Abstracts Health Sciences

Practice, Protocols and Innovation of Public Health DecisionSupport Systems that Advance Automated Disease Reporting

by Denisha N Abrams

Public health reporting is the cornerstone of disease surveillance and is a 'requisite for managing disease burden in a community'. In the United States, selected diseases and conditions must be reported to public health authorities by physicians, hospitals, laboratories and other reporters to control disease and outbreaks. The current process of disease reporting is a manual process, prone to human error and lack of knowledge of what is reportable. Each jurisdiction determines the 'who, what, when, where and how' of disease reporting, which is resource-intensive and scattered across documents and websites. The specifications associated with reportable events also vary by condition, which contributes to the complexity and management of changes that occur in reporting guidelines or clinical terminology standards. There is a need for national collaboration that looks towards interoperable standards and system development that can move disease reporting beyond its current state. Standard terminologies such as Logical Observation Identifiers Names and Codes (LOINC®) provide a building block to the data exchange between clinical care and public health. The development of public health decision systems that support automated disease reporting has some notable early adopters. The population of study includes three systems: Massachusetts Department of Health (MDPH) - Electronic Support for Public Health (ESP); Regenstrief Institute - Notifiable Condition Detector (NCD); and the Council of State and Territorial Epidemiologists (CSTE) - Reportable Conditions Knowledge Management System (RCKMS). The purpose of this research is to examine the practice of two locally developed public health decision support systems and compare their development protocols to a national prototype. A content analysis of the existing models will inform national efforts of how these systems work and the innovation behind their development. The reusability of what currently works shows that progress has been made but the associated gaps between local implementations and a national platform to automate disease reporting reveals a journey fraught with barriers to widespread adoption. Advisors/Committee Members: Conn, Laura (Committee Member), McGarvey, Sunanda R (Thesis Advisor).