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Emerging Methods in Public Health
Informatics: Addressing the
Collaboration Gap
Susanne Jul, Ph.D.
Robert Kirkpatrick
Judith Kleinberg
Dennis Israelski, M.D.
Eric Rasmussen, M.D., MDM, FACP
Summary
In Cambodia, a poor country in a region
vulnerable to potential pandemic-producing
outbreaks (H5N1, SARS), baseline health
surveillance circa 2008 begins with village health
workers collecting data from local village elders
and using this data to compile reports. Next, the
health workers travel by bicycle or boat to a
district clinic to transcribe the reports, which the
clinic then sends to the provincial medical office
via high-frequency radio. Here, a clerk who barely
knows English enters the reports into WHO’s
EWARN database in English. The information is
then fed by EWARN to the country’s health
ministry using modems on dial-up land line
phones over a computer system powered part of
the time by car batteries.
This system is technically fragile, prone to
transcription errors, and time- and labor-
intensive. It requires knowledge of at least two
languages (Khmer and English), and offers little
opportunity for feedback.
We can do better.
InSTEDD’s work is currently focused on
Cambodia, but the technologies and system
architecture described in this white paper for
developing a more effective approach to health
surveillance in a country with extremely limited
resources can be adapted almost anywhere.
Indeed, only when surveillance systems are
technologically harmonized to allow for timely
data analysis will the goal of predicting and
preventing global public health crises be realized.
Public Health Informatics (PHI) is an umbrella
term for technologies and methods to improve the
sensitivity, specificity and speed at which health
threats are identified. There are four main
components to PHI: discovery, analysis,
decision-making and collection action.
It is a collaborative effort. Success depends just
as much on socio-cultural factors as it does on
technologies. S