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Item Applied Public Health Informatics: An eHealth Discipline Focused on Populations(2020-12) Dixon, Brian E.; Epidemiology, School of Public HealthThe discipline of public health informatics, part of the broader eHealth field, brings methods, knowledge, and theories from computer science and information science to support population health and well-being. This branch of informatics is most often found in governmental public health agencies that focus on population-level activities, including surveillance of disease as well as disease prevention. There are several specialised public health information systems used to prevent or mitigate disease, including syndromic surveillance, electronic laboratory reporting, and population health dashboards. This article defines and describes public health informatics and its role in eHealth. The article further discusses the role of public health information systems and challenges they face for the future. Strengthening public health will require greater investment in interoperability as well as analytics and the workforce. Disease outbreaks like COVID-19, Ebola, and H1N1 demonstrate the need for robust public health informatics applications and methods. Yet there is much work to be done to evolve existing tools and methods to strengthen the public health infrastructure for the next pandemic.Item An Integrated Surveillance System to Examine Testing, Services, and Outcomes for Sexually Transmitted Diseases(IOS, 2017) Dixon, Brian E.; Tao, Guoyu; Wang, Jane; Tu, Wanzhu; Hoover, Sarah; Zhang, Zuoyi; Batteiger, Teresa A.; Arno, Janet N.; Epidemiology, School of Public HealthDespite laws that require reporting of sexually transmitted diseases (STDs) to governmental health agencies, integrated surveillance of STDs remains challenging. Data and information about testing are fragmented from information on treatment and outcomes. To overcome this fragmentation, data from multiple electronic systems spanning clinical and public health environments were integrated to create an STD surveillance registry. Electronic health records, disease case records, and birth registry records were linked and then stored in a de-identified, secure server for use by health officials and researchers. The registry contains nearly 6 million tests for 628,138 individuals over a 12-year period. The registry supports efforts to understand the epidemiology of STDs as well as health services and outcomes for those diagnosed with STDs. Specialized disease registries hold promise for collaboration across clinical and public health domains to improve surveillance efforts, reduce health disparities, and increase prevention efforts at the local level.Item Toward Timely Data for Cancer Research: Assessment and Reengineering of the Cancer Reporting Process(JMIR Publications, 2018-03-01) Jabour, Abdulrahman M.; Dixon, Brian E.; Jones, Josette F.; Haggstrom, David A.; BioHealth Informatics, School of Informatics and ComputingBackground Cancer registries systematically collect cancer-related data to support cancer surveillance activities. However, cancer data are often unavailable for months to years after diagnosis, limiting its utility. Objective The objective of this study was to identify the barriers to rapid cancer reporting and identify ways to shorten the turnaround time. Methods Certified cancer registrars reporting to the Indiana State Department of Health cancer registry participated in a semistructured interview. Registrars were asked to describe the reporting process, estimate the duration of each step, and identify any barriers that may impact the reporting speed. Qualitative data analysis was performed with the intent of generating recommendations for workflow redesign. The existing and redesigned workflows were simulated for comparison. Results Barriers to rapid reporting included access to medical records from multiple facilities and the waiting period from diagnosis to treatment. The redesigned workflow focused on facilitating data sharing between registrars and applying a more efficient queuing technique while registrars await the delivery of treatment. The simulation results demonstrated that our recommendations to reduce the waiting period and share information could potentially improve the average reporting speed by 87 days. Conclusions Knowing the time elapsing at each step within the reporting process helps in prioritizing the needs and estimating the impact of future interventions. Where some previous studies focused on automating some of the cancer reporting activities, we anticipate much shorter reporting by leveraging health information technologies to target this waiting period.