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
Jacqueline Merrill, RN, MPH, DNSc
Department of Biomedical Informatics
Columbia University
AcademyHealth June 2, 2007
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
Sources
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 (cont)
Association of Public Health Laboratories
Requirements for Public Health Laboratory Information Management
Systems Business Process Descriptions
National Public Health Performance Standards Program
Local Public Health System Performance Assessment Instrument
Association of Schools of Public Health
MPH Core Competencies
North Carolina Local Health Department Accreditation Program
2007 Health Department Self-Assessment Instrument
Council on Linkages between Academia and Public Health Practice
Core Competencies for Public Health Professionals
Public Health Workforce Recruitment, Retention and Promotion in the Civil
Service System
Public health position descriptions
NACCHO
2005 Profile of Local Health Department
Operational Definition of a Functional Local Public Health Agency
Healthy People 2010
Chapter 23 Public Health Infrastructure Objectives
Public Health Informatics Institute
Taking Care of Business: A collaboration to define local public health
business practices (Elements of nine business processes, using standard
Public Health Functions Committee
Essential Services of Public Health
business process analysis tools, such as context and task flow diagramming)
1
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 Develop policy and
solve health problems plans
Enforce laws and regs Help people receive
services
annual childhood
immunization data
annual childhood
immunization data
area health
education centers
annual childhood
immunization data
ACIP vaccine
consumer
management protocols satisfaction
communicable
disease data
emergency operations crisis
communicable disease quality assurance / BOH bylaws
plan
communication plan data
quality
improvement
policies and
procedures
professional licensing education material for community health care
Federal and state
requirements
the public
providers
legislation, rules or
regulations
Activities
Immunization
community health
assessment
electronic computer low literacy brochures forms
files
department policies
emergency
response
coordinator
maternal and child
health data
vital records of births
and deaths
time and activity
schedules
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
Healthy People 2010
medical records
policies
public health law
media communication
plan
translated
educational
materials
Expert Opinion
equipment
US government
auditing standards
Health Insurance
Portability and
Accountability Act
•
•
•
•
Conference call
Each term reviewed for suitability
Terms added and removed
Terms grouped (ie admin tasks, service
tasks)
• Result: 45T, 56K, 59R
Comm Dx Surveillance
academic institutions
case investigation
protocols
area health
education centers
census data
communicable
disease data
communicable disease community health
data
advocate
communicable
disease data
communicable
disease data
complaint/ referral
log
crisis communication
plan
community health
assessment
disease investigation
reports
education material for community health
the public
improvement plan
communicable
disease data
Board of county
commisioners
data sharing
agreements
BOH bylaws
community health care department policies
network, alliance or
partnership
data on utilization of
agency services
Federal and state
legislation, rules or
regulations
guidelines for handling federal regulations for
samples
clinical and
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
2
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?
3