and even local context.
As public health falls further behind the technology of clinical healthcare, PHII is tackling this widening gap with projects intended to increase the timeliness and automation of public health surveillance to help it remain more real-time and responsive to rising threats. On the domestic front, PHII is partnering with organizations across public health, healthcare and health IT on the ambitious Digital Bridge initiative — a promise to advance two-way data exchange between healthcare and public health. Under Digital Bridge, key stakeholders designed a multi-jurisdictional approach to electronic case reporting (eCR), the automated transmission of case reports from electronic health records to public health for review and action. eCR replaces the old fax- and mail-based reporting methods and uses existing technology to flag potential reportable disease cases (conditions that are required to be reported when diagnosed) and digitally send them to the appropriate public health agency, improving disease interventions and preventing slow response times that can lead to dangerous outbreaks.
PHII is also working on several global projects. Most notably on the digital surveillance front, we’re a key partner in the Child Health and Mortality Prevention Surveillance network (CHAMPS). In response to high child mortality rates around the world, coupled with the fact that the causes for these deaths are largely unknown, the Gates Foundation funded this network to identify key regions of Sub-Saharan Africa and South Asia with high mortality rates and set up seven catchment sites across these regions to capture causes of death in children. CHAMPS collects, processes and shares these data with partners to inform interventions that may strive to eliminate, reduce or control the causes of these deaths.
As public health continues to push itself forward and embrace technological innovation to close the information gap with clinical healthcare, PHII will continue to be an advocate for innovation. We believe that improving automation and digital public health will allow rapid outbreak response and stem potential epidemics. These next few years will be a formative time in the field of public health, and only time will tell if we emerge successful — and fully evolved — from this decisive phase in public health history.
Vivian Singletary, MBA, serves as director of the Public Health Informatics Institute (PHII), a program of The Task Force for Global Health. In this role, Singletary guides PHII’s work to improve health outcomes worldwide by strengthening health practitioners’ abilities to use information effectively.
Editor’s Note: This article first appeared in The Atlanta Business Chronicle.