This Center of Excellence in Public Health Informatics will be a partnership of three principal entities: theHarvard Medical School/Harvard Pilgrim Health Care Department of Ambulatory Care and Prevention, theHarvard-MIT-Children's Hospital Boston Informatics Program, and the Massachusetts Department of PublicHealth. The Center has expertise in design and use of Electronic Medical Records (EMRs), PersonallyControlled Health Records (PCHRs), and electronic public health reporting and communication systems. Thecenter will link these disparate systems by developing scalable information infrastructures to enableinformation exchange between individuals, health care providers and public health authorities. During theinitial funding period, the Center will conduct two projects that build on existing infrastructure to enhancecommunications to improve public health practices. Both will yield products that can be widely disseminatedand readily adopted. This work will be informed by collaboration with a statewide regional health informationorganization (RHIO). The Center will create a new software solution, Electronic medical record Support for Public healthpractice (ESP). ESP will leverage existing data in EMRs by providing secure, PHIN and HIPAA compliantcommunications between clinicians and public health authorities. ESP will initiate reporting to public healthauthorities when data entered into EMRs meet criteria for reportable conditions. ESP will also receive andrespond to electronic queries from public health authorities when additional clinical information is required forlaboratory reported cases. ESP will also include new statistical methods for identifying spatio-temporaldusters from data residing in EMRs. Although initially focusing on STDs and asthma, ESP will address thebroad range of reportable conditions of interest to public health authorities. It will be designed as a scalable,configurable system to work with a wide array of EMRs and health department information systems. The Center will also enhance the capabilities of PCHRs to add bi-directional communications betweenindividuals and public health authorities to the PCHRs' existing communications capabilities betweenindividuals and providers. These new capabilities will allow collection of specific risk information and thedelivery of highly customized advice regarding specific recommended actions. Although these capabilitieswill be applicable to a wide range of health conditions, the initial focus will be on improving influenzaimmunization rates in high-risk populations. There will be a bi-directional link with a state immunizationregistry. The utility of this system will be demonstrated through its successful deployment in a large healthplan that includes both technology rich and poor practices. In addition, the Center will assume a leadership role in public health informatics by participating in nationaland regional informatics initiatives, through training programs and other scholarly academic activities.
