Public health systems have embraced health informatics and information technology as a potential transformational tool to improve real-time surveillance systems, communication, and sharing of information among various agencies. Global pandemic outbreaks like Zika and Ebola were quickly controlled due to electronic surveillance systems enabling efficient information access and exchange. However, there is the need for a more robust technology to enhance adequate epidemic forecasting, data sharing, and effective communication. The purpose of this review was to examine the use of informatics and information technology tools and its impact on public health delivery.
Method:
Investigators searched six electronic databases. These were MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Cochrane Database of Systematic Reviews, COMPENDEX, Scopus, and Academic Search Premier from January 2000 to 31 March 2016.
Results:
A total of 60 articles met the eligibility criteria for inclusion. These studies were organized into three areas as (1) definition of the term public health informatics; (2) type of public health surveillance systems and implications for public health; and (3) electronic surveillance systems functionality, capability, training, and challenges. Our analysis revealed that due to the growing expectations to provide real-time response and population-centered evidence-based public health in this information-driven age there has been a surge in informatics and information technology adoption. Education and training programs are now available to equip public health students and professionals with skills in public health informatics. However, obstacles including interoperability, data standardization, privacy, and technology transfer persist.
Conclusion:
Re-engineering the delivery of public health is necessary to meet the demands of the 21st century and beyond. To meet this expectation, public health must invest in workforce development and capacity through education and training in informatics.
YasnoffWAOverhageJMHumphreysBLet al. A national agenda for public health informatics. J Am Med Inform Assoc2001;8(6):535–45.
2.
Disease Control Priorities Project. Public health surveillance: the best weapon to avert epidemics. May2008. Available online at: http://dcp-3.org/dcp2/chapters.
Castillo-SalgadoC. Trends and directions of global public health surveillance. Epidemiol Rev2010;32:93–109.
5.
McHughMStaitiABFellandLE. How prepared are Americans for public health emergencies? Twelve communities weigh in. Health Aff2004;23(3):201–9.
6.
DuchinJS. US Public health preparedness for Zika and other threats remains vulnerable. Disaster Med Public Health Prep2016;10(2):298–9.
7.
HovengaEJS.Importance of achieving semantic interoperability for national Health Information Systems. Text & Context Nursing Journal2008;17(1):158-67. Available online at: http://www.scielo.br/pdf/tce/v17n1/18.pdf
8.
CoieraEHovengaE. Building a sustainable health system. Yearb Med Inform2007;2(1):11–8.
9.
HovengaEJS. Importance of achieving semantic interoperability for national health information systems. Texto Contexto Enfer2008;17(1):158–67.
10.
BellBDamonIJerniganDet al. Overview, control strategies, and lessons learned in the CDC response to the 2014–2016 Ebola epidemic. MMWR Suppl2016;65(3):4–11.
11.
KatehFNagbeTKietaAet al. Rapid response to Ebola outbreaks in remote areas – Liberia, July–November 2014. MMWR: Morbid Mortal W2015;64(7):188–92.
12.
WiddowsonM-A.Implementing an Ebola vaccine study – Sierra Leone. MMWR Suppl2016;65:98–106.
13.
BoomJADragsbaekACNelsonCS. The success of an immunization information system in the wake of Hurricane Katrina. Pediatrics2007;119(6):1213–7.
14.
BradleyCARolkaHWalkerDet al. BioSense: implementation of a national early event detection and situational awareness system. MMWR Morb Mortal Wkly Rep2005;54(Suppl):11–9.
15.
BravataDMMcDonaldKMSmithWMet al. Systematic review: surveillance systems for early detection of bioterrorism-related diseases. Ann Intern Med2004;140(11):910–22.
16.
BuckeridgeDLBurkomHCampbellMet al. Algorithms for rapid outbreak detection: a research synthesis. J Biomed Inform2005;38(2):99–113.
17.
BuckeridgeDLBurkomHMooreAet al. Evaluation of syndromic surveillance systems – design of an epidemic simulation model. MMWR: Morbid Mortal W2004;53(Suppl):137–43.
18.
BuehlerJWBerkelmanRLHartleyDMet al. Syndromic surveillance and bioterrorism-related epidemics. Emerg Infect Dis2003;9(10):1197–204.
19.
DerbyMPMcNallyJRanger-MooreJet al. Poison control center-based syndromic surveillance for foodborne illness. MMWR: Morbid Mortal W2005;54:35–40.
20.
DoyleTJMaHGrosecloseSLet al. PHSkb: a knowledgebase to support notifiable disease surveillance. BMC Med Inform Decis Mak2005;5:27.
21.
EspinoJUWagnerMMTsuiFCet al. The RODS Open Source Project: removing a barrier to syndromic surveillance. Stud Health Technol Inform2004;11(Pt 2):1192–6.
22.
FanCvan DijkAFernandoDet al. Automated mortality surveillance in south-eastern Ontario for pandemic influenza preparedness. Can J Public Health2010;101:459–63.
23.
FanSBlairCBrownAet al. A multi-function public health surveillance system and the lessons learned in its development: the Alberta Real Time Syndromic Surveillance Net. Can J Public Health2010;101:454–8.
24.
FlamandCFabregueMBringaySet al. Mining local climate data to assess spatiotemporal dengue fever epidemic patterns in French Guiana. J Am Med Inform Assoc2014;21(e2): e232–40.
25.
FlamandCQuenelPArdillonVet al. The epidemiologic surveillance of dengue-fever in French Guiana: when achievements trigger higher goals. Stud Health Technol Inform2010;169:629–33.
26.
FrickerRDJrRolkaH. Protecting against biological terrorism: statistical issues in electronic biosurveillance. Chance2006;19(4):4–14.
27.
GraberJMSmithAE. Results from a state-based surveillance system for carbon monoxide poisoning. Public Health Rep2007;122(2):145–54.
28.
HanrahanLPAndersonHABusbyBet al. Wisconsin’s environmental public health tracking network: information systems design for childhood cancer surveillance. Environ Health Perspect2004;112:1434–9.
29.
HeffernanRMostashariFDasDet al. New York City syndromic surveillance systems. MMWR: Morbid Mortal W2004;53Suppl:23–7.
30.
Heisey-GroveDMChurchDRHaneyGAet al. Enhancing surveillance for hepatitis C through public health informatics. Public Health Rep2011;126(1):13–8.
31.
HenaoOLJonesTFVugiaDJet al. Foodborne diseases active surveillance network – 2 decades of achievements, 1996–2015. Emerg Infect Dis2015;21:1529–36.
32.
HughesHEMorbeyRHughesTCet al. Emergency department syndromic surveillance providing early warning of seasonal respiratory activity in England. Epidemiol Infect2016;144(5):1052–64.
33.
Hurt-MullenKJCoberlyJ.Syndromic surveillance on the epidemiologist’s desktop: making sense of much data. MMWR: Morbid Mortal W2005;54(Suppl):141–6.
34.
HutwagnerMLThompsonMWSeemanGMet al. The bioterrorism preparedness and response early aberration reporting system (EARS). J Urban Health2003;80(1): i89–96.
35.
JosseranLCaillèreNBrun-NeyDet al. Syndromic surveillance and heat wave morbidity: a pilot study based on emergency departments in France. BMC Med Inform Decis Mak2009;9(1):1.
36.
KarrasBTO’CarrollPOberleMWet al. Development and evaluation of public health informatics at University of Washington. J Public Health Man2002;8(3):37–43.
37.
KooDO’CarrollPLaVentureM.Public health 101 for informaticians. J Am Med Inform Assoc2001;8(6):585–97.
38.
KrauseGAltmannDFaensenDet al. SurvNet electronic surveillance system for infectious disease outbreaks, Germany. Emerg Infect Dis2007;13(10):1548–55.
39.
KukafkaR. Public health informatics: the nature of the field and its relevance to health promotion practice. Health Promot Pract2005;6(1):23–8.
40.
KulldorffMZhangZHartmanJet al. Benchmark data and power calculations for evaluating disease outbreak detection methods. MMWR: Morbid Mortal W2004;53:144–51.
41.
LewisSHHoltryRSLoschenWAet al. The collaborative experience of creating the National Capital Region Disease Surveillance Network. J Public Health Manag Pract2011;17(3):248–54.
42.
LiangHXueY. Investigating public health emergency response information system initiatives in China. Int J Med Inform2004;73(9):675–85.
43.
LoberWBTriggLKarrasB. Information system architectures for syndromic surveillance. MMWR: Morbid Mortal W2004;53(Suppl):203–8.
44.
LombardoJSBurkomHPavlinJ. ESSENCE II and the framework for evaluating syndromic surveillance systems. MMWR: Morbid Mortal W2004;53:159–65.
45.
MandlKDOverhageJMWagnerMMet al. Implementing syndromic surveillance: a practical guide informed by the early experience. J Am Med Inform Assoc2004;11(2):141–50.
46.
MirhajiP. Public health surveillance meets translational informatics: a desiderata. J Assoc Lab Autom2009;14(3):157–70.
47.
MnatsakanyanZRLombardoJS. Decision support models for public health informatics. J Hopkins APL Tech D2008;27(4):332–9.
48.
NaumovaENO’NeilEMacNeillI. INFERNO: a system for early outbreak detection and signature forecasting. MMWR Morb Mortal Wkly Rep2005;54(Suppl):77–83.
49.
World Health Organization. Communicable disease surveillance and response systems: guide to monitoring and evaluating. Lyon: World Health Organization; 2006.
50.
OrtegaJAAVelazquezJGMRenlySRet al. Improving disease surveillance capabilities through a public health information affinity domain. Paper presented at 1st ACM International Health Informatics Symposium, IHI’10, Arlington, VA, 11–12 November 2010.
51.
ReederBHillsRADemirisGet al. Reusable design: a proposed approach to Public Health Informatics system design. BMC Public Health2011;11.
52.
ReisBYMandlKD. Time series modeling for syndromic surveillance. BMC Med Inform Decis Mak2003;3(1):2.
53.
SavelTHallKLeeBet al. A Public Health Grid (PHGrid): architecture and value proposition for 21st century public health. Int J Med Inform2010;79(7):523–9.
54.
ScotchMYipKYCheungKH. Development of grid-like applications for public health using Web 2.0 Mashup techniques. J Am Med Inform Assoc2008;15(6):783–6.
55.
SheaDAListerSA. The BioWatch program: detection of bioterrorism, 2003. Congressional Research Service Report No. RL 32152. Available online at: https://fas.org/sgp/crs/terror/RL32152.html.
56.
ShmueliGBurkomHS. Statistical challenges in modern biosurveillance. Technometrics2010;52(1):39–51.
Uscher-PinesLFarrellCLBabinSMet al. Framework for the development of response protocols for public health syndromic surveillance systems: case studies of 8 US states. Disaster Med Public Health Prep2009;3
(Suppl S1): S29–36.
64.
WagnerMMEspinoJTsuiFet al. Syndrome and outbreak detection using chief-complaint data – experience of the Real-Time Outbreak and Disease Surveillance Project. MMWR: Morbid Mortal W2004;53:28–31.
65.
WagnerMMTsuiF-CEspinoJet al. National retail data monitor for public health surveillance. MMWR: Morbid Mortal W2004;53:40–2.
66.
WilsonJMPolyakMGBlakeJWet al. A heuristic indication and warning staging model for detection and assessment of biological events. J Am Med Inform Assoc2008;15(2):158–71.
67.
XueYLiangH. Is-driven process reengineering: China’s public health emergency response to the SARS crisis. J Inform Technol Theory Appl2004;6(3):41–58.
68.
YanPChenHZengD. Syndromic surveillance systems. Annu Rev Inform Sci2008;42(1):425–95.
69.
YasnoffWAO’CarrollPWKooDet al. Public health informatics: improving and transforming public health in the information age. J Public Health Man2000;6(6):67–75.
YihWKDeshpandeSFullerCet al. Evaluating real-time syndromic surveillance signals from ambulatory care data in four states. Public Health Rep2010;125:111–20.
72.
FriedeABlumHLMcDonaldM. Public health informatics: how information-age technology can strengthen public health. Annu Rev Public Health1995;16(1):239–52.
73.
EdmundsMThorpeLSepulvedaMet al. The future of public health informatics: alternative scenarios and recommended strategies. eGEMs2014;2(4):1156.
74.
Organisation for Economic Co-operation and Development. Improving value in health care: measuring quality. Paris: Organisation for Economic Co-operation and Development; 2010.
75.
AndersonGFFrognerBKJohnsRAet al. Health care spending and use of information technology in OECD countries. Health Aff2006;25(3):819–31.
76.
HopeKDurrheimDNd’EspaignetETet al. Syndromic surveillance: is it a useful tool for local outbreak detection?J Epidemiol Commun H2006;60(5):374.
77.
Centers for Disease Control Prevention. Public health preparedness: strengthening CDC’s emergency response. Atlanta, GA: Centers for Disease Control Prevention; January2009.
78.
BerndtDJHevnerARStudnickiJ. Bioterrorism surveillance with real-time data warehousing. In: ChenHMirandaRZengDDet al. (eds). Intelligence and security informatics. Berlin: Springer; 2003, pp. 322–35.
79.
McKinneyWPWesleyGCSprangMVet al. Educating health professionals to respond to bioterrorism. Public Health Rep2005;120:42–47.
80.
SandtCHKrouseDACookCRet al. The key role of pulsed-field gel electrophoresis in investigation of a large multiserotype and multistate food-borne outbreak of salmonella infections centered in Pennsylvania. J Clin Microbiol2006;44(9):3208–12.
BrittainJMNorrisA. Delivery of health informatics education and training. Health Libr Rev2000;17(3):117–28.
83.
KukafkaRYasnoffWA. Public health informatics. J Biomed Inform2007;40(4):365–9.
84.
SavelTGFoldyS. The role of public health informatics in enhancing public health surveillance. MMWR Surveill Summ2012;61(Suppl):20–4.
85.
TominesAReadheadHReadheadAet al. Applications of electronic health information in public health: uses, opportunities & barriers. eGEMs2013;1(2):1019.
86.
NorrisABrittainJ. Education, training and the development of healthcare informatics. Health Inform J2000;6(4):189–95.
87.
WilliamsFBorenSA. The role of electronic medical record in care delivery in developing countries. Int J Inform Manage2008;28(6):503–7.
88.
WilliamsFBorenSA. The role of the electronic medical record (EMR) in care delivery development in developing countries: a systematic review. Inform Prim Care2008;16(2):139–45.
89.
KlinglerCSilvaDSSchuermannCet al. Ethical issues in public health surveillance: a systematic qualitative review. BMC Public Health2017;17(1):295.
90.
WinslowC-E.The untilled fields of public health. Science1920;51:23–33.
91.
LumpkinJR. History and significance of information systems and public health. New York: Springer; 2003.
92.
America IoMCoQoHCi. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press; 2001.
