Public Health Informatics and Information Systems

The use of information to guide public health practice extends back to John Graunt’s pioneering work in the 17th century. It has been only in the past 2 decades that dramatic advances in information technology, including the nearly universal access to computers, the immediacy of instantaneous global communications, and the capacity to manage vast amounts of information have brought new and powerful tools to the desks (and the airborne tray-tables) of the public health practitioner and managers. Advances have enabled major information systems to share information. Today, the management of electronic information now underlies nearly all aspects of public health practice, research, and policy development. A basic understanding of how the major information systems work is essential. Those who are unable to maneuver in the world of information and information technology become marginalized. The Institute of Medicines (IOM) 2002 report, The Future of the Public’s Health, declares the “emphasis on communication as a critical core competency of public health practice.” The companion IOM report, Who Will Keep the Public Healthy? Education of Public Health Professionals for the 21st Century, calls for informatics as a core area in graduate-level public health education. The present book is most timely. It builds on a prior initiative, duly cited in the book. In 1995, the Centers for Disease Control and Prevention and the University of Washington School of Public Health developed training materials in public health informatics, then a new field. This book is very much grounded in the specifics of the disciplines unique to public health, starting with its core functions, and admirably fills an important niche that is not otherwise addressed, such as the literature on medical informatics. Public health informatics is defined in the opening chapter as “the systematic application of information and computer science and technology to public health practice, research and learning.” The book is organized into five parts: The Context for Public Health Informatics; The Science of Public Health Informatics; Key Public Health Information Systems; New Challenges, Emerging Systems; and Case Studies: Applications of Information Systems Development. Examples of covered topics include the historical roots of public health informatics, the public health framework, the legislative context, information systems in the contexts of organization, systems management, program development, critical competency areas, data standards, privacy, confidentiality, and ethics. Also included are descriptions of the major data systems presently in use as well as newly emerging applications in such areas as surveillance, registries, networking, and international health. Sixty authors have contributed to the book’s 34 well-referenced chapters. The editors have done a creditable job in smoothing differences in writing styles and in providing coherence, flow, and internal crossreferences, which keeps repetitions to an acceptable level. Most chapters move into their subject matter deliberately, so that the material becomes readily accessible for the informatics novice. The formatting is excellent, with clear section and subsection headings that allow for self-pacing through areas of greater or lesser interest. People already comfortable in the world of informatics will be able to move quickly across the breadth of topics to areas of specific interest. The book serves best as an overall introduction and orientation to the field for the student or those in careers who feel overtaken, bewildered, or intimidated by the explosion of information technology. The presentation is not at all technical. Rather, the book lays out the conceptual breadth of the field, showing how the pieces fit together and are used across the many aspects of public health. Readers new to informatics will find elements that are familiar, and will learn how these fit in a broader context of basic concepts, components of a system, issues, opportunities, and limitations. Hoping to be of benefit in the classroom, each chapter starts with a brief list of learning objectives and closes with questions for review. (The publisher provides a separate instructor’s manual, retrievable in portable document format [pdf] online.) While well indexed, the book does not work particularly well as an off-the-shelf reference. This is an important book that can serve a wide audience, including public health practitioners and managers as well as students and teachers. Even the experienced information technologist will benefit from its clear framing of issues around the principles of public health and the contexts of public health practice.