Center of Excellence
As part of a $27 million Mayoral initiative to improve the quality and efficiency of health care in NYC, the Primary Care Information Project (PCIP) has been established to support the adoption and use of prevention-oriented EHRs primarily among providers who care for the city's underserved and vulnerable populations.
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Overview
The New York City Center of Excellence in Public Health Informatics is a collaborative effort led by the New York City Department of Health and Mental Hygiene (DOHMH) and supported by the Columbia University Department of Biomedical Informatics (DBMI) and the Institute for Urban Family Health (IUFH), a network of Federally Qualified Health Centers. This Center is distinguished by virtue of its public health leadership and mission, in addition to scientific rigor and depth.
The unifying scientific theme of our Center for the next three years will be Using Health Information Technology to Meet Public Health Challenges. We shall focus especially on emerging public health threats such as bioterrorism, pandemic influenza, and antibiotic resistance, as well as existing health threats with the highest burden and/or preventability, such as chronic diseases, HIV, substance abuse and mental health. We will demonstrate the potential of information technology to transform public health capabilities through three perspectives- that of the patient/ consumer, the health care provider, and the public health practitioner.
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Goal
The overall goals of the Center are to develop, disseminate, and demonstrate:
- A Personal Health Record that incorporates public health priorities and cognitive research to empower patients in improving their preventive care.
- An electronic clinical decision support system that incorporates public health priorities and epidemiologic data to empower clinicians in providing better preventive and acute care.
- Electronic health information exchange from clinical information systems that improves public health surveillance of antibiotic resistance and emerging health issues.
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Key Projects
Project A. "The Model EHR for Public Health" Principal Investigators: Neil Calman, M.D. and Rita Kukafka DrPH, MA). This project will explore the feasibility and utility of incorporating public health priorities and epidemiologic data into clinical decision support tools. The setting will be the Institute for Urban Family Health, a Federally Qualified Health Center with 13 clinical sites, and a fully functional Electronic Health Record (EHR) from Epic Systems (Madison, Wisconsin), which serves approximately 70,000, predominantly low-income patients in Manhattan and the Bronx. Over the three year project cycle, we will evaluate the feasibility and effectiveness of implementing automated ambulatory clinical indicator reporting and clinical decision support tools for each of the 10 TCNY priority areas. We will also implement and evaluate the effectiveness of clinical decision supports informed by epidemiologic data, such as communitywide illness patterns (syndromic surveillance), local antibiotic resistance patterns (from Project 2), and age/gender/neighborhood- specific rates of smoking, problem drinking, and depression (from the Community Health Survey).
Project B. "Public Health Reporting" Principal Investigators: George Hripcsak, M.D., M.S., Hadi Makki, M.S. This project will assess the utility of structured and unstructured EHR data for syndromic surveillance using natural language processing, and will also build on the infrastructure developed for regional health information exchanges to pilot non-mandatory, deidentified public health reporting.
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