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.