Difference between revisions of "Journal:Developing workforce capacity in public health informatics: Core competencies and curriculum design"

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The core public health functions are assurance, assessment, and advocacy, which are used to maximize population health.<ref name="CDCPublic17">{{cite web |url=https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html |title=The Public Health System & the 10 Essential Public Health Services |work=National Public Health Performance Standards |author=Centers for Disease Control and Prevention |date=2014 |accessdate=08 May 2017}}</ref> The PHI program design focuses on understanding how information systems achieve these functions rather than having a sub-goal focus on technological, computer science, or data mining aspects of PHI. Because PHI focuses on designing PHInfSys it has a foundation in design thinking.<ref name="SimonTheSci81" /><ref name="DymEng13" /><ref name="Johansson‐SköldbergDesign13" /> Design thinking focuses on identifying problems as gaps in population health that information systems can help reduce by determining the root causes of those gaps and designing and implementing information systems to reduce population health gaps. Systems analysts are the architects who bridge the gap between users and technologies by understanding and translating user needs to system specifications and collaborating with technologists to implement those systems. The goal of systems analysis is to minimize the frequent disconnects between information system development and the usefulness of the resulting information systems<ref name="HarrisonUnintended07">{{cite journal |title=Unintended Consequences of Information Technologies in Health Care—An Interactive Sociotechnical Analysis |journal=JAMIA |author=Harrison, M.I.; Koppel, R.; Bar-Lev, S. |volume=14 |issue=5 |pages=542–49 |year=2007 |doi=10.1197/jamia.M2384}}</ref><ref name="PentlandDesign08">{{cite journal |title=Designing routines: On the folly of designing artifacts, while hoping for patterns of action |journal=Information and Organization |author=Pentland, B.T.; Feldman, M.S. |volume=18 |issue=4 |pages=235–250 |year=2008 |doi=10.1016/j.infoandorg.2008.08.001}}</ref> by avoiding simply automating existing inefficient information pathways.
The core public health functions are assurance, assessment, and advocacy, which are used to maximize population health.<ref name="CDCPublic17">{{cite web |url=https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html |title=The Public Health System & the 10 Essential Public Health Services |work=National Public Health Performance Standards |author=Centers for Disease Control and Prevention |date=2014 |accessdate=08 May 2017}}</ref> The PHI program design focuses on understanding how information systems achieve these functions rather than having a sub-goal focus on technological, computer science, or data mining aspects of PHI. Because PHI focuses on designing PHInfSys it has a foundation in design thinking.<ref name="SimonTheSci81" /><ref name="DymEng13" /><ref name="Johansson‐SköldbergDesign13" /> Design thinking focuses on identifying problems as gaps in population health that information systems can help reduce by determining the root causes of those gaps and designing and implementing information systems to reduce population health gaps. Systems analysts are the architects who bridge the gap between users and technologies by understanding and translating user needs to system specifications and collaborating with technologists to implement those systems. The goal of systems analysis is to minimize the frequent disconnects between information system development and the usefulness of the resulting information systems<ref name="HarrisonUnintended07">{{cite journal |title=Unintended Consequences of Information Technologies in Health Care—An Interactive Sociotechnical Analysis |journal=JAMIA |author=Harrison, M.I.; Koppel, R.; Bar-Lev, S. |volume=14 |issue=5 |pages=542–49 |year=2007 |doi=10.1197/jamia.M2384}}</ref><ref name="PentlandDesign08">{{cite journal |title=Designing routines: On the folly of designing artifacts, while hoping for patterns of action |journal=Information and Organization |author=Pentland, B.T.; Feldman, M.S. |volume=18 |issue=4 |pages=235–250 |year=2008 |doi=10.1016/j.infoandorg.2008.08.001}}</ref> by avoiding simply automating existing inefficient information pathways.
To address these disconnects, effective systems analysis requires that PHInf are “well grounded in the fundamentals of organization theory, decision-making, teamwork and leadership, and research methods as well as current and emerging information systems technologies.”<ref name="CMUInfo18">{{cite web |url=https://www.cmu.edu/information-systems/ |title=Information Systems |publisher=Carnegie Mellon University |date=2016 |accessdate=29 January 2018}}</ref> PHInf also need the ability to design, implement, and evaluate information systems in multiple contexts, using approaches such as realistic evaluation and context-mechanism-outcome configurations (CMOc).<ref name="PawsonARealist12" />


==References==
==References==

Revision as of 21:40, 13 May 2019

Full article title Developing workforce capacity in public health informatics: Core competencies and curriculum design
Journal Frontiers in Public Health
Author(s) Wholey, Douglas R.; LaVenture, Martin; Rajamani, Sripriya; Kreiger, Rob.; Hedberg, Craig; Kenyon, Cynthia
Author affiliation(s) University of Minnesota, Minnesota Department of Health, AllinaHealth
Editors Caron, Rosemary M.
Year published 2019
Volume and issue 6
Page(s) 124
DOI 10.3389/fpubh.2018.00124
ISSN 2296-2565
Distribution license Creative Commons Attribution 4.0 International
Website https://www.frontiersin.org/articles/10.3389/fpubh.2018.00124/full
Download https://www.frontiersin.org/articles/10.3389/fpubh.2018.00124/pdf (PDF)

Abstract

We describe a master’s level public health informatics (PHI) curriculum to support workforce development. Public health decision-making requires intensive information management to organize responses to health threats and develop effective health education and promotion. PHI competencies prepare the public health workforce to design and implement these information systems. The objective for a master's and certificate in PHI is to prepare public health informaticians with the competencies to work collaboratively with colleagues in public health and other health professions to design and develop information systems that support population health improvement. The PHI competencies are drawn from computer, information, and organizational sciences. A curriculum is proposed to deliver the competencies, and the results of a pilot PHI program are presented. Since the public health workforce needs to use information technology effectively to improve population health, it is essential for public health academic institutions to develop and implement PHI workforce training programs.

Keywords: public health informatics, public health practice, public health workforce, systems analysis, systems design

Introduction

With the increasing use of electronic data collection and storage, there is an increasing focus on information and knowledge management systems.[1] This results in public health workforce needs for public health informatics (PHI) professionals skilled in designing and implementing these systems. PHI professionals are those who “work in practice, research, or academia and whose primary work function is to use informatics to improve the health of populations.”[2] Recent studies highlight the need for informatics training in the public health workforce.[3][4] Similarly, the Council on Education for Public Health (CEPH) includes informatics as a foundational competency for accreditation of public health programs.[5][6] We build on the literature for developing informatics' savvy public health departments[7][8][9][10] and PHI core competency descriptions[2][11] to design a curriculum for a master's program in public health (MPH) and a certificate in PHI. The proposed curriculum differs from many existing health informatics programs by emphasizing the public health informatician's architectural role as a systems analyst linking public health users and information technology specialists by guiding the analysis and design of information systems. The focus is on: (a) problem definition for public health information systems (PHInfSys); (b) analyzing, designing, and implementing effective PHInfSys, such as surveillance, community health assessment, and population health management systems;[2][12] (c) encoding, collecting, curating, storing, retrieving, and analyzing data to create information; (d) assuring system and data governance, management, integration, confidentiality, and security; (e) creating and managing information technologies; and (f) collaborating in and leading inter-disciplinary and cross-cutting teams.

The foundation of public health is information, collected across a variety of sources, with the goal of generating and disseminating new knowledge and instituting actions to improve the public’s health. The need for public health education programs to be informed by current public health needs and employment opportunities has been long noted[13], as has the importance of establishing academic-practice links with public health agencies and training students in practice situations. In 2001, the need for PHI training was noted in an American Medical Informatics Association (AMIA) conference on developing a PHI agenda.[14] In 2012, AMIA revisited and updated these recommendations.[15] Both reports covered technical topics, such as information architecture and standards; governance and policy, including confidentiality and privacy; and workforce training. These needs are addressed by the PHI training program we describe.

The 2012 AMIA report noted that the “[t]he public health value chain is composed of business processes and use cases that describe the flow of data and information. Business processes describe how data, information, and knowledge are used by creating a framework that relates work activities to domains of public health function.”[15] PHI is a foundation for modernizing public health value chains, including public health department business processes[16], public health surveillance[17][18], public health emergency response, population health science[19], population health management[20], learning health systems[21], and public health research. PHI is an essential specialization that bridges the digital gap public health agencies face given growing expectations of service and preparedness. PHI integrates knowledge and skills from the information sciences (computer, information, organizational, and systems sciences) with public health expertise and “includes the conceptualization, design, development, deployment, refinement, maintenance, and evaluation of communication, surveillance, and information systems relevant to public health.”[22]

While PHI shares some core skills with other health informatics domains, such as bioinformatics or clinical and nursing informatics, it is distinct in necessitating integration of core informatics skills with public health systems, such as surveillance systems, community health assessment, disease/condition registries, and prevention programs in an overall framework of population health science. Public health informaticians (PHInf) differ from information technologists (ITs) because “[t]he focus of IT is to implement and operate information systems (hardware and software) that meet programmatic needs. In contrast, PHInf have a strategic and systems view of how information systems and technology can impact public health, such as how information systems can support public health decision-making. Unlike IT specialists, PHInf work within the larger context of how information systems function within the political, cultural, economic, and social environment and evaluate their impact within the broad sphere of public health. Thus, PHInf are in the unique position to understand how information systems can improve the practice and science of public health while contributing to the evidence-based practice of public health informatics.”[2]

Our paper focuses on training PHInf through MPH and certificate programs to provide them a foundation for a PHI professional career. The professional role is one of four related PHI roles identified by the PHI Institute, the Association of State and Territorial Health Officials, and the National Association of County and City Health Officials (NACCHO): executive; manager; professional; and clinical.[23] The curriculum design highlighted here focuses on the professional role because it is a frontline position that is the foundation for a career path through management to executive leadership.[24]

Our paper describes program design objectives and assumptions, design challenges, and core competencies. This overview provides context and prioritization for the program design.

PHI program design objectives and assumptions

The objective of PHI training is to educate PHInf with public health and PHI knowledge and skills that enable them to design and implement effective PHInfSys and have a successful PHI career. The design assumes that PHInf require competencies in (a) public health core competencies[25], functions, and systems (e.g., disease and environmental surveillance[18], population health management[20], and community health assessment[20][26][27]); (b) design thinking and systems analysis[28][29][30]; (c) computer, information, organizational, and systems sciences[22][31]; (d) evaluating information systems effectiveness[32]; and (e) teamwork and project management.

The core public health functions are assurance, assessment, and advocacy, which are used to maximize population health.[33] The PHI program design focuses on understanding how information systems achieve these functions rather than having a sub-goal focus on technological, computer science, or data mining aspects of PHI. Because PHI focuses on designing PHInfSys it has a foundation in design thinking.[28][29][30] Design thinking focuses on identifying problems as gaps in population health that information systems can help reduce by determining the root causes of those gaps and designing and implementing information systems to reduce population health gaps. Systems analysts are the architects who bridge the gap between users and technologies by understanding and translating user needs to system specifications and collaborating with technologists to implement those systems. The goal of systems analysis is to minimize the frequent disconnects between information system development and the usefulness of the resulting information systems[34][35] by avoiding simply automating existing inefficient information pathways.

To address these disconnects, effective systems analysis requires that PHInf are “well grounded in the fundamentals of organization theory, decision-making, teamwork and leadership, and research methods as well as current and emerging information systems technologies.”[36] PHInf also need the ability to design, implement, and evaluate information systems in multiple contexts, using approaches such as realistic evaluation and context-mechanism-outcome configurations (CMOc).[32]

References

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  2. 2.0 2.1 2.2 2.3 Centers for Disease Control and Prevention, University of Washington's Center for Public Health Informatics (September 2009). "Competencies for Public Health Informaticians" (PDF). US Department of Health and Human Services, Centers for Disease Control and Prevention. Archived from the original on 13 June 2017. https://web.archive.org/web/20170613082955/https://www.cdc.gov/informaticscompetencies/pdfs/phi-competencies.pdf. 
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  7. LaVenture, M.; Brand, B.; Ross, D.A. et al. (2014). "Building an informatics-savvy health department: Part I, vision and core strategies". Journal of Public Health Management and Practice 20 (6): 667–9. doi:10.1097/PHH.0000000000000149. PMID 25250757. 
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  9. LaVenture, M.; Brand, B.; Baker, E.L. (2017). "Developing an informatics-savvy health department: From discrete projects to a coordinating program - Part I: Assessment and governance". Journal of Public Health Management and Practice 23 (3): 325–7. doi:10.1097/PHH.0000000000000551. PMID 28350628. 
  10. Brand, B.; LaVenture, M.; Baker, E.L. (2018). "Developing an informatics-savvy health department: From discrete projects to a coordinating program - Part III: Ensuring well-designed and effectively used information systems". Journal of Public Health Management and Practice 24 (2): 181–4. doi:10.1097/PHH.0000000000000756. PMID 29360696. 
  11. Miner, K.; Alperin, M.; Brogan, C.W. et al. (28 February 2011). "Applied Public Health Informatics Curriculum - Preface and Modules". Public Health Informatics Institute. https://www.phii.org/resources/view/158/applied-public-health-informatics-curriculum-preface-and-modules. 
  12. Fond, M.; Volmert, A.; Kendall-Taylor, N. (September 2015). "Making Public Health Informatics Visible: Communicating an Emerging Field" (PDF). FrameWorks Institute. https://www.frameworksinstitute.org/assets/files/health_care/phiistrategicmtgfinalseptember2015.pdf. 
  13. Institute of Medicine (1988). "The Future of Public Health". The National Academies Press. doi:10.17226/1091. https://www.nap.edu/catalog/1091/the-future-of-public-health. 
  14. Yasnoff, W.A.; Overhage, J.M.; Humphreys, B.L. et al. (2001). "A national agenda for public health informatics: summarized recommendations from the 2001 AMIA Spring Congress". JAMIA 8 (6): 535–45. PMC PMC130064. PMID 11687561. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC130064. 
  15. 15.0 15.1 Massoudi, B.L.; Goodman, K.W.; Gotham, I.J. et al. (2012). "An informatics agenda for public health: Summarized recommendations from the 2011 AMIA PHI Conference". JAMIA 19 (5): 688-95. doi:10.1136/amiajnl-2011-000507. PMC PMC3422819. PMID 22395299. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422819. 
  16. Public Health Informatics Institute (2008). Taking Care of Business: A Collaboration to Define Local Health Department Business Processes (2nd Printing ed.). Public Health Informatics Institute. https://www.phii.org/resources/taking-care-business-second-edition. 
  17. McNabb, S.J.; Conde, J.M.; Ferland, L. et al. (2016). Transforming Public Health Surveillance: Proactive Measures for Prevention, Detection, and Response. Elsevier. ISBN 9780702063374. 
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  19. Bachrach, C.A.; Daley, D.M. (2017). "Shaping a New Field: Three Key Challenges for Population Health Science". American Journal of Public Health 107 (2): 251–52. doi:10.2105/AJPH.2016.303580. PMC PMC5227949. PMID 28075642. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227949. 
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  24. Public Health Informatics Institute (April 2014). "Professional Level Public Health Informatician: Sample Position Description and Sample Career Ladder" (PDF). https://www.phii.org/sites/www.phii.org/files/resource/pdfs/Professional%20Sample%20Position%20AND%20Career%20Ladder.pdf. Retrieved 05 October 2017. 
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  34. Harrison, M.I.; Koppel, R.; Bar-Lev, S. (2007). "Unintended Consequences of Information Technologies in Health Care—An Interactive Sociotechnical Analysis". JAMIA 14 (5): 542–49. doi:10.1197/jamia.M2384. 
  35. Pentland, B.T.; Feldman, M.S. (2008). "Designing routines: On the folly of designing artifacts, while hoping for patterns of action". Information and Organization 18 (4): 235–250. doi:10.1016/j.infoandorg.2008.08.001. 
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Notes

This presentation is faithful to the original, with only a few minor changes to presentation. A few grammar and spelling errors were also corrected. In some cases important information was missing from the references, and that information was added. Reference 2 and 11 in the original are unintentionally duplicated; we've removed a duplicate for this version.