Jacqueline Merrill, RN, MPH, DNScDepartment of Biomedical Informatics

Columbia University

AcademyHealth June 2, 2007

Identifying a minimum data set of public health

tasks, knowledge and resources for

network analysis

Overview

• Describe method and results

• Thoughts on implications/potential value of a minimum data set

Background

Organizational network analysis

Feasibility study 2005 showed need for

• accurate capture of public health work• improved network method to serve public

health

• standard instrument for network data collection for baseline, interagency comparison

Method

Multi-step qualitative method to develop minimum data set

• Term extraction• Iterative review • Expert opinion• Practitioner review• Survey development• Field test of survey

SourcesAssociation of Public Health Laboratories

Requirements for Public Health Laboratory Information Management Systems Business Process Descriptions

Association of Schools of Public HealthMPH Core Competencies

Council on Linkages between Academia and Public Health PracticeCore Competencies for Public Health Professionals

NACCHO 2005 Profile of Local Health DepartmentOperational Definition of a Functional Local Public Health Agency

Public Health Informatics InstituteTaking Care of Business: A collaboration to define local public health business practices (Elements of nine business processes, using standard business process analysis tools, such as context and task flow diagramming)

Sources (cont)National Public Health Performance Standards Program

Local Public Health System Performance Assessment Instrument

North Carolina Local Health Department Accreditation Program 2007 Health Department Self-Assessment Instrument

Public Health Workforce Recruitment, Retention and Promotion in the Civil Service SystemPublic health position descriptions

Healthy People 2010Chapter 23 Public Health Infrastructure Objectives

Public Health Functions CommitteeEssential Services of Public Health

Term Extraction

• Over 500 task knowledge resource terms extracted through iterative review

• Crosswalk w/ Essential Services and most common activities (from NACCHO survey plus management and finance)

• De-duplicated and consolidated

• Result: 58T, 75K, 68R

Essential Services Monitor health status Protect people Give information Engage community to solve health problems

Develop policy and plans

Enforce laws and regs Help people receive services

ActivitiesImmunization

annual childhood immunization data

annual childhood immunization data

area health education centers

annual childhood immunization data

department policies ACIP vaccine management protocols

consumer satisfaction assessmentcommunicable

disease dataemergency operations plan

crisis communication plan

communicable disease data

quality assurance / quality improvement policies and procedures

BOH bylaws equipment

community health assessment

professional licensing requirements

education material for the public

community health care providers

Federal and state legislation, rules or regulations

time and activity schedules

electronic computer files

low literacy brochures forms emergency response coordinator

federal regulations for clinical and environmental laboratory testing

utilization statistics

GIS information Health alert network

Health alert network Healthy People 2010

health risk data low literacy brochures health care providers medical records policies

maternal and child health data

media communication plan

public health law

vital records of births and deaths

translated educational materials

US government auditing standards

Health Insurance Portability and Accountability Act

Comm Dx Surveillance

academic institutions case investigation protocols

area health education centers

communicable disease data

communicable disease data

Board of county commisioners

data on utilization of agency services

census data communicable disease data

communicable disease data

community health advocate

data sharing agreements

BOH bylaws

communicable disease data

complaint/ referral log

crisis communication plan

community health care network, alliance or partnership

department policies Federal and state legislation, rules or regulations

community health assessment

disease investigation reports

education material for the public

community health improvement plan

guidelines for handling samples

federal regulations for clinical and environmental death, illness or

injury dataemergency operations plan

FAX community organizations

health improvement plan

guidelines for handling samples

diagnostic labs local emergency planning committee

graphics presentation software

community stakeholders

local emergency planning committee

Health Insurance Portability and Accountability Act

electronic birth and death certificates

local emergency planning committee

Health alert network

directory of local organizations

local rules or ordinances

Healthy People 2010

electronic computer files

low literacy brochures internet and email access

emergency response coordinator

policies and procedures for handling clinical and environmental laboratory samples

local rules or ordinances

epi team referral information linguistically and culturally appropriate health information

Health alert network quality assurance / quality improvement policies and procedures

public health law

Expert Opinion

• Conference call

• Each term reviewed for suitability

• Terms added and removed

• Terms grouped (ie admin tasks, service tasks)

• Result: 45T, 56K, 59R

Practitioner Review

• Focus Group w/ 12 practitioners LHD

• Formatted as mock survey

• Result

44 Task terms

53 Knowledge terms

57 Resource terms

Outcome

• Minimum data set • Based on established practice

documentation• For use across health departments that

vary in composition yet conduct common activities

• Current pilot test in NYS LHD’s• Future use in national sample for

comparative study

Survey Instrument

Implications

Standard results

• support local management decisions

• build baselines for network performance

• allow comparisons between LHDs that can inform system-wide infrastructure development

• Other uses?