A Public Health Grid: Accelerating the Interoperability of Information Systems for Public Health

Technologically, public health must move away from individual, independent software applications, separate databases without any form of interconnectedness and lock-in from traditional vendors selling software for solving complex domain problems. The Internet has clearly added a level of interconnectedness both socially and technically, but the Internet does not solve the larger public health computational and data sharing dilemmas. A Public Health Grid infrastructure would build upon the model of the Internet by providing the tooling and infrastructure necessary for application, data and computational interconnectedness and interoperability.

The public health community is always faced with financial challenges. From a budgetary perspective, contrary to historical and current practice with the development of a large-scale infrastructure, the intrinsically open and collaborative nature of this project facilitates highly efficient use of resources, thus minimizing required capital investments, and maximizing sustainability. By its very nature, this initiative provides a technology infrastructure which parallels the social initiative known as a "community of practice." This infrastructure is built upon a philosophy of distribution of effort and collaboration - not centralization and control. Although there are significant, and impressive health-related grid initiatives internationally, this technology has yet to be examined for implementation in the US public health system.

About You

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Location

Project Street Address

Project City

Project Province/State

Project Postal/Zip Code

Project Country

n/a

Your idea

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Focus of activity

Technology

Year the initiative began (yyyy)

2007

Positioning of your initiative on the mosaic diagram

Which of these barriers is the primary focus of your work?

Monopolies of knowledge

Which of the principles is the primary focus of your work?

Simplify through technology

If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:

Barrier: Data, Information, and Knowledge fragmentation. This initiative is focused on accelerating the ability of the public health community to improve its ability to exchange and share data, information, knowledge, and services, and do so using open, technology neutral, interoperable systems and standards.

Name Your Project

A Public Health Grid: Accelerating the Interoperability of Information Systems for Public Health

Describe Your Idea

Technologically, public health must move away from individual, independent software applications, separate databases without any form of interconnectedness and lock-in from traditional vendors selling software for solving complex domain problems. The Internet has clearly added a level of interconnectedness both socially and technically, but the Internet does not solve the larger public health computational and data sharing dilemmas. A Public Health Grid infrastructure would build upon the model of the Internet by providing the tooling and infrastructure necessary for application, data and computational interconnectedness and interoperability.
The public health community is always faced with financial challenges. From a budgetary perspective, contrary to historical and current practice with the development of a large-scale infrastructure, the intrinsically open and collaborative nature of this project facilitates highly efficient use of resources, thus minimizing required capital investments, and maximizing sustainability. By its very nature, this initiative provides a technology infrastructure which parallels the social initiative known as a "community of practice." This infrastructure is built upon a philosophy of distribution of effort and collaboration - not centralization and control. Although there are significant, and impressive health-related grid initiatives internationally, this technology has yet to be examined for implementation in the US public health system.

Innovation

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Define the innovation

Technologically, public health must move away from individual, independent software applications, separate databases without any form of interconnectedness and lock-in from traditional vendors selling software for solving complex domain problems. The Internet has clearly added a level of interconnectedness both socially and technically, but the Internet does not solve the larger public health computational and data sharing dilemmas. A Public Health Grid infrastructure would build upon the model of the Internet by providing the tooling and infrastructure necessary for application, data and computational interconnectedness and interoperability.

The public health community is always faced with financial challenges. From a budgetary perspective, contrary to historical and current practice with the development of a large-scale infrastructure, the intrinsically open and collaborative nature of this project facilitates highly efficient use of resources, thus minimizing required capital investments, and maximizing sustainability. By its very nature, this initiative provides a technology infrastructure which parallels the social initiative known as a "community of practice." This infrastructure is built upon a philosophy of distribution of effort and collaboration - not centralization and control. Although there are significant, and impressive health-related grid initiatives internationally, this technology has yet to be examined for implementation in the US public health system.

Context for Disruption:

Through the support of the US Centers for Disease Control and Prevention (CDC) significant achievements have been made in the Public Health Information Network (PHIN) initiative, in terms of the development of standards, requirements, and software applications; however, the challenge remains that public health community does not yet have a cohesive infrastructure that is multidirectional, distributed, inherently integrated, and scalable, as does the US cancer research community. This initative will build upon the award-winning achievements in the cancer domain from NIH—specifically known as the cancer biomedical informatics grid (caBIG™).

As a bit of background, this proposal focuses on a technology known as “grid”. Initially, grid technology development was driven by computing needs of the particle physics research community and enabled by the availability of high-performance computer networks. The term "grid" rapidly evolved toward a concept of ubiquitous and transparent computing to support a wide variety of applications, and builds on the well-known metaphor of the pervasive "electricity grid". Today, grid-related activities in the healthcare space represent some of the most innovative drivers for progress in knowledge-based ubiquitous and transparent computing. This activity is in complete harmony with, and builds upon, existing interconnectivity and interoperability standards being developed at the national / federal level (i.e., the Department of Health and Human Services (HHS) Office of the National Coordinator for Health IT (ONC), the Healthcare Information Technology Standards Panel (HITSP), and the American Health Information Community (AHIC)).

Delivery Model

A national public health grid could interconnect Public Health Departments, Regional Health Information Organizations (RHIO), healthcare providers, as well as federal agencies. Such a configuration would facilitate a grid of shared services based upon national standards, providing collaboration resources, semantic and syntactic data exchange, as well as computational and application resources. This rich computational environment would include a variety of services based upon a Service Oriented Architecture (SOA), an innovative architecture approach encouraged by the Department of Health and Human Services (HHS). A small sample of services that would become essential components in the Public Health Grid "toolkit" could include: Security Services, Architectural Services, Vocabulary Services, Analytical Services, Visualization Services, Search Services, Directory and Alerting Services, and Health Level 7 (HL7) Message Transformational Services.

These services would provide the necessary building blocks for all those involved in public health activities. As services on a Public Health Grid, they can be accessible by all grid participants (with proper authorization). As an example, a local public health epidemiologist in Attica, New York may use the same Period Prevalence Analytical Service that a CDC epidemiologist uses in Atlanta, Georgia; each supplying different sets of data yet utilizing the same statistical tool. A researcher at the University of Washington may run a query against public health data located within Washington, Oregon and Idaho to develop a tuberculosis outbreak simulation within these three states. Her research could be shared through the public health access grid with other researchers at other institutions throughout the country. The applications and capabilities are innumerable.

Key Operational Partnerships

Partners would be involved both inside and outside the Centers for Disease Control and Prevention. This includes federal partners (e.g., NIH), the Public Health Informatics Centers of Excellence (research) community, and the Public Health Information Network (PHIN) community – including public health partners such as National Association of County and City Health Officials (NACCHO), Association of State and Territorial Health Officials (ASTHO), Council of State and Territorial Epidemiologists (CSTE), Association of Public Health Laboratories (APHL), National Association for Public Health Statistics and Information Systems (NAPHSIS), National Association for Public Health Information Technology (NAPHIT), state and local health departments. In addition, the clinical heath community is a key partner as well. This includes Regional Health Information Organizations, Health Information Exchanges, hospital networks, hospitals, providers, as well as the health technology vendor community.

Impact

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Financial Model

Once this initial prototype has been tested and evaluated, the ongoing support should be achievable through a wide variety of sources including all the partners mentioned in the Key Operational Partnerships section above. Part of the mature funding of this initiative will be based on the well-established open-source, collaborative model.

What is your annual operating budget?

TBD

What are your current sources of revenue? (please list any sources that are foundation grants)

The National Center for Public Health Informatics is located within the US Centers for Disease Control and Prevention.

Effectiveness

This project is currently in the concept and investigation phase.

Which element of the program proved itself most effective?

TBD

Number of clients in the last year?

TBD

What is the potential demand?

A Public Health Grid can grow as fast or as slowly as the public health community requires – both inside and outside the agency. Most likely, it will develop first as a research activity with the Public Health Informatics Centers of Excellence community, and then gradually grow into an open collaborative effort involving the Public Health Information Network (PHIN) community – including public health partners such as National Association of County and City Health Officials (NACCHO), Association of State and Territorial Health Officials (ASTHO), Council of State and Territorial Epidemiologists (CSTE), Association of Public Health Laboratories (APHL), National Association for Public Health Statistics and Information Systems (NAPHSIS), National Association for Public Health Information Technology (NAPHIT), state and local health departments. As the public health system is working to exchange information with the clinical healthcare system, the number of partners will only increase over time (see Key Operational Partnerships section above).

Scaling up Strategy

The following broad activities will be required to move the Public Health Grid from research to practice, thus, building out and supporting of a nationwide public health grid infrastructure. This scaling will only take place once adequate research and evaluation has taken place.

1. Close collaboration and communication with NIH – to leverage best practices (people, processes, and technology);
2. Evaluate NIH's (i.e., caBIG) grid technologies and services to determine the degree to which existing sophisticated grid governance models can be leveraged;
3. Establish a Public Health Grid governance model (for coordination purposes);
4. Complete secondary gap analysis between the Public Health Information Network initiative, the Nationwide Health Information Network initiative and this Public Health Grid initiative;
5. Develop and implement a broad communications plan;
6. Foster Public Health Grid community of practice within the Pubic Health Information Network Community;
7. Successfully connect CDC-managed data sources to the Public Health Grid;
8. Launch Public Health Grid nodes throughout CDC, at other federal agencies, select state and local health departments, and state-wide Health Information Exchanges (HIEs);
9. Foster community-based development (via an open-source, open collaborative development process) of a suite of services for the Public Health Grid. Examples could include analytic and visualization services;
10. Modify CDC-developed applications and services to function on the Public Health Grid (e.g., outbreak management system, alerting and communication systems, countermeasure administration tracking, countermeasure inventory tracking);
11. Foster development of a consumer public health portal and alerting service on the Public Health Grid;
12. Successfully engage Electronic Health Record (EHR)/Personal Health Record (PHR) vendors to develop grid-enabled access to their systems-further enhancing public health-clinical system information exchange.

Stage of the initiative:

0

Expansion plan:

See Scaling up Strategy

Origin of the Initiative

Health-related grid activities are rapidly advancing in the US and abroad, and have resulted in the development of organizations, such as the HealthGrid.US (HG.US) alliance. This organization is a partnership of scientific, medical and technology professionals from academia, industry and government, whose shared mission is to promote the application of advanced information technology to solve cutting-edge problems in Biomedical Science and Healthcare.

This initiative would build upon the national and international HealthGrid initiatives as well as the activities of the National Institute of Health (NIH), to afford the public health community secure, comprehensive, and timely access to the data, information, knowledge, and services it needs to provide the greatest impact to the public's health.

This Entry is about (Issues)

Sustainability

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What are your two main challenges to finance the growth of your initiative

I truly do not see long-term financial challenges as the main challenges. From a budgetary perspective, contrary to historical and current practice with the development of a large-scale infrastructure, the intrinsically open and collaborative nature of this project facilitates highly efficient use of resources, thus minimizing required capital investments, and maximizing sustainability. Short-term funding is necessary to achieve initial critical Public Health community involvement.

How did you hear about this contest and what is your main incentive to participate?

I heard about this from a former CDC colleague who is currently at RWJ.

The Story

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Do you have an annual financial statement?

Annual CDC budget is available at www.cdc.gov

Do you currently have an annual financial statement that tracks profit/loss?

$500,000 (initial start-up research funding) and $5,000,000 (growth and maintenance - to scale nationally)

Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.

372 weeks ago Tara Bahait said: The CDC, along with the partners they have enlisted, seem like the ideal organization to set and manage the standards for universal ... about this Competition Entry. - read more >
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