UDOH: the Cradle of Public Health Informatics

Barry Nangle Ph. D., DirectorCenter for Health Data (Outgoing)

Presentation Overview

• Asked to look back on 30+ years for something useful going forward

• Anecdotal evidence for (admittedly) too provocative title

• Challenges and opportunities for future of UDOH informatics

The Present: EHR Interoperabilty Demonstrated at 2013 NAPHSIS Annual Meeting

• Seth Foldy on the Inevitability of Birth and Mortality Data originating in the EHR

• UDOH work central to the “Connectathon.”• Why is this ? – History ?– Geography ?– Sociology ?

History: UDOH in 1979

• Interviewed in Health IT• Formative informatics skill: person matching (metabolic

screening, Medicaid, WIC)• Person matching remains a key contribution of

informatics (Medicaid breach)• Matching skills enabled development of UPDB in Utah• CODES, USIIS, CHARM etc. reveal Utah as a center for

development of this skill

Data Science

• From NY Times April 2013: “HARVARD BUSINESS REVIEW calls data science “the sexiest job in the 21st century,” and by most accounts this hot new field promises to revolutionize industries from business to government, health care to academia… institutions teaching data science include New York University, Stanford, Northwestern, George Mason, Syracuse, University of California at Irvine and Indiana University. “

Data Science (continued)

• From Wikipedia - Data science is taking certain theories and technologies from many fields (mathematics, statistics, computing) with the goal of extracting meaning from the data and creating data products.

• This was our job under John Brockert in the 70s and 80s.

…even if our methods were a bit primitive

• Primary tool – the card punch• Job involved significant waiting and walking

UDOH and Assessment Informatics

• Our signature contribution to public health informatics

• My overview of the steps in this (narrative in About IBIS):– ODOH receives a CDC Assessment Initiative Grant– Bureau of Surveillance and Analysis (Cathy

Schumacher, Bob Rolfs, Darry Snyder, Elvin Assay, Kim Neerings) creates Action 2000.

– Under Denise Love’s direction, Zhiwei Liu develops Hospital Inpatient Internet Query (HI-IQ)

UDOH and Assessment Informatics (cont.)

• NCHS’s Charlie Rothwell asks, “Has anybody seen the amazing things they are doing in Utah ?”

• ZW “web enabled” ACTION2000 using HI_IQ.• Under Wu Xu’s direction ZW created Maternal

and Child Health Information Internet-query Module (MatCHIIM). Six states adopted/contributed under HRSA grant.

UDOH and Assessment Informatics (cont.)

• IBIS developed under Lois Haggard and UDOH leadership.

• IBIS adoption by other states, the de facto model of WDQS in public health.

• Through efforts of Sam Lefevre, Environmental Pubic Health Tracking in Utah and US adopt IBIS technology.

• I deserve, and have gotten, very little credit for any of this.

Innovations in Child Health Informatics

• Under Peter van Dyck, Utah among the first mainframe-based maternal and child health information systems in the 1970’s.

• High-risk Hearing surveillance and prevention informatics pioneered in Utah

• USIIS a leader in immunization registry development.

• Child Health Advanced Records Management (CHARM) and NAPHIT

Many More Recent Innovation Platforms

• PHII sponsored Community of Practice• Center for Excellence in Public Health

Informatics• NIH MPI Grant• etc.

Critical Success Factors for Utah Public Health Informatics

• Informatics rich institutions• Collaborative culture• In-house IT staff at UDOH, Intermountain and

U of U Departments.• CDC Investments in Utah informatics• Question: Is innovation possible under IT

contracts ?

Thank You

Please send questions to:

bnangle13@gmail.com