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Public health informatics : designing for change

Public Health Informatics: Positioning Within an Informatics Framework Public Health Within an Informatics Framework Our Point of Departure A Historical Overview of Developments in Computer Science and Informatics A note on terminology Computer science and informatics A historical overview of developments in health informatics Health informatics developments in high-income countries Health Informatics Developments in Low and Middle-Income Countries Summarizing Trends in Informatics and Health Informatics Primary orientation towards health and medical informatics Strongly positivistic orientation towards practice and academics of health informatics Neglect of informatics for primary healthcare systems in rich countries Neglect of low and middle-income countries in the study of health informatics evolution A Case For a More Expanded Public Health Informatics Focus in Low and Middle-Income Countries Conclusions References Understanding Public Health Informatics in Context of Health in Low and Middle-Income Countries Public Health Informatics in the Context of Health in Low and Middle-Income Countries Defining Public Health Public Health and Primary Healthcare A Health Systems Understanding of Public Health Information Needs of Public Health Systems: Transcending Primary and Medical Care Domains Understanding Health Status: Sourcing Real Time Morbidity and Mortality Data Measuring Health Coverage: Data on Service Delivery and Organization of Services On the Nature of Population-based Information Systems and Health Services Information for Health Governance and Public Health Management: Cross-cutting Health Systems-based Analysis Public Health as Never Before: 'Health in All'The Interface with Clinical Informatics For creating a continuum between clinical and population-based approaches For ease of recording For continuity of care For assuring access to care For ensuring patient rights and autonomy in clinical care Evolution and Path Dependence of Public Health Informatics Origins in monitoring vertical programmes and health sector reforms Origins in building primary care systems Origins in insurance-based systems—mainly in developed nations Establishing Principles of Design for the 'Expanded PHI' Approach for Low and Middle-Income Countries Multidisciplinary and systems-based approaches Building open architectures—not stand-alone systems Multidisciplinary—certainly, but with public health at its core Contextualization Plurality of methods for development with action research at the core Conclusions References The 'Information-Use Problematic' in Health Information Systems The 'Use of Information' Problematic in General Use of information in health Analysing the case: Understanding information needs and systems design Data Quality Issues: Beyond False Reporting Learnings from the Himachal case study Learnings from the Zanzibar case study The Politics of Information Use: Beyond Traditional Rationalities The Way Forward: How the Expanded PHI Approach Engages with the Use of Information Problematic References The Challenge of Integration: (In)adequacy of Technical Solutions to Institutional Challenges Integration in Public Health Informatics The Problematic of Integration The Why (or not) of Integration National integration efforts in India Primary Health Centre Online System Institutional Service Monitoring Report Pregnancy and Infant Cohort Monitoring System of Tamilnadu Hospital Information System in Tamilnadu's public hospitals Learnings from the case studies The How of Integration: Modern Efforts of the Open Health Information Exchange What is the Open Health Information Exchange?Health interoperability layer Point of service applications Learnings from the case study Contemporary Global Integration Priorities and Approaches to Address Them Integration of parallel systems into the national health management information system Integrating community health data with the national health management information system Developing standardized dashboards linked to guidance and training material Integrating patient-based and aggregate data to support continuity of care Developing and implementing case-based mortality reporting Developing and implementing tracking systems for case-based disease surveillance Developing and implementing tracking systems for case-based malaria control Integrating logistics and drug management in district health information systems and health management information systems Developing a facility register combined with an infrastructure dashboard and access system The Way Forward: Informed by an Expanded PHI Approach Understanding the different whys and wherefores of integration Adopting evolutionary approaches for flexible integration Adopting bottom-up design supported by good governance for integration Allowing for time to embed integration solutions Conclusions References Decentralized Information Use: Are The Cloud and Big Data Supporting This?The Cloud, Big Data, and Data Analytics What is Cloud Computing?Defnition and components of cloud computing Deployment models Private cloud Community cloud Public cloud Hybrid cloud Technical configurations and business models Cloud Infrastructure for Health in Low and Middle-Income Countries: Becoming Increasingly 'Autonomous'?Cloud Infrastructure: Moving from 'Closer to Machine' Applications to Further Away Leveraging Cloud Infrastructure: Health Applications in Low and Middle-Income Countries Reflecting on Paradoxes of the Cloud and Local Use of Data Cloud Infrastructure: Leveraging Big Data and Bigger Expectations Big data possibilities in low and middle-income countries Challenges and Opportunities for Health in Low and Middle-Income Countries Key challenges Privacy and security Ownership Epistemological dilemmas Infrastructure Capacity strengthening Key opportunities Supporting transitions in models of healthcare delivery Addressing the challenge of scale Ability to access low-cost and community-based software solutions Enabling more effective surveillance of diseases Inductive Building of Design Principles: Use of the Cloud in Low and Middle-Income Countries Enable a more sensitized engagement of development partners Build mutual synergies between national health information systems and cloud initiatives Support the establishment of cloud and data science expertise in low and middle-income countries Build regulatory frameworks to protect ethical and legal issues References Institutions as Barriers and Facilitators of Health Information Systems Reform The Need to Describe the Institutional Perspective Building an Institutional Perspective to Understand Expanded PHI An introduction to the institutional perspective From a macro-institutional perspective A micro-level institutional perspective Institutions in Which Health Information Systems Are Embedded The logic of healthcare institutions The logic of healthcare information management The institution of procurement: A key constraint to health management information systems reform The logic of public health decision-making institutions The logic of donor institutions Design Principles for Building Institutions to Support Expanded PHI Treat information and communications technologies' introduction and use as a process of negotiation Enable incentives from the system for all Redefine rules of procurement Decentralized systems are more effective than centralized ones References Complexity and Public Health Informatics in Low and Middle-Income Countries Defining Complexity Understanding complexity in low and middle-income countries Complexity and Fragmentation in Health Information Systems Analytical concepts Informality and Fuzzy Complexity in Public Health Information Systems and Low and Middle-Income Countries Formalization and general development From a Stand-Alone System to Central Server and the Cloud Data Quality and Data Access in the New System DHIMS 2 as Attractor for Change Formalization in medicine and public health Data quality and population-based systems Models of Complexity, Big Data, and Service Big data and service models A model for analysing complexity The context-sensitive versus context-free dichotomy The more or less networked and interdependent dichotomy Outsourcing of services from the south to the north Examples from the Gambia and Uganda Complexity: Can health data and systems be black-boxed in service models?Concluding remarks on black-boxing services and big data Approaches to Handling Complexity in Public Health Information Systems in Low and Middle-Income Countries References Measuring Progress Towards Universal Health Coverage and Post-2015 Sustainable Development Goals: The Informational Challenges Introduction: Scope of Contemporary Informational Challenges Understanding Universal Health Coverage: Implications for Information Support Origins and definition Current discourses on universal health coverage in the global health community and its relation to providing information support Measurement of universal health coverage Health informatics-related challenges Measuring service coverage on the x-axis Measuring financial protection on the y-axis Measuring the Post-2015 Sustainable Development Goals Health Data Collaborative—International Partnership for Health Information and Tracking Health-related Sustainable Development Goals Data Sources Existing situation Rethinking and restructuring data sources Household surveys Primary healthcare data Hospital-related data Reporting morbidity and mortality Enabling continuity of care Supporting purchase of care Civil registration and vital statistics Aligning Information Flows: The Architecture Problematic The centralized electronic health record approach Thinking about alternative architecture Conclusion References Health Information Systems Governance and Standards: The Challenges of Implementation Defining Governance Health governance and IT governance Governance as power and politics Governance in Public Health Informatics The Political Economy of Standards Governance of IT standards Standards for IT Governance Learnings from the Philippines case study Creating New Institutions Origins Triggers and Pain Points Adopting an IT Governance Framework Expert Groups Other Expert Groups Data Sharing Agreements Monitoring and Evaluation Bottom-up Governance Conclusion References Strengthening Healthcare Systems and Health Information Systems: Building Synergies Introduction Health Reforms and Potential Implications on National Health Information Systems The path to universal health coverage Improvement of civil registration and vital statistics systems Accelerating the Expanded Programme on Immunization to meet global and regional targets Saving the lives of mothers and children Monitoring the core set of indicators Health information systems challenges with health in the post-2015 development agenda UN political declaration on prevention and control of non-communicable diseases Complying with International Health Regulations (2005)Health systems strengthening in countries Measurement and accountability Interdependence and Synergies: Health Sector Reform and Reform of National/Public Health Information Systems Moving Forward: At the Level of Policy, Academics, and Practice Creating an enabling policy environment to guide health information systems development Data policy Widening the scope and content of information dissemination Human resources policies and capacity development Implications for research and academia: Establishing theoretical foundations for Expanded PHI Formulating research challenges around Expanded PHI Choice of technology and innovation Institutions of governance Guiding theoretical approaches Guiding methodological approaches Establishing communities of practice and activist networks Conclusion References

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