Integrating Informatics Principles in Public Health Barbara L

Integrating Informatics Principles in Public Health Barbara L. Massoudi, MPH, Ph. D bmassoudi@rti. org Janise Richards, MS, MPH, Ph. D jrichards@cdc. gov APHA Continuing Education Institute, 134 th Annual Meeting & Exposition November 5, 2006

Making Sense of Informaticspeak

Overheard at various meetings… “Our goal is to professionally leverage other's mission-critical infrastructures” In other words – we’re going to steal your really good stuff! Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Overheard at various meetings… “It is our job to synergistically restore error-free information in order that we may conveniently simplify scalable sources because that is what public health professionals expect ” We’re not really sure of what this is– but we know it needs to be accurate, easy to use, and able to grow! Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Overheard at various meetings… “It is our business to interactively provide access to prospective catalysts for change so that we may seamlessly promote value-added paradigms” We think it means somebody’s responsible for making some important changes happen – we just don’t know who! Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Overheard at various meetings… “We authoritatively integrate performance-based meta-services such that we may continue to proactively revolutionize cost effective materials in order to solve business problems” Integration is key – and we can bring things together that you never knew you had or needed and charge lots of money to do it! Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Agenda for Today Introduction to Public Health Informatics n Key Issues in Informatics n Information Systems Planning n Change Management, Project Management & Informatics Analysis n Case Study n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Introduction to Public Health Informatics Definitions, Approach, and Analysis Janise Richards, MS, MPH, Ph. D

Public Health Informatics: What is it? A Definition: Public health informatics is the systematic application of information and computer science and technology to public health practice, research, and learning. What does that mean? ? Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

What is Public Health Informatics? A Definition: Public health informatics is the systematic application of information and computer science and technology to public health practice, research, and learning. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

What is Public Health Informatics? Information science Theories in information science try to explain how we think, store, retrieve, and transmit information. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Information Science Wisdom Knowledge Information Data Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston Data

Information Science Definition of Data n Data = undigested observations and unvarnished facts ¨ Fact, text, graphic, image, sound ¨ Without meaningful relation to anything else ¨ A thing Cleveland, 1983 Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Information Science Definition of Information n Information = organized data ¨Formatted, filtered, organized, structured, interpreted, summarized data ¨ data + meaning = information ¨Relates to a description, definition or perspective (what, who, when , where) Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Information Science Definition of Knowledge n Knowledge = information that has been organized, internalized and integrated with experience, study, or intuition ¨ Case, rule, process, model, ideas ¨ Rules and procedures that guide decisions and actions ¨ Information + application = knowledge ¨ Comprises of strategy, practice, method, or approach (how) Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Information Science: n Vocabularies - A vocabulary is a set of words known to a person or other entity, or that are part of a specific language n Classifications - A classification consists of tables of subject headings and classification schedules used to assign a class number to each item being classified n Taxonomies - A hierarchical taxonomy is a tree structure of classifications for a given set of objects; it may also apply to relationship schemes other than hierarchies, such as network structures. . A taxonomy might also be a simple organization of objects into groups, or even an alphabetical list. In current usage taxonomies are seen as slightly less broad than ontologies. n Ontologies – seek to describe the basic categories and relationsh of being or existence to define entities and types of entities within its framework. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Information Science – Me. SH (controlled vocabularies) Abnormalities, Drug Induced Abnormalities, Multiple Alagille Syndrome Angelman Syndrome Diseases Digestive System Diseases Abdominal Pain Biliary Tract Diseases Digestive System Abnormalities Digestive System Fistula Digestive System Neoplasms Esopageal Diseases Gastrointestinal Diseases Liver Diseases Pancreatic Diseases Peritoneal Diseases Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Information Science: Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Information Science– Semantic Network (Ontology) STY|T 001|Organism|A 1. 1|Generally, a living individual, including all plants and animals. |Homozygote; Radiation Chimera; Transgenic Organisms|||orgm|| STY|T 002|Plant|A 1. 1. 1|An organism having cellulose cell walls, growing by synthesis of inorganic substances, generally distinguished by the presence of chlorophyll, and lacking the power of locomotion. Plant parts are included here as well. |Pollen; Potatoes; Vegetables|||plnt|| STY|T 003|Alga|A 1. 1|A chiefly aquatic plant that contains chlorophyll, but does not form embryos during development and lacks vascular tissue. |Chlorella; Laminaria; Seaweed|||alga|| Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

What is Public Health Informatics? A Definition: Public health informatics is the systematic application of information and computer science and technology to public health practice, research, and learning. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

What is Public Health Informatics? Computer science: Is the systematic study of algorithmic processes that describe and transform data and information – including theory, analysis, design, efficiency, implementation and application Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

What is Public Health Informatics? Computer science: q A foundational concept in computer science is the algorithm-- a precise sequence of instructions q Basically, a computer program is an executable algorithm q A second foundational concept in computer science is the data structure, or an abstract representation of information Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Computer Science: n Algorithms - is a procedure (a finite set of well-defined instructions) for accomplishing some task which, given an initial state, will terminate in a defined end-state n Data models - is a concrete representation of an information model. It represents the entities, properties, relationships and operations defined in an information model in a manner that allows actual instances of those entities to be managed, manipulated, stored, operated upon and verified n Natural language processing - Natural language generation systems convert information from computer databases into normal-sounding human language, and natural language understanding systems convert samples of human language into more formal representations that are easier for computer programs to manipulate n Expert systems/artificial intelligence/decision support systems Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Computer Science: Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Computer Science: Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

What is Public Health Informatics? Information Technology: Information technology is the development and use of hardware, software, and supporting infrastructure to manage and deliver information. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

What is Public Health Informatics? Public Health Practice Public Health Foundation, 2003 Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Public health and informatics Informatics Public Health Informatics Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Creative acts people in Informatics do… formulate models for acquiring, representing, processing, displaying or transmitting health information or knowledge develop computer systems that use the models to deliver the information or knowledge install information technology systems to support the models assess outcomes regarding the effects to the overall health care system Friedman, 1995 Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Public Health Workforce and Informatics 3 Classes of Informatics q. Use of information (per se) for professional effectiveness q. Use of information technology for personal effectiveness q. Development of information systems to improve the effectiveness of the public health enterprise Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Expertise level needed by Workforce Segment Advanced Moderate Use of info technology increase personal effectiveness Basic Development and management of Information systems Front-line Staff Sr. -level Technical Superv. / Managers Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Public Health Workforce and Informatics Public Health Workforce 13 topical areas Digital Literacy Electronic communication On-line information access Use of information System development Project management Procurement Accountability Research Databases Standards Human resource management Confidentiality and security systems Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Public Health Workforce and Informatics Public Health Workforce Competency examples All staff Utilizes information technology for full range of electronic communication appropriate to their programmatic area. All staff Applies relevant procedures and technical means to ensure confidential information is appropriately protected. Sup. /Mgmt Utilizes proven informatics principles and practices when managing information technology projects. Tech-Sup. / Mgmt Participates in the development of new and enhanced databases for public health and applies principles of good database design. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Why is informatics important to public health? n We can do it the hard way or the right way, but either way the application of information technology to public health practice is inevitable O’Carroll, 2001 Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Public Health Informatics Needed approach Multidisciplinary/collaborative n Systematic n Applied n Integrated n Management n ¨ Project ¨ Change Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Public Health Informatics: Applications not Public Health Specific Electronic Data Collection n Collaborative tools n Geographic Information Systems (GIS) n Data Visualization tools n Knowledge Management Systems (KMS) n Electronic Health Record (EHR) n Decision Support Systems n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Public Health Informatics: Applications Specific to Public Health Registries n Electronic Lab Reporting n Electronic Disease Surveillance n Early Event Detection n Program Monitoring and Evaluation n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Loonsk, 2004 Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

PHIN The Public Health Information Network Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Hospital or Health Plan Investigation Team Ambulatory Care Vaccination Center Public Health Lab Law Enforcement and First Responders Health Department The many public health stakeholders The many data streams The need for rapid communication! CDC and Other Federal Organizations Early Detection Sources RX Pharmaceutical Stockpile Public Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Early Event Detection Bio. Sense, NEDSS Base System, PAM Development Platform, Call Triage and Tracking Outbreak Management System Connecting Laboratory Systems Laboratory Response Network Results Messenger, LUNA Partner Communication and Alerting, Epi-X Countermeasure Administration and Response Countermeasure Response Administration, VAC Man Cross Functional Components PHIN Directory, PHIN Messaging Service, PHIN Vocabulary Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston Federal Health Architecture & Consolidated Health Informatics, NHII

Common Ground Robert Wood Johnson Foundation (RWJF) Purpose: n Transforming Public Health Information Systems will support state and local public health agencies' collaboration in two areas: ¨ 1) to prepare agencies to analyze and redesign their business processes; and ¨ 2) to develop collaborative requirements definitions for information systems to strengthen public health agencies that will help to improve preparedness and chronic disease prevention and control. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Key Issues in Informatics Standards, Vocabularies and Strategic Planning Barbara L. Massoudi, MPH, PHD

Standards & Vocabulary

Standards in Informatics n Why use standards? ¨ Exchange data and share information efficiently (HIE within RHIOs/NHIN) ¨ Correctly interpret data (Males=1 or 0) ¨ Improve data quality (Allows for easy grouping) ¨ Collaboration opportunities (Multi-state outbreaks) ¨ Handle more complex information (Laboratory reports) Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Standards in Informatics n Everyone benefits from a common approach to representing and exchanging public health data ¨ Those who collect it from outside sources ¨ Those who enter it into electronic format ¨ Those who analyze it ¨ Those who verify the findings ¨ Those that communicate the information for public health interventions Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

A Figure of Speech… n Conversation ¨ Vocabulary n n The words you choose to use Content standards ¨ Grammar n n The way you put the words together Format standards ¨ Context n n The environment where you have the conversation Software, hardware, and resources required for data exchange Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Vocabulary n Big tables of codes that describe things ¨ Numbers as county codes (FIPS) ¨ Reportable diseases as numbered codes ¨ ICD-9, ICD-9 CM, ICD-10 codes for underlying cause of death n Vocabularies can be: ¨ Locally-defined vs universally-defined ¨ Lumpers vs splitters Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Vocabulary Examples n LOINC-Logical Observation Identifiers Names and Codes (www. regenstrief. org/loinc) ¨ Developed for billing purposes in early 1990 s ¨ Gathers concepts into a single code ¨ “ 13951 -9” = “Serum EIA for Hep A Antibody” ¨ PHIN standard for reportable disease test requests ¨ Codes not assigned in systematic or hierarchical way – the actual number is meaningless Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Vocabulary Examples n SNOMED CT-Systematized Nomenclature of Medicine Clinical Terms (www. snomed. org) ¨ Pathologist developed – mid – 1960 s ¨ Teases out concepts into atomic elements ¨ “Enzyme immunoassay”, “Serum”, “Hepatitis A Virus”, “Antibody” ¨ PHIN standard for reportable disease test results Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Vocabulary Examples - UMLS - Unified Medical Language System (1994 -present) (http: //www. nlm. nih. gov/research/umls/) n Goal: To integrate systems by allowing the mapping of concepts to different standardized vocabularies and the development of vocabularies in biomedicine and health that have not been previously developed n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Vocabulary Examples - UMLS n n n Metathesaurus - Very large, multi-purpose, and multi-lingual vocabulary database that links all included vocabularies Lexicon – A dictionary-like database organized by concept or meaning with attributes that help to define its meaning Semantic Network – A database of biomedical and health related concepts, their various names, and the relationships among them Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Grammar n The way you put words together is important ¨ “The disinfectant is contaminated with blood” ¨ “The blood is contaminated with disinfectant” ¨ Critical in Natural Language Processing (NLP) n Can be: ¨ Storage (database) or Message (transmissions from one database to another over a network) ¨ Flat files or Relational databases Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Grammar Examples n n Storage: comma-delimited, tab-delimited, MS Access, SAS Message: HL 7 -Health Level Seven (www. hl 7. org) ¨ Clinical and administrative data ¨ Standardizes format and protocol ¨ Defines the sequence in the message for data elements as well as the data type ¨ Currently implemented in immunization and cancer registries, emergency department reporting, and lab reporting Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Grammar Example n HL 7 allows multiple patients per message, multiple orders per patient, multiple tests per order, multiple results per test, etc. MSH|^~&||LABMED-SOUTHWEST^68 D 089677^CLIA|… PID|1||78893565||DOE^JOHN||490 Elm St^Phoenix^AZ OBR|1||05099409000|220738^STD SCREEN^L|… OBX|1|CE|5292 -8^RPR-SYPHILIS^LN||G-A 200^POSITIVE^SNM| OBX|2|CE|6487 -3^GONNORRHEA ANTIGEN^LN||G-A 201^NEGATIVE OBX|3|CE|14468 -3^CHLAMYDIA ANTIGEN^LN||G-A 201^NEGATIVE Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Context n Along with the vocabulary and format, there needs to be an infrastructure to support the data exchange ¨ Data model ¨ Communication (business rules, protocols, etc. ) ¨ Security software ¨ Support staff n Standard approaches to implementation of interoperable systems are needed Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Context Example n What is the NHIN? Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

National Health Information Network (NHIN) Personal/ Consumer Clinical/ Provider Public Health/ Community Research/ Policy Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Nationwide Health Information Network Nationwide “system” n Interoperable Exchange of Data, Information, Knowledge (ultimately) n Secure n Containing multiple Regional Health Information Organizations (RHIOs) n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

NHIN - RHIOs n RHIOs – at the regional / local level ¨ Provide: Leadership n Oversight n Governance n Funding Coordination n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Regional Health Information Organizations (RHIOs) AKA Health Information Exchanges (HIEs) AKA Local Health Information Infrastructure Initiatives (LHIIs) Physician’s Office Hospital or Health Plan Ambulatory Care Health Clinic Private and Public Health Labs Hospital or Health Plan Health Department Hospital or Health Plan Physician’s Office Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston Physician’s Office

NHIN n Overall Issues that must be (are) being addressed: ¨ Organization and Business Framework ¨ Privacy and Security ¨ Legal Issues ¨ Management and Operational Considerations ¨ Standards and Policies to Achieve Interoperability Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Privacy, Security & Confidentiality

Background n n Technology versus people/practices? Technology ¨ Always a moving target ¨ Excellent track record overall n People ¨ Human errors in judgment ¨ Social engineering ¨ Lack of standardization in laws across states ¨ Good record in public health Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

NHIN Privacy & Security Project n n AHRQ, ONC (HIT) collaborative initiative with 34 states/territories Goals: ¨ ¨ ¨ n Identify both best practices and challenges Develop consensus-based solutions for interoperable electronic health information exchange (HIE) that protect the privacy and security of health information, and Develop detailed implementation plans to implement solutions. Nationwide report due early summer 2007 Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

HIPAA n Health Insurance Portability and Accountability Act (1996) (www. hipaa. org) ¨ Improved efficiency and effectiveness of healthcare through standardization of shared electronic information including financial and administrative data ¨ Improved privacy of personal information ¨ Public health exemption Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

HIPAA n Two rules: ¨ Security rule n Need for hardware security, access security, and transmission security ¨ Privacy rule n Need for de-identified data to provide for patients’ privacy of personal information Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

HIPAA n Personal identifiers that cannot be included in shared data: ¨ ¨ ¨ Names, address, zip codes Telephone numbers, Fax numbers, Email addresses Birth date, admission date, discharge date, date of death, age Social security numbers Medical record numbers, Health plan beneficiary numbers Account numbers, Certificate/license numbers License plate numbers Device identifiers and serial numbers Web URL, IP address numbers Biometric identifiers Full face photographic images Any other unique identifying number, characteristic, or code Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Strategic Planning

Strategic Management Framework ram plann ing external environment o techn strategic resource management YOU strategic control internal environment lo s lder o h e k p sta / s r e artn organizational culture s tem s y s / gy strategic planning organizational development resource availability prog struc ture/ mana geme Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston nt

Strategic Planning I n How does it fit with other kinds of planning? ¨ Strategic Plans n Sets the direction ¨ Tactical Plans n Establish and maintain the direction ¨ Operational Plans n Carry out the directions Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Strategic Planning II n Dimensions of Planning ¨ Type of Plan n ¨ Organizational Scope of Plan n ¨ Individual, Work Group, Organizational Unit, Enterprise Time Frame/Planning Horizon n n Strategic, Tactical, Operational Immediate, Near-term, Mid-term, Long-term (traditionally) Who do we involve? Individuals at all levels of the organization (internal) ¨ Stakeholders - the individuals and constituencies that contribute, either voluntarily or involuntarily, to an organization’s success and programs, and that are therefore its potential beneficiaries and/or risk bearers (internal and external) ¨ Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Strategic Planning III n Who do we involve? Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Informatics Strategic Planning I n Unique characteristics to public health ¨ Usually reactive environment ¨ Driven by governmental policies; subject to political influence ¨ Independence and interdependence of various public health agencies ¨ Financial and resource constraints; programmatic funding cycles; unfunded, mandated programs; difficulty defining return on investment ¨ Short term leadership horizon in contrast to the continuous business of public health; chronic workforce issues Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Informatics Strategic Planning II n n Informatics Strategy - A definition of the structure within which information, information systems and information technology is to be applied in some organization Why have one? ¨ Information systems are expensive!!! ¨ Information systems need to be tied to strategic business objectives to be useful ¨ Limited time and other resource investments must yield the best value Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Informatics Strategic Planning III n Enterprise Architecture - an explicit, common and meaningful structural frame of reference to enable efficient business processes and information systems planning for public health agencies and partners. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Enterprise Architecture (EA) The use of EA as a focal point for strategic action and IT systems design is a critical success factor contributing to organizations’ effective use of IT to meet mission goals. Source: Graphic by Gartner Consulting Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Making Public Health Informatics Work Change, Projects, and Analysis Janise Richards, Ph. D, MS, MPH

Managing change

Types of Change Operational n Strategic n Cultural n Political n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Helping Change Happen n Resistance to Change ¨ Change – vs – changer ¨ Lack of skills or knowledge ¨ Loss of perceived or real power ¨ Negative attitudes towards organization ¨ Negative attitudes towards change agent ¨ Magnitude of change Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Helping Change Happen n A suggested strategy: ¨ Inform all potentially affected people in writing of the upcoming change ¨ Survey/interview a sample of those affected by the change to determine the issues regarding the change ¨ Use this feedback to develop or modify the change process strategy, if needed ¨ During implementation of change process strategy, interview a sample of those affected to determine any new issues – recursive process ¨ About 6 months after change has been made, conduct an assessment of new process Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Managing Projects

Project Management 1. 2. Define project concept – problem to be solved Develop project plan n 3. 4. 5. Develop resources and support Build team Establish milestones and deliverables Implement project plan Monitor progress and make adjustments as needed Complete project – if ongoing project, establish a logical endpoint annually n n Examine product Determine accomplishments Outline challenges and unexpected opportunities Develop a lessons learned document Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Project Management Strategic Transitions, 2005 Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

10 Ways to fail as a project manager… 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Lientz, 2002 Take a hands-off approach Do not get involved in individual tasks Let issues drift and remain unresolved Be unwilling to list to suggestions for change Be overfocused on specific project management tools Measure milestones by accomplishment, not quality Focus on relationship with management and not with project team Attempt to micromanage project and not delegate Make too many changes to schedule Develop an overly general project plan without detailed tasks, milestones and timelines. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

10 Ways to succeed as a project succeed manager Know what is happening in the project in detail 2. Be able to make decisions 3. Understand issues including importance and meaning to project 4. Develop alternative actions and implement them when needed 5. Communicate effectively with team and management 6. Be able to criticize yourself and take criticism from others 7. Understand the trade-offs between project needs and organizational needs 8. Manage your time well 9. Maintain up-to-date project documentation 10. Have patience, a sense of humor and vision for the project Lientz, 2002 1. Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

y a w Requires: e n s i o Systems thinking! s n y l a a h Who? t n a e r s i What? o How well? h m t s h When? i c e a r o Where? e r h T app. Why? o t How? Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Zachman Framework Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Popkin/Zachman Framework http: //government. popkin. com/frameworks/zachman_grid. htm Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

A review! Function – How? Business Process Model – Functional Process Chart Process Resources Data – What? Sematic Model – Conceptual Data Model Business Entity Business Relationship People – Who? Work Flow Model – Organizational Chart People Work Product Network – Where? Logistics Network – Business Concept Location Linkage Time – When? Master Schedule – Object State Transition Business Event Time Business Cycle Motivation – Why? Business Plan – Business Rules End (objectives) Means (strategy) Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

The PPT framework People Process Technology Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Steps to analysis Getting started n Current status n Goal/vision n Transition to implementation n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Getting started Determine scope, objectives n Determine approach/methodology n Identify project team n Develop project workplan n Obtain commitment/resources n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Current status: where are we today? Organizational structure n Document organizational goals and objectives n Preliminary functional business model n ¨ A function is any set of actions performed in the course of conducting business ¨ A function is defined by its parts ¨ Function=task=process=activity Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Current status: where are we today? n Organizational structure ¨ Gather recent organizational charts (including originating and partner organizations) Department names and location n People’s titles/position n People’s names and contact information n Reporting lines (direct and indirect) n Number of people in department n ¨ Indicate relationships between organizational units Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Current status: where are we today? n Document organizational goals and objectives ¨ Review organizational goals and objectives ¨ Determine organizational critical success factors ¨ Identify any political or controversial factors ¨ Produce report of findings for review and confirmation by administration Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Current status: where are we today? n Preliminary functional business model ¨ ¨ ¨ Include all domains (major functional area) within organizational structure Divide each functional area into its subfunctions (important to take time and careful notes when conducting this step) Decompose functions using an iterative process until all functional areas and connected sub-functions are identified Examine functions to determine if a new categorization or hierarchy of the functional business model appears to better describe the functions Use an iterative process with team and stakeholders to determine if new functional business model Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Current status: Lab Information Flow Example: Initial INITIAL RAW DATA Lab WORKSHEET (start) SUSPECT REPORT PATIENT INFO IDPH Laboratory Specimen FINAL REPORT Repeat REPEAT RAW DATA Tomines, 2004 Patient WORKSHEET (finish) PROBABLE REPORT Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston CDC REPORT

Goal and Vision: what needs to change? n n n Review functional analysis Identify and interview/survey all stakeholders Analyze information gained to identify significant findings and opportunities Develop project goal and vision Review project goals and vision with all participants Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Goal and Vision: Lab Info Flow WORKSHEET (start) SUSPECT REPORT PATIENT INFO Specimen IDPH Laboratory WORKSHEET (finish) Tomines, 2004 PROBABLE REPORT Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston Patient FINAL REPORT

Transition to Implementation: what needs to happen? n n Meet with stakeholders to discuss project implementation Develop appropriate sequence of actions ¨ Systems/applications that create data should be developed before systems/applications that use data n n Develop a plan for conversion from existing to new system Maintain project monitoring Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

What are informatics principles that must be applied in public health? n Infrastructure ¨ Integration ¨ Interoperability n Strategic Planning ¨ Vision ¨ Business process n Management ¨ Project ¨ Change Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Working groups: Informatics Analysis

Some Online Resources http: //www. phii. org/ n http: //endingthedocumentgame. gov/ n http: //toolkit. ehealthinitiative. org/ n http: //healthit. ahrq. gov n http: //www. cdc. gov/biosense/ n http: //www. cdc. gov/phin/ n Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston

Debrief and Evaluation Integrating Informatics Principles in Public Health Session 2018. 0 - APHA 2006 - Boston