Public Health Informatics and Information Systems

Public Health Informatics and Information Systems

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Editors J.A. Magnuson, PhD Department of Medical Informatics and Clinical Epidemiology Oregon Health and Science University Portland, OR USA

Paul C. Fu, Jr., MD, MPH Pediatrics Department Health and Policy and Management Los Angeles County Harbor-UCLA Medical Center David Geffen School of Medicine at UCLA UCLA Fielding School of Public Health Torrance , CA USA

As a medical student in the early 1980s, I was rather scandalized to discover that my required textbook of medicine did not provide standard treatment protocols for even the most common of medical conditions. What good is a textbook, I asked myself, if it does not provide even this most basic treatment information? The textbook in question was the (then) current edition of the Principles and Practices of Medicine , originally published by William Osler in 1892 and continually updated by Johns Hopkins University School of Medicine faculty in many editions to this day. In suc- ceeding years, of course, I came to realize that fi eld-encompassing textbooks cannot and should not be concerned with the specifi c treatments and protocols of the day, but rather – as Osler understood – the principles and practices that perennially defi ne the fi eld from generation to generation. This is similarly the essence and focus of this, the second edition of this public health informatics textbook: the principles and practices that defi ne and shape this growing and exciting discipline.

Having said that, there is a reason why Osler’s venerable textbook has been updated through dozens of editions and an ever-changing cast of editors: the chal- lenges and context for a discipline, whether medicine or public health informatics, are ever-changing, and textbooks that seek to guide, inform, and inspire new stu- dents of a given discipline must change likewise.

The fi rst edition of Public Health Informatics and Information Systems [1] was begun as a straightforward compendium of key public health–relevant information systems: mortality and natality data systems, survey-based systems (like the Behavioral Risk Factor Surveillance System), and so forth. But the editors quickly came to feel that a more comprehensive focus on informatics was needed, for two primary reasons: (1) the burgeoning information age presented the fi eld of public health with extraordi- nary and unprecedented opportunities to improve its effi ciency and effectiveness, and even to revolutionize the ways in which public health itself was practiced; and (2) an absence of familiarity with the basic tenets of informatics had led, and would inevita- bly lead in the future, to costly (and sadly predictable) failures to develop effective, integrated, and sustainable new information system applications for public health.


With this in mind, the project evolved into what would become the fi rst American public health informatics textbook, and its fi rst edition was expanded to include a broad presentation of the principals and practices, as well as the context and basic science, of



public health informatics. To be sure, the major information systems in general use by public health professionals were described and explained. But two concluding parts of the book were included, to describe then-emerging information systems and chal- lenges; and to illustrate through a diverse series of case studies the kinds of value that were being accrued through public health information system development, as well as the special challenges that the development of these systems often entailed. Through these case studies, undergirded by the material that preceded them, the essential prin- ciples and practices of public health informatics were illustrated in real-world terms.

This second edition, developed by JA Magnuson and Paul Fu, Jr., continues this focus and tradition. The basic sections of the original textbook have been preserved, providing the student with the context and science of public health informatics; descriptions of key public health information systems; overviews of new challenges and emerging systems; and a series of illustrative case studies. The material in every section has been enormously updated, however, to refl ect astonishingly rapid advances in information technology as well as profound changes in the societal and legislative context for both healthcare and public health.

By way of illustration, consider that when the fi rst edition was published in 2003, social media and social networking applications were essentially unknown. Facebook © , for example, was not launched until 2004. Yet as of September 2012, Facebook © had over one billion active users—roughly one-seventh of the entire global population (and a much higher proportion in developed countries). Consider also that the US Patient Protection and Affordable Care Act was only signed into law in March 2010 (roughly 3 years ago at this writing), and will not take full effect until 2014. Yet this game-changing legislation is already altering the landscape for healthcare in ways that powerfully promote truly health- oriented (as opposed to procedure-oriented) healthcare. By highlighting the importance of prevention—in fi nancial as well as ethical terms—the Act also promotes closer con- nections and collaboration between the healthcare and public health sectors.

These and many other rapid technological and societal developments present today’s informatics professionals with enormous, unprecedented opportunities to apply information science and technology in innovative ways to promote the pub- lic’s health. There has never been a better time to exert passionate and creative lead- ership to improve existing systems of prevention and public health, and to invent new and yet-undreamt-of approaches to promote human health and well-being.

With that, let me invite the student of public health informatics to take full advan- tage of the information and guidance in this textbook to ignite your passion and develop your creative informatics leadership; and let me congratulate the editors on this much-improved second edition.