Identifying a minimum data set of public health tasks, knowledge and resources for network analysis Jacqueline Merrill, RN, MPH, DNSc Department of Biomedical Informatics Columbia University AcademyHealth June 2, 2007 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 Sources Association of Public Health Laboratories Requirements for Public Health Laboratory Information Management Systems Business Process Descriptions Association of Schools of Public Health MPH Core Competencies Council on Linkages between Academia and Public Health Practice Core Competencies for Public Health Professionals NACCHO 2005 Profile of Local Health Department Operational Definition of a Functional Local Public Health Agency Public Health Informatics Institute Taking 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 System Public health position descriptions Healthy People 2010 Chapter 23 Public Health Infrastructure Objectives Public Health Functions Committee Essential 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 annual childhood immunization data annual childhood immunization data Give information Engage community to Develop policy and solve health problems plans area health education centers annual childhood immunization data Enforce laws and regs Help people receive services Activities Immunization communicable disease data community health assessment ACIP vaccine consumer management protocols satisfaction assessment emergency operations crisis communicable disease quality assurance / BOH bylaws equipment plan communication plan data quality improvement policies and procedures professional licensing education material for community health care Federal and state time and activity requirements the public providers legislation, rules or schedules regulations electronic computer low literacy brochures forms files department policies emergency response coordinator federal regulations for utilization statistics clinical and environmental laboratory testing Health alert network Health alert network low literacy brochures health care providers GIS information health risk data maternal and child health data vital records of births and deaths Healthy People 2010 medical records policies public health law media communication plan 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 census data communicable disease data communicable disease community health data advocate communicable disease data complaint/ referral log crisis communication plan community health disease investigation education material for community health communicable disease data Board of county commisioners data sharing agreements BOH bylaws community health care department policies network, alliance or partnership Federal and state legislation, rules or regulations guidelines for handling federal regulations for data on utilization of agency services 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?