Public health labs need better IT infrastructure for data exchange

I got this article off on Public Health.

Of late, I’ve taken a fair bit of interest in this area, so much so that I am undertaking a Post Graduate Diploma in Public Health to gain deeper insights and appreciation to the discipline. This article takes a look at (some of) the challenges Public Health Informatics will face in the modern day context.


Without a basic IT infrastructure, public health laboratories (PHLs) will be unable to effectively manage their laboratory data or electronically message laboratory test results, according to an article in Public Health Reports.

PHLs provide specialized services to the communities they serve including applied research, laboratory training and diagnostic testing. PHLs are integral to the health system through their provision of a range of essential services, including disease surveillance and the timely, accurate identification of infectious organisms associated with outbreaks of disease, according to Patina Zarcone, MPH, of the Association of Public Health Laboratories (APHL) in Silver Spring, Md., and colleagues.

According to the authors, there are more than 600 PHLs in the U.S. operating at the state, county or city level. A survey conducted in 2007 by APHL found that approximately 90 percent of PHLs have a laboratory information management system. However, according to the authors, many are in various stages are in various stages of implementing their system, and some do not have the necessary funding to complete implementation.

“Public health legal jurisdictions typically end at state borders, yet infectious diseases easily cross such boundaries,” wrote Zarcone and colleagues. “The importance of sharing public health data is illustrated by the detection of E.coli O157:H7 in hamburgers in multiple stages…National interoperability and data-sharing standards, policies and practices need to accommodate each stakeholder’s specific needs with regard to the variable levels of data required.”

Launched by the APHL and the Centers for Disease and Control and Prevention in September 2006, PHL Interoperability Project (PHLIP) was introduced to leverage a community-based collaborative process, catalyzing national capabilities to more effectively share electronic laboratory-generated diagnostic information and bolster the nation’s health security, according to the authors.

According to the authors, PHLIP champions the evolution of the PHL community through the establishment of an open-innovation initiative and, in the past four years, a robust collaborative infrastructure has developed to allow more than 20 additional laboratories to join the project, thus incorporating one-third of the nation’s largest laboratories into a collaborative effort to create the technical specification that will make a national standards-based electronic data-sharing network a reality.

Future work, according to the authors, will include the completion of harmonized data elements for remaining nationally notifiable diseases, closer collaboration with the epidemiology and clinical communities to ensure effective data exchange for all programs and the leveraging of the open-innovation PHL network to accelerate and improve public health program, including the national or local response to emerging infections or acute threats.

However, the authors state that challenges in the public health domain lie ahead. “It is imperative to secure sustainable funding sources for these projects so the infrastructure and processes created will be lasting,” wrote Zarcone and colleagues. The authors went on to state that the maintenance of a large, complex collaborative requires a long-term commitment on the part of many stakeholders and there must be effective mechanisms in place to maintain strong program stewardship to ensure robust community collaboration.

“The primary outcome of this project has been the cost-effective acceleration of collaborative innovation to improve information sharing in the management of major public health challenges,” the authors concluded. “Such innovation is imperative if our finite public health resources are to counter an ever-expanding myriad of challenges and threats to the public’s well-being.”

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