Department of Family Medicine Works

Permanent URI for this collection

https://hdl.handle.net/1805/4427

Browse

Browsing Department of Family Medicine Works by Issue Date

Filter results by year or month
Now showing 1 - 10 of 103
  • Thumbnail Image
    Item
    Development and Assessment of a Public Health Alert Delivered through a Community Health Information Exchange
    (2010-10) Gamache, Roland; Stevens, Kevin C; Merriwether, Rico; Dixon, Brian E.; Grannis, Shaun
    Timely communication of information to health care providers during a public health event can improve overall response to such events. However, current methods for sending information to providers are inefficient and costly. Local health departments have traditionally used labor-intensive, mail-based processes to send public health alerts to the provider community. This article describes a novel approach for delivering public health alerts to providers by leveraging an electronic clinical messaging system within the context of a health information exchange. Alerts included notifications related to the 2009 H1N1 flu epidemic, a syphilis outbreak, and local rabies exposure. We describe the process for sending electronic public health alerts and the estimated impact on efficiency and cost effectiveness.
  • Thumbnail Image
    Item
    Electronic Laboratory Data Quality and the Value of a Health Information Exchange to Support Public Health Reporting Processes
    (2011-10) Dixon, Brian E.; McGowan, Julie J; Grannis, Shaun J
    There is increasing interest in leveraging electronic health data across disparate sources for a variety of uses. A fallacy often held by data consumers is that clinical data quality is homogeneous across sources. We examined one attribute of data quality, completeness, in the context of electronic laboratory reporting of notifiable disease information. We evaluated 7.5 million laboratory reports from clinical information systems for their completeness with respect to data needed for public health reporting processes. We also examined the impact of health information exchange (HIE) enhancement methods that attempt to improve completeness. The laboratory data were heterogeneous in their completeness. Fields identifying the patient and test results were usually complete. Fields containing patient demographics, patient contact information, and provider contact information were suboptimal. Data processed by the HIE were often more complete, suggesting that HIEs can support improvements to existing public health reporting processes.
  • Thumbnail Image
    Item
    Why “What Data Are Necessary for This Project?” and Other Basic Questions are Important to Address in Public Health Informatics Practice and Research
    (2011-12) Dixon, Brian E.; Grannis, Shaun J
    Despite the likelihood of poor quality data flowing from clinical information systems to public health information systems, current policies and practices are pushing for the adoption and use of even greater numbers of electronic data feeds. However, using poor data can lead to poor decision-making outcomes in public health. Therefore public health informatics professionals need to assess, and periodically re-evaluate, the quality of electronic data and their sources. Unfortunately there is currently a paucity of tools and strategies in use across public health agencies. Our Center of Excellence in Public Health Informatics is working to develop and disseminate tools and strategies for supporting on-going assessment of data quality and solutions for overcoming data quality challenges. In this article, we outline the need for better data quality assessment and our approach to the development of new tools and strategies. In other words, public health informatics professionals need to ask questions about the electronic data received by public health agencies, and we hope to create tools and strategies to help informaticians ask questions that will lead to improved population health outcomes.
  • Thumbnail Image
    Item
    Towards Estimation of Electronic Laboratory Reporting Volumes in a Meaningful Use World
    (2012) Dixon, Brian E.; Gamache, Roland E; Grannis, Shaun J
  • Thumbnail Image
    Item
    State and Local Health Agency Engagement in HIE: A Cross-Sectional Survey
    (2012) Dixon, Brian E.; Gamache, Roland E; Grannis, Shaun J
  • Thumbnail Image
    Item
    Impact of Selective Mapping Strategies on Automated Laboratory Result Notification to Public Health Authorities
    (2012-11) Gamache, Roland E; Dixon, Brian E.; Grannis, Shaun; Vreeman, Daniel J
    Automated electronic laboratory reporting (ELR) for public health has many potential advantages, but requires mapping local laboratory test codes to a standard vocabulary such as LOINC. Mapping only the most frequently reported tests provides one way to prioritize the effort and mitigate the resource burden. We evaluated the implications of selective mapping on ELR for public health by comparing reportable conditions from an operational ELR system with the codes in the LOINC Top 2000. Laboratory result codes in the LOINC Top 2000 accounted for 65.3% of the reportable condition volume. However, by also including the 129 most frequent LOINC codes that identified reportable conditions in our system but were not present in the LOINC Top 2000, this set would cover 98% of the reportable condition volume. Our study highlights the ways that our approach to implementing vocabulary standards impacts secondary data uses such as public health reporting.
  • Thumbnail Image
    Item
    Effect of Electronic Health Record Systems Access on Communicable Disease Report Completeness
    (2013) Kirbiyik, Uzay; Dixon, Brian E.; Grannis, Shaun J
  • Thumbnail Image
    Item
    A Vision for the Systematic Monitoring and Improvement of the Quality of Electronic Health Data
    (2013) Dixon, Brian E.; Rosenman, Marc; Xia, Yuni; Grannis, Shaun J
    In parallel with the implementation of information and communications systems, health care organizations are beginning to amass large-scale repositories of clinical and administrative data. Many nations seek to leverage so-called Big Data repositories to support improvements in health outcomes, drug safety, health surveillance, and care delivery processes. An unsupported assumption is that electronic health care data are of sufficient quality to enable the varied use cases envisioned by health ministries. The reality is that many electronic health data sources are of suboptimal quality and unfit for particular uses. To more systematically define, characterize and improve electronic health data quality, we propose a novel framework for health data stewardship. The framework is adapted from prior data quality research outside of health, but it has been reshaped to apply a systems approach to data quality with an emphasis on health outcomes. The proposed framework is a beginning, not an end. We invite the biomedical informatics community to use and adapt the framework to improve health data quality and outcomes for populations in nations around the world.
  • Thumbnail Image
    Item
    Using Information Entropy to Monitor Chief Complaint Characteristics and Quality
    (2013) Grannis, Shaun J; Dixon, Brian E.; Xia, Yuni; Wu, Jianmin
    As we enter the 'big medical data' era, a new core competency is to continuously monitor quality of data collected from electronic sources, including population surveillance data sources. We describe how entropy, a fundamental information measure, can help monitor the characteristics of chief complaints in an operational surveillance system.
  • Thumbnail Image
    Item
    Evaluating the Variation on Public Health’s Perceived Field Need of Communicable Disease Reports
    (2013-04) Kirbiyik, Uzay; Gamache, Roland; Dixon, Brian E.; Grannis, Shaun