2014.ISDS.Abstracts.Final.pdf


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ISDS 2014 Conference Abstracts

Public Health (PH) Preparedness: Improving Data 
Exchange for Monitoring PH Threats through Content 
Standardization

Nikolay Lipskiy*

CSELS/DHIS, CDC, Atlanta, GA, USA

Objective
The objective of this presentation is to evaluate progress in 

developing semantically interoperable content for PH systems that 
monitor PH threats. Also, it highlights potential solutions for improve 
standardization of those data exchanges.

Introduction
Effective PH information exchange depends on standardized data to 

ensure system-to-system interoperability and is a critical component 
of preparedness and response. The Common Ground Preparedness 
Framework (CGPF) was developed through a three-year collaboration 
of eight state and local health departments to define and categorize 
PH business processes related to preparedness to include prepare, 
manage, monitor, investigate, intervene and recover.  The CGPF may 
be used to prioritize standardization activities.[1] Monitoring, which 
is the crucial CGPF category for the entire PH preparedness business 
processes includes assessing population trends, and conducting 
surveillance.[2]. The author used the CCPF monitoring process as 
a basis for the comparison to determine those standards that aligned 
with these processes and identified any gaps in the standards. This 
assessment may help in better understanding content standardization 
for preparedness and areas for improvement.

Methods
The following four CGPF Monitoring business processes were 

analyzed in our study: Assess Population Trends and Patterns; Conduct 
Syndromic Surveillance; Conduct Notifiable Disease Surveillance and 
Conduct Environmental Surveillance [1]. The standardization needs 
for these processes were assessed against Public Health Information 
Network (PHIN) standards’ repository that contains 62 electronic 
data exchange standards [3] and 15 data classifications [4]. Based on 
CDC guidance [5] we made an assumption that the PHIN repositories 
reflect the landscape of existing PH standards implemented by CDC 
and partners’ PH systems. We assessed data elements, value sets and 
classifications that are included in standards against already defined 
content categories such as, patient information, encounter, health 
problems etc. [6] and content categories that support CGPF business 
processes.

Results
We found that the methodology used to assess the standards by 

specific business process and content categories was helpful for 
purposes of this study. It demonstrates that PHIN content standards 
supports standardization of all four business processes that comprise 
the CGPG PH threats Monitoring category. However, we observed 
differences in the level of content standardization of these processes 
as well as level of standardization for exchanging of data on patient- 
and population-levels. Specifically, Assess Population Trends and 
Patterns business process appeared to be on the lowest level of 
standardization. Existing content standards for the CGPF Monitoring 
category are primarily oriented for exchange of patient-level data. 
We found that the PHIN classifications effectively cover contents 

standardization needs for the CGPF PH threats Monitoring category. 
However, a level of a codification appeared to be different by content 
category. For example, existing standards do not provide guidance on 
mapping of ICD-9/10 codes to syndromes for conducting syndromic 
surveillance.

Conclusions
While progress towards content standardization for exchange of 

data for monitoring of PH threats exists, there are some gaps that 
become evident in this study approach. This study demonstrates that 
content standards for Monitoring PH threats at a patient-level are 
better defined than at population level.

Results of this study underline the importance of better coordination 
of data harmonization efforts between and within domains of PH 
knowledge.

Keywords
. Monitoring PH threats; Standardization of surveillance; Content 
standards

References

1. Gibson PJ, Theadore F, Jellison JB. The common ground preparedness 
framework: acomprehensive description of public health emergency 
preparedness. Am J Public Health, 2012; 102(4):633-642. http://www.
ncbi.nlm.nih.gov/pmc/articles/PMC3489381/

2. ISDS. Electronic Syndromic Surveillance Using Hospital Inpatient and 
Ambulatory Clinical Care Electronic Health Record Data. http://www.
syndromic.org/storage/ISDS_2012-MUse-Recommendations.pdf

3. PHIN. Data Interchange Standards. http://www.cdc.gov/phin/resources/
standards/data_interchange.html Assessed on 07/16/2014

4. PHIN. Classifications. http://www.cdc.gov/phin/resources/standards/
classifications.html

CDC. Public Health Preparedness Capabilities: National Standards for 
State and Local Planning, 2011. http://www.cdc.gov/phpr/capabilities/

5. HHS. HHS/ONC. Standards and Interoperability Framework. Data
Harmonization Profile. Version 2.0 http://wiki.siframework.org/
file/view/DataHarmonizationProfile_02132018.docx/428760522/
DataHarmonizationProfile_02132018.docx

*Nikolay Lipskiy

E-mail: dgz1@cdc.gov    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e36, 201