BEACH Update
Population and Public Health
Public Health Tiger Team
Dr. James Killeen
UC San Diego Dept. of Emergency Medicine
Beacon Education, Analytic and Coordination Hub
SD Beacon Objectives
Build Regional HIE Infrastructure
• Integrate Health IT into Care Delivery
– Improve care coordination among providers
– Engage patients and families
• Quality: Cardiovascular disease
– Acute care: EKG transmission from EMS to Hospitals for acute
Myocardial Infarctions
• Reduce Time to Catheterization and False Positive Rates
– Chronic care: Reduce 30 day re-admissions
• Public Health Enhancements & Meaningful Use
– Immunizations
– Syndrome Surveillance
– Electronic Lab Reporting
• Cost Efficiency
– Reduce repeat ED visits, hospital admissions & Redundant Tests
2
Beacon Innovations
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Regional and inter-state EMS Hub Services
Situation Awareness
Population health data and analytics
Public health data, visualization and analytics
Meaningful Use public health reporting certification and
compliance support
• Embedded Medical Devices
• Tele-medicine and Tele Lab
• Environmental Data
State/Local
Government
Community B
SSA
VA/DOD
County PH
CDC
SD
VA/DOD
EMS
Clinics
Community A
Evolving from the BEACON to the BEACH
Beacon
Leveraging information and best practices across all Beacon
Communities while also
Education
Including and informing communities that were not participants in the
grant program by
Analytic
Using analytical tools to create situational awareness
Coordination
Creating a forum in an aligned manner for the exchange of data and
information using
Hub
The UCSD Emergency Medicine Department as the common center of
activity
Public Health Data Starts Locally
• Raw Data is reported to PH – PHI, De-identified and Aggregate
• PH Applications and Informatics Analyze
• Information is Generated and Shared
Data
Public Health
Raw
Data
Info
Population Health utilizes PH Analysis
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PH Shared Info is Source data – De-Identified and Aggregated
New data sources – EMS, Behavioral Health
Includes Healthcare, Research and Businesses
Generated new Information that is Shared
Data
Population Health
Data
New
Data
Public Health
Raw
Data
Info
Info
Community Health
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Pop Shared Info is Source data –Aggregated
New data can be added
Includes Entire Community, State and Federal
Generated new Information that is Shared
Data
Community Health
Info
Data
New
Data
Population Health
Data
Public Health
Raw
Data
Info
Info
Current Focus
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Population and Public Health
Maximizing data to public health
Support existing applications and systems
Enable rich analytics, visualization and reporting
Consistent interfaces for interoperability
Data
Population Health
Data
New
Data
Public Health
Raw
Data
Info
Info
SDIR
Imperial
Health System
CAIR
RIDE
Immunization
Hospital
Provider
Network
FQHC, DOD
& VA
Individual
Practice
Other States
Population and Public
Health Hub
Regional Reg
Cancer Case
SD webvCMR
HIE
Interface
(optional)
Electronic Lab
Reporting
CDPH CalREDIE
Others
Childhood
Lead
RASSCLE
Clinical
Laboratory
HMS EpiCenter
Syndrome
Surveillance
Public Health
Collaborate.org
Others
CDC BioSense
ACKs, Feedback & Data Provenance
JH ESSENCE
Support Existing Systems
Health Partner
EMR/EHR
IZ
Immunization
Registry
PHCR
ELR
LIS
POU Dx
PH Case Management
and Investigation
PH Cases
SS
Surveillance
Hub Simplifies the Process
Health Partners
IZ
LIS
ELR
POU Dx
PHCR
Immunization
Registry
SS
PH Cases
Surveillance
Health
Indicators
Demographics
EMR/EHR
Now  Applying the Data
1. Upcoming back-to-school and fall vaccination
campaigns
2. Asthma
3. Diabetes
Immunizations
Case Reporting
Syndromes
Lab Results
POU Dx
Care Facilities
Populations
Regions
Seasons
Pharmacies
Schools
Elderly Care
Economic
Transportation
BMI
Air Quality
Seasonal Influenza
• Thousands die every year
• Vaccination campaigns are a tool
– Both influenza and pneumonia
• Challenges
– How effective are we?
– Can we be more effective?
• If we can collect and analyze data faster…
– Campaigns can be targeted and adjusted
– Surveillance can be a by-product of routine care
Surveillance – Influenza-Like
Illness
Goal
Compress time to
knowledge to mitigate
overall impact and cost
Emergency
Department
Urgent Care
• Rapid Diagnostic
• Diagnostic &
Typing
Public Health
Laboratory
• Typing &
Subtyping
School
Nurse
• Screening Test
Encounter
• Assessment
Vaccinations
Encounters
Real-Time Situation Awareness
Test Results
Population and Public Health Hub
Immunizations
Community
ELR
Population
and Public
Health Hub
Rapid Diagnostics
Policy /
Governance
Case Reporting
Cloud & Desktop
Toolkits
(Aggregate)
Syndrome Surv
Regional &
Healthcare
(De- & UnIdentified)
Business Rules
Public Health
Exposure
Monitoring
(Protected Health
Information)
Environmental Data
ACKs, Feedback & Data Provenance
Platform Deployment
• Priorities
– Support existing applicationspecific data flows
– Establish new flows to support
analytics and other needs
– Provide information back to
stakeholders in a timely manner
• Rules
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Interoperability by design
Reduce dependence on HL7
Open standards
Open interfaces
• Agile in the Extreme
• 2-6 cycles
• Discovery
– 2-6 hours concept
– 2-6 days proto
• Dynamic
– 2-6 days concept
– 2-6 weeks proto
• Map to existing design
patterns and enhance
services
High Level Architecture
Analysis, Visualization, Reporting
New Applications
Data In
Router
Pre
Process
Engine
Data
Access
Layers
Legacy
Apps
Post
Process
Engine
Data
Out
Router
Data
Marts
Ext
Data
Service Bus
Coding,
Look up
Staging
Data
App
Data
Data
Whse
Governance
Provenance
Security
Syndrome Surveillance Example
Validation
Router
BioSense
PP
Filter
Collaborate
PP
Enrich
AppData
Sequence
Enrich
Data Whse
Case Reporting – Pertussis
EHR ICD-9
33.X Trigger
Watchdog:
LabOrder
Validation
Notify:
PH Case
EHR or
SDC
Enrich:
Care Detail
Router
Patient
Enrich:
Pat Detail
Exposure
Monitor
Enrich:
IZ Lookup
HEAT Data
IZ Data
Create:
Pot Case
Dr. James Killeen
jkilleen@ucsd.edu
QUESTIONS?