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Governmental and Legislative Context of Informatics

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Part of the Health Informatics book series (HI)

Abstract

The Institute of Medicine has identified three core functions of public health that recognize the importance of timely and accurate information and are central to contemporary public health practice: assessment of population health, policy development, and assurance of the availability of high-quality public health services [1]. Others have noted that an information infrastructure is considered to be central to those functions [2]. Historically, federal funding for public health information systems was both limited and categorical, leading to non-standardized, non-interoperable, disease-specific applications that were difficult for state and local health departments to support and maintain. However, the terrorist events of 2001 led to the largest federal investment in public health infrastructure since World War II [3].

Over the past two decades, the term public health informatics has been used to describe the intersection of public health and information technology [4]. The purpose of this chapter is to describe the emergence and evolution of public health informatics policy, which began to develop in the mid to late 1990s, accelerated after the terrorist events of 2001, and came into new prominence when the public health objectives in Stage 2 meaningful use rules were released in September 2012. The chapter begins with a review of the fundamentals of the public policy process and the government, legal, and regulatory framework for public health informatics. It then describes the policy environment for public health informatics, showing how large-scale public events and public-private collaboration and leadership from professional organizations helped to move the policy process forward by increasing transparency and investments in public health information infrastructure. The chapter closes with a look forward to future policy issues at the national level.

Keywords

  • Health policy
  • Health information technology policy
  • Public health informatics
  • Policy development
  • Population health
  • Regulatory framework
  • Funding
  • Congress
  • Public health funding
  • HIPAA
  • NEDSS
  • HAN
  • ONC
  • HITECH
  • Meaningful use
  • PCAST

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Fig. 4.1

References

  1. Institute of Medicine. The future of public health. Washington, DC: National Academy Press; 1988.

    Google Scholar 

  2. Turnock BJ. Public health – what it is and how it works. 2nd ed. Gaithersburg: Aspen Publishers; 2001.

    Google Scholar 

  3. National Committee on Vital and Health Statistics. Information for health: a strategy for building the national health information infrastructure; 2001. Available at: http://www.ncvhs.hhs.gov/nhiilayo.pdf. Accessed 12 Jan 2013.

  4. Yasnoff WA, O’Carroll PW, Koo D, Linkins RW, Kilbourne EM. Public health informatics: improving and transforming public health in the information age. J Public Health Manag Pract. 2000;6(5):67–75.

    PubMed  CrossRef  CAS  Google Scholar 

  5. Baker EL, Koplan JP. Strengthening the Nation’s Public Health Infrastructure: historic challenge. Unprecedented opportunity. Health Aff. 2002;21(6):15–27.

    CrossRef  Google Scholar 

  6. Centers for Disease Control and Prevention (2012). National notifiable diseases surveillance system (NNDSS). History and background. Available at: http://wwwn.cdc.gov/nndss/script/history.aspx. Accessed 9 Feb 2013.

  7. Lumpkin JR, Richards MS. Transforming the public health information infrastructure. Health Aff. 2002;21(6):45–56.

    CrossRef  Google Scholar 

  8. Turnock BJ. Public health – what it is and how it works. 3rd ed. Boston: Jones and Bartlett Publishers; 2004.

    Google Scholar 

  9. American Public Health Association. The prevention and public health fund: a critical investment in our nation’s physical and fiscal health; 2012. Available at: http://www.apha.org/NR/rdonlyres/8FA13774-AA47-43F2-838B-1B0757D111C6/0/APHA_PrevFundBrief_June2012.pdf. Accessed 21 Feb 2013.

  10. Teitelbaum JB, WIlensky SE. Essentials of health policy and law. Sudbury: Jones and Bartlett Publishers; 2007.

    Google Scholar 

  11. Institute of Medicine. For the public’s health: investing in a healthier future. Washington, DC: National Academies Press; 2012. Available at: http://www.iom.edu/Reports/2012/For-the-Publics-Health-Investing-in-a-Healthier-Future.aspx. Accessed 25 Mar 2013.

  12. Office of the National Coordinator for Health Information Technology (ONC). The federal health IT strategic plan 2011–2015. Available at: http://www.healthit.gov/sites/default/files/utility/final-federal-health-it-strategic-plan-0911.pdf. Accessed 25 Mar 2013.

  13. Department of Homeland Security (DHS) Healthcare and Public Health Sector Overview. 2013. Available at: http://www.dhs.gov/healthcare-and-public-health-sector. Accessed 25 Mar 2013.

  14. Cusack CM, Knudson AD, Kronstadt JL, Singer RF, Brown AL. Practice-based population health: information technology to support transformation to proactive primary care. AHRQ Publication No 10-0092-EF. Rockville: Agency for Healthcare Research and Quality; 2010.

    Google Scholar 

  15. McNabb SJN, Koo D, Pinner R, Seligman J. Informatics and public health at CDC. MMWR Morb Mortal Wkly Rep. 2006;55(2):25–8. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/su5502a10.htm. Accessed 26 Feb 2013.

  16. National Center for Public Health Informatics (NCPHI). Board of scientific counselors. Summary report. Atlanta: Centers for Disease Control and Prevention; 2008.

    Google Scholar 

  17. Humphreys BL. Building better connections: the national library of medicine and public health. J Med Libr Assoc. 2007;95(5):293–300.

    PubMed  CrossRef  Google Scholar 

  18. Health Insurance Portability and Accountability Act (HIPAA), P. L. 104–191. Available at: http://aspe.hhs.gov/admnsimp/pl104191.htm. Accessed 21 Jan 2013.

  19. O’Carroll PW, Halverson P, Jones DL, Baker EL. The health alert network in action. Northwest public health. Seattle: University of Washington School of Public Health and Community Medicine; 2002.

    Google Scholar 

  20. Centers for Disease Control and Prevention. Public health’s infrastructure: a status report. 2001 Available at: http://stacks.cdc.gov/view/cdc/11337/. Accessed 25 Mar 2013.

  21. Koplan J. CDC’s strategic plan for bioterrorism preparedness and response. Public Health Rep. 2001;116(Supplement 2):9–16. Accessed 27 Jan 2013.

    PubMed  CrossRef  Google Scholar 

  22. Centers for Disease Control and Prevention. National notifiable diseases surveillance system history. Available at: http://www.cdc.gov/nndss. Accessed 25 Mar 2013.

  23. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001. Available at: http://www.iom.edu/Reports/2001/Crossing-the-Quality-Chasm-A-New-Health-System-for-the-21st-Century.aspx. Accessed 17 Feb 2013.

  24. Yasnoff WA, Overhage JM, Humphreys BL, LaVenture M. A national agenda for public health informatics: summarized recommendations from the 2001 AMIA Spring Congress. J Am Med Inform Assoc. 2001;8:535–45.

    PubMed  CrossRef  CAS  Google Scholar 

  25. Centers for Disease Control and Prevention. HIPAA privacy rule and public health: guidance from CDC and the U.S. Department of Health and Human Services. MMWR Morb Mortal Wkly Rep. 2003; MMWR 52(411):1–20. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/m2e411a1.htm. Accessed 25 Mar 2013.

  26. Agency for Healthcare Research and Quality (AHRQ). Health information technology programs update 2005–06. Available at: http://www.ahrq.gov/research/hitfact.pdf. Accessed 20 Jan 2013.

  27. HHS Press Office. HHS enters into agreements to support digital health recovery for the gulf coast. Available at: http://archive.hhs.gov/news/press/2005pres/20051117.html. Accessed 20 Jan 2013.

  28. Centers for Disease Control and Prevention. Meaningful use. Available at: http://www.cdc.gov/ehrmeaningfuluse/introduction.html. Accessed 27 Dec 2012.

  29. ONC. HITECH Programs. State Health Information Exchange Cooperative Agreement Program. Available at: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__rec_program/1495. Accessed December 27, 2012.

  30. Rosenbaum S. The patient protection and affordable care act: implications for public health policy and practice. Public Health Rep. 2011;126(1):130–5.

    PubMed  Google Scholar 

  31. iHealthbeat. FCC Unveils U.S. Broadband Plan Promoting Health IT, Telehealth. 2010 Available at: http://www.ihealthbeat.org/articles/2010/3/17/fcc-unveils-us-broadband-plan-promoting-health-it-telehealth.aspx?topic=policy. Accessed 27 Dec 2012.

  32. Centers for Medicare and Medicaid Services. Stage 2. Available at: http://www.cms.gov/regulations-and-guidance/legislation/ehrincentiveprograms/stage_2.html. Accessed 2 Feb 2013.

  33. HHS, Office of Civil Rights. New rule protects patient privacy, secures health information. 2013. Available at: http://www.hhs.gov/news/press/2013pres/01/20130117b.html. Accessed 3 Feb 2013.

  34. Baker EL, Porter J. The health alert network: partnerships, politics, and preparedness. J Public Health Manag Pract. 2005;11(6):574–6.

    PubMed  CrossRef  Google Scholar 

  35. US Congress. Committee on appropriations. Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriation Bill, 2000. 106th Congress, 1st sess, 1999. Committee report, 106–166. 1999. Available at: http://thomas.loc.gov/cgi-bin/cpquery/T?&report=sr166&dbname=106&. Accessed 2 Jan 2013.

  36. Centers for Disease Control and Prevention. Health alert network best practice workgroup. Health Alert Network (HAN): program description and best practices. 2011. Available at: http://api.ning.com/files/EA*ieNx7rEF7Lxs6E6D5W8EYHqbsQ2n0efzza3JNcmw8bF6ceFDs*Q1TnViOC9rFAMyznsUZPL9ahHERDi874fAPPpa1TKkN/HANBPDraft62011.doc&ei=HstQUeXxBOOZiAKK-4C4Bw&usg=AFQjCNEEK6m8ftPKxvpBewui3hpmAKzNjg&sig2=fbm4MGT-myrYyEnzRVdCBw&bvm=bv.44342787,d.cGE. Accessed 2 Mar 13.

  37. Turnock BJ. Public health – what it is and how it works. 4th ed. Boston: Jones and Bartlett Publishers; 2009.

    Google Scholar 

  38. Massoudi BL, Goodman KW, Gotham IJ, Holmes JH, Lang L, Miner K, Potenziani DD, Richards J, Turner AM, Fu PC Jr. An informatics agenda for public health: summarized recommendations from the 2011 AMIA PHI Conference. J Am Med Inform Assoc. 2012;19(5):688–95. Available at: http://jamia.bmj.com/content/19/5/688.long. Accessed 22 Dec 2012.

  39. Choi E. Disaster relief informatics: access to KatrinaHealth.org prescription data vis OQO ultra mobile PC and cellular wireless connectivity. AMIA Annu Symp Proc. 2006;2006:888. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839658/. Accessed 3 Feb 2013.

  40. Markle Foundation, American Medical Association, Gold Standard, RxHub, SureScripts. Lessons From Katrina Health; 2006. Available at: http://www.surescripts.com/media/660511/katrinahealthlessons.pdf. Accessed 1 Mar 2013.

  41. Blumenthal D, Berwick D. Adoption and meaningful use of EHRs – the journey begins. Health Aff Blog. 2010. Available at: http://healthaffairs.org/blog/2010/08/05/adoption-and-meaningful-use-of-ehrs-%E2%80%93-the-journey-begins/. Accessed 8 Aug 2012.

  42. Office of the National Coordinator for Health Information Technology (ONC). Health IT adoption programs. Available at: http://www.healthit.gov/policy-researchers-implementers/federal-advisory-committees-facas?tid=125. Accessed 25 Mar 2013.

  43. President’s Council of Advisors on Science and Technology (PCAST). Realizing the full potential of health information technology to improve healthcare for Americans: the path forward. White House; 2010. Available at: http://www.whitehouse.gov/administration/eop/ostp/pcast/docsreports. Accessed 25 Mar 2013.

  44. Manatt Health Solutions. HITECH revisited. Achieving HITECH’s goals for a high-performing health IT-enabled healthcare system; 2010. Available at: http://www.manatt.com/ThreeColumn.aspx?pageid=199&id=5443. Accessed 12 Feb 2013.

  45. Savel TF, Foldy S. The role of public health informatics in enhancing public health surveillance. MMWR Supplement. 2012;61(03):20–4. Accessed 22 Feb 2013.

    Google Scholar 

  46. Frisse ME. Health information technology: one step at a time. Health Aff (Millwood). 2009;28(2):w379–84. Available at: http://content.healthaffairs.org/content/28/2/w379.abstract. Accessed 28 Feb 2013.

  47. Diamond CC, Mostashari F, Shirky C. Collecting and sharing data for population health: a new paradigm. Health Aff (Millwood). 2009;28(2):454–66. Available at: http://content.healthaffairs.org/content/28/2/454.long. Accessed 25 Mar 2013.

  48. Institute of Medicine. Effectiveness of National Biosurveillance Systems: BioWatch and the Public Health System. Interim Report; 2009. Available at: http://www.iom.edu/Activities/PublicHealth/BioWatchEfficacy.aspx. Accessed 3 Mar 2013.

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Correspondence to Margo Edmunds PhD .

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Edmunds, M. (2014). Governmental and Legislative Context of Informatics. In: Magnuson, J., Fu, Jr., P. (eds) Public Health Informatics and Information Systems. Health Informatics. Springer, London. https://doi.org/10.1007/978-1-4471-4237-9_4

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  • DOI: https://doi.org/10.1007/978-1-4471-4237-9_4

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