The Past, Present and Future of Informatics: Q&A with Public Health Informatics Experts

Photo credit: Public Health Informatics Institute

By Lisa Jones, PHII Communications Manager  and Piper Hale, PHII Assistant Director of Communications

On October 6, the Public Health Informatics Institute (PHII) hosted a special panel of experts in honor of PHII’s 30th-anniversary celebration. Below is a sampling of their discussion about the past, present and future of PHII, as well as their insights on the field of public health informatics: the science of how to use data, information and knowledge to improve human health and the delivery of healthcare services.

Panelists included former Task Force for Global Health President and CEO Dave Ross, PHII Director Vivian Singletary, and Bryant Karras, Chief Medical Informatics Officer of Washington State Department of Health. Piper Hale, PHII’s Assistant Director of Communications, moderated the conversation. 

What comes to mind when you think back on 30 years of PHII?

SINGLETARY: One of the most notable things for public health is it has focused on the importance of coming together, collaborating and working together on those most daunting issues related to public health informatics. Thirty years later, information is still at the heart of controlling disease spread, whether it’s COVID-19, monkeypox or the next emerging disease. 

What PHII initiatives are you the proudest of?

SINGLETARY: I came into PHII in 2011 and the Collaborative Requirements Development Methodology [CRDM] was one of the things I’m most proud of because I think that was groundbreaking for public health informatics at the time that it was developed. 

The other thing that we’re proud of is the 8 Steps to Success course. It was developed when we first launched our Informatics Academy at PHII, and it’s one of the courses that has had staying power and is still relevant to the field. We are revising this course and preparing to give it as part of the TRIUMPH [TRaining in Informatics for Underrepresented Minorities in Public Health] Consortium that works off the Office of the National Coordinator for Health Information Technology (ONC) Workforce Grants. We’re looking forward to sharing this revised course with a new and existing public health workforce.

When I first came to PHII, we were mainly focused on having a domestic portfolio. And since that time, we have expanded our footprint to be a real international player as it relates to public health informatics. One of the projects that we’ve been working on for eight years that Dave helped bring to PHII is the Child Health and Mortality Prevention Surveillance [CHAMPS] network. This project has been funded by the Bill and Melinda Gates Foundation, and PHII has been responsible for developing all of the IT infrastructure, maintaining it and enhancing it for this program. We’re proud of the work that we’re doing there helping to collect information that can be used by communities to make interventions so that they can reduce child mortality [in sub-Saharan Africa and South Asia]. 

ROSS: This idea of bringing people together, defining the problem together is powerful. We adopted from the get-go the idea that informatics is an enabling discipline; it is not the end in itself.

What has changed in public health informatics and the field of public health since the 90s?

KARRAS: I think one of the most influential changes that PHII brought into existence was the Common Ground project where folks from state and local jurisdictions from across the country pulled together to demystify the challenge of the idea – ”if you’ve seen one health department, you’ve seen one health department”– and instead work together to define our business processes consistently. We really can go far when we work together. It takes that discipline of reaching out to your neighboring jurisdictions, reaching across the aisle to other states and coming together to figure out what standards and implementations can we do and share so that we’re all raising up the ships with the tide.

SINGLETARY: As we are in the midst of this Data Modernization Initiative work, it’s going to be important setting that vision – that greater vision – for what we want public health informatics infrastructure to be able to provide. What questions do we want to be able to answer and how rapidly do we need to be able to answer these questions? The COVID pandemic has shown us that we definitely had some fractures in our infrastructure and now we’re going after that. 

What is that greater vision that we need the public health departments working together on? And what are those policies – not just in my state but across the nation that we need to enact to make sure that we can share our data in a timely fashion to make a meaningful impact to slow down diseases? We’re seeing these diseases emerge faster and faster now and we’re going to have to develop our infrastructure to do that. And that means developing trust among us within the public health community, as well as in the clinical settings.

What would you say the future of informatics holds?

ROSS: If you want to be a public health informaticist, you need to see yourself as an effective diplomat. Public health is a discipline where science meets policy, and you can’t necessarily make policy the way you want it. But we can at least try to create informed policy. As I look at the future, there’s no doubt everything is in the cloud. The time has long passed when every state should be cooking up its own answer to everything. As I’ve said for years, you’re special, but you’re not different. Let’s acknowledge the commonalities and move to solutions that will be more powerful and cost-effective. 

SINGLETARY: Right now, we’re focused on collecting data from the electronic health record. There’s lots of data that are personally collected that will need to come into the space of public health so that we can understand health better. Because health is – as we always talk about – not just what’s going on with your doctor. Health is every day, so we need to start thinking about “what are those data we need to leverage?”

In terms of the Public Health Informatics Institute, I think our future is bright. I think we have to continue to be this innovative and nimble organization so that we can be responsive to the needs of public health informatics and the population at large.

KARRAS: We’re not all about data anymore. We’re about information and about delivering that information and that decision-making not only to the professionals anymore. The pivot, the future, is delivering that information to the person out in the field and that’s totally possible. 

What infrastructure and data challenges will public health need to tackle in the future?

KARRAS: COVID has obviously been an impetus for another surge of invention. But I think it’s also been this impetus for another surge of collaboration. The public/private academic partnerships and collaborations and the multi-state collaborations have been just extraordinary. I think that’s what’s going to keep carrying us forward. 

SINGLETARY: If we want to think about sustainability, we want to think about our dollars going far. We have to rethink our approach to how we develop these systems and how we maintain them in a much more collective manner so that we can make our dollars stretch. 

What are the challenges in the public health workforce development for informatics?

SINGLETARY: We need to really have an impact in terms of how we build this pipeline for public health informatics. We have to take an approach like we see the tech companies taking. We have to begin early in their career with people coming out of high school or maybe a two-year college, and we build them and we train them and give them an opportunity to build a full career in public health. We’re going to have to take a different approach to how we recruit, retain and pay public health informaticians. We absolutely need them to help drive us forward.

KARRAS: It’s not just the curriculum of the MPH programs that we need to be reaching out to. We need to be reaching out to data scientists and computer scientists. We need to be finding those folks who see it as an opportunity for service. We’re not going to be able to pay as much as the private sector, but you can have a meaningful career and really make a difference. We need them to create the modern force that we need for data modernization.

Watch the full webinar celebrating PHII’s 30-anniversary here.

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