HLN ConsultingSoftware and Services for Public Health

Or Maybe It’s Siloed Workflow?

Share

Or Maybe It’s Siloed Workflow?

In an earlier post I wondered whether public health’s siloed systems might not be more appropriately thought of as siloed data. But after attend a meeting of the Joint Public Healt ...

In an earlier post I wondered whether public health’s siloed systems might not be more appropriately thought of as siloed data. But after attend a meeting of the Joint Public Health Informatics Taskforce (JPHIT) I am wondering whether the issue is really siloed workflow.

In public health, data is used to support specific programs, and systems develop to provide a means to collect, analyze, and disseminate this data. Individuals in the programs define the data sets and create systems that support specific protocols and activities that are considered unique to the program area. This is often the result of increased specialization in both the clinical and epidemiological practice and can result in processes that are at their core quite similar being described in diverse ways. Data definitions, codes and terminology sets often also evolve in a divergent way when often they are describing the same qualities or attributes, often about the same patients, conditions, or environment.

Public health agencies need to focus on the commonalities across their programs rather than on the differences. Existing and emerging standards activities should help promote a convergence of systems, data, and workflow to increase interoperability, reduce redundancy, and promote sharable, reusable, cheaper system components. As collaboration among programs and agencies moves some implementations to shared solutions or cloud-based implementations, public health needs to be careful not to create a set of siloed platforms that provide parallel, non-interoperating services to the same agencies.

Siloed Systems or Siloed Data?

Share

Siloed Systems or Siloed Data?

Categorical funding, insufficient resources, and lack of agency vision keep public health systems isolated and unintegrated – a phenomenon often referred to as “siloed” systems. In ...

Categorical funding, insufficient resources, and lack of agency vision keep public health systems isolated and unintegrated – a phenomenon often referred to as “siloed” systems. In a 2007 white paper on the Evolution of Public Health Information Systems I argued that public health agencies needed to think about enterprise-wide systems integration, and several models from distributed, to cooperative, to more centralized were offered for consideration. More recently the action has shifted to interoperable systems (see both the ONC Nationwide Interoperability Roadmap, and my reaction to it in The Interoperability of Things). Interoperability focuses more on the implementation of standards that permit data to flow between systems rather than on combining disparate systems into larger objects to facilitate data sharing.

While this distinction between system integration and system interoperability does have implications for system architects, at the end of the day users are concerned about data. It is more important to focus on siloed data rather than siloed systems as a way to break the impasse that often arises when an agency tries to improve its operational or analytical capabilities. Agencies should consider many different strategies – system redesign, Commercial and Government off-the-shelf (COTS/GOTS) solutions, Master Data Management (MDM) strategies, service-oriented architecture (SOA), Open Source components – but always focus on the impact on the user and ultimately on the user’s experience. And of course as time goes on agencies will want to exchange data with systems outside of public health more and more which requires even more flexibility.

HLN at AIRA 2016

Share

HLN at AIRA 2016

HLN delivered several presentations at the 2016 AIRA National Meeting including: A presentation on Open Source strategies and issues for IIS A presentation with Bill Brand fr ...

HLN delivered several presentations at the 2016 AIRA National Meeting including:

It was truly a great conference. And congratulations to NYC CIR for winning the Center of Excellence award, and Kim Salisbury-Keith from RI KIDSNET for winning a volunteer service award!

New Articles: Interoperability; Information Blocking

Share

New Articles: Interoperability; Information Blocking

Two new articles written by Dr. Noam Arzt, President of HLN, have been published in the most recent (Fall 2015 - just published now) issue of the HIMSS Journal of Health Informatio ...

Two new articles written by Dr. Noam Arzt, President of HLN, have been published in the most recent (Fall 2015 – just published now) issue of the HIMSS Journal of Health Information Management:

  1. The Interoperability of Things is an essay about the state of health data interoperability in the US and it grew largely out Dr. Arzt’s experience working on the ONC Nationwide Interoperability Roadmap.
  2. Fighting Information Blocking in the Emerging Learning Health System is a feature article offering perspectives on the emerging issue of “information blocking.”

Reflecting on Past Technology Predictions

Share

Reflecting on Past Technology Predictions

I recently came upon two pieces I had written on technology trends in the distant past. The first was written for the strategic technology plan of a major US research university. I ...

I recently came upon two pieces I had written on technology trends in the distant past. The first was written for the strategic technology plan of a major US research university. I wrote this piece based on a set of campus forums, vendor presentations, literature review, and just pure speculation. One of my favorite lines: “While it’s too soon to tell how the race to wire America will end, it’s possible that we’ll all be watching our telephones and answering our televisions by the end of the decade as the boundaries between phones, TVs, and computers begin to disintegrate.” That was in 1993.