In the summer of 2011, nearly 800 public health and informatics professionals from across the country convened in Atlanta for the Public Health Informatics 2011 conference. 

Around the conference, NewPublicHealth spoke with Farzad Mostashari, M.D., S.c.M., Director of the Office of the National Coordinator for Health Information Technology in the U.S. Department of Health and Human Services, to get his perspective on how health information technology can impact public health, and how the public health informatics field is evolving.

NewPublicHealth: The Public Health Informatics Conference is coming up this month. For those who aren't familiar with the field, what exactly is public health informatics?

Dr. Mostashari: I think that I’m a little bit of a student of public health informatics myself, and an avid follower. In the early days it was about building better systems – disease surveillance and outbreak detection systems. The second phase was building the connection between those systems and clinical systems, and using clinical information systems as primary data sources for public health. The third stage is about how public health informatics systems can embed within them a public health consciousness. I think about having a Tom Frieden [Director of the Centers for Disease Control and Prevention (CDC)] on the left shoulder of every physician to help inform clinical decisions from a public health perspective, as enabled by health information technology.

NPH: What is the role of the Office of the National Coordinator (ONC) in advancing public health informatics?

The National Conference on Health Communication, Marketing and Media kicked off in Atlanta, GA this week with more than a thousand health communicators, public health researchers, and practitioners from all levels of government and private sectors. With a heavy focus on digital and social media, the conference is exploring how these tools can be leveraged to improve health.

One session today focused on the different ways social media can be used strategically – and opportunities for improvement. Rosemary Thackeray, PhD, MPH, from the Department of Health Science at Brigham Young University, discussed a study on how state health departments across the country are using social media.

The study included a content analysis of state health department social media platforms, identified through the National Public Health Information Coalition from February through March 2011. Thackeray said the objective was to determine how social media was being used, and whether social media was simply one more channel to distribute the same kind of information.

The findings? 27 states are using Twitter; 17 have hopped on Facebook; and just 4 are using photo-sharing social site Flickr.

Creating an agenda on your smart phone? An app development challenge? Using Twitter feeds as study data? All this and more was highlighted at the opening day of the AcademyHealth Annual Research meeting yesterday in Seattle.

Embracing innovation in approach and technology was a key focus of AcademyHealth CEO and President Dr. Simpson’s opening remarks to the meeting attendees.

“While AcademyHealth and the field we represent enjoy broad support and respect among those who know us well, there remain significant opportunities to educate policymakers about the work we do and its impact,” Dr. Simpson said.

Strategies to achieve this impact, said Dr. Simpson, include remaining relevant by embracing innovations and new opportunities.

The keynote speaker for the opening session was Molly Coye, M.D, M.P.H., Chief Innovation Officer at the UCLA Health System. Coye said new technologies are important because they support engagement, not just dissemination.

A key example she noted was an observational study conducted by patient members of a community called PatientsLikeMe. Following publication of a small study showing that lithium might slow down symptoms of ALS, patient members created their own observational trial to see if the drug would help them.

Although they weren’t able to replicate the earlier study results, the PatientsLikeMe data was published in Nature Biology, a peer-reviewed journal. Said Coye: “This has the potential to change who pays for research – prompting industry, foundations and providers who need information to support it and to generate new tools and sources of information.”

Are you at AcademyHealth's Annual Research Meeting? Follow the Twitter conversation at #ARM11.

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Health: There's an app for that.

Technology, data, and innovative health apps will be the focus Thursday, June 9, when the Department of Health and Human Services and the Institute of Medicine hold the second annual Health Data Initiative Forum. The Forum, held at the National Institutes for Health in Bethesda, Maryland, will bring together more than 500 people to showcase how health data can create tools and applications to support more informed decision-making by consumers, patients, health care systems and community officials. NewPublicHealth spoke with Todd Park, Chief Technology Officer at HHS, about the forum.

NewPublicHealth: How is the conference different this year?

Todd Park: A year’s time makes a substantial difference in turn out. There has been a lot more activity as the ecosystem of innovation has grown. First of all, HHS and partner agencies of the federal government have been liberating broader and broader swaths of data. For example, last year the data was really oriented toward community health performance and quality. The kinds of data that are going to be demonstrated on Thursday as incorporated into solutions on how to improve health and health care--it’s much more diverse, much broader--a deeper array of data than last year. And the range of solutions that are going to be demonstrated and discussed are similarly much more diverse and broader and deeper just because an additional year has passed.

NPH: What are examples of government data that is available for use now?

Todd Park: I’ll start with community health data. We launched something called the Health Indicators Warehouse. It was launched in February of this year. It’s a website that contains national, state, regional, and local community health and health care performance metrics, as well as drivers of health. For example, smoking rates, obesity rates, rates of access to healthy food. It includes over 150 Medicare indicators of prevalence of disease, utilization of services, quality and prevention at the community level, which Medicare has never released before.

NPH: The County Health Rankings make use of government data to compile their rankings. How has this project demonstrated how government data can be used to improve community health?

Todd Park: I think the County Health Rankings is one of the best applications of government data to help mobilize action and improve health performance. The stories I’m hearing about communities gaining additional awareness of their health performance through the rankings and mobilizing local action to improve health have been absolutely terrific.

NPH: What is a new data tool you’d like to highlight?

Todd Park: Another type of data that we actually are liberating is provider directory and quality data. iTriage was an app that was part of last year’s forum. It’s a really cool mobile and web app that helps users research medical situations and find providers. Last year for the forum, they integrated community health centered data that we had made newly downloadable and it was incorporated into the app so community health centers started popping up as options. And thousands of iTriage users have found community health centers through the app as a result. The idea is that instead of making people jump out of their work flow to go to another web site entirely, bring the data to a platform where people already are searching for health information. It strikes me as a much more effective way to do this. And iTriage this year is going to be demonstrating the incorporation of mental health provider data into their platform.

NPH: What else would you point to?

Todd Park: There are going to be over 45 applications demonstrated at the Forum. And there were many more that we would have liked to fit in--we just literally didn’t have the room, [like]:

* Finding healthy food in a food desert

* Clinical trials based on location

* Applications that help providers find and communicate securely with other providers

* Apps that help local leaders--like mayors and county commissioners make better informed decisions

NPH: How is the government-generated health data used beyond apps?

Todd Park: Healthdata.gov is the site that we launched in February that is the universal inventory of all the data that we’re making publicly available. On healthdata.gov, there is an apps expo run by health 2.0, which showcases a growing array of examples of applications that leverage health data to do useful things. The health data is going everywhere. It’s going into a lot of the apps in the app stores, on smart phones. But, it’s also going into services, products, and programs that are just really diverse, and being harnessed by innovators in ways that are very powerful and very subtle. It is making products and services more effective with better data to help do a better job of helping patients and consumers and doctors and employers and millions of other folks who can benefit.

NPH: Where is a place where a public health department might find applications or new technologies that would help them improve the delivery service or information retrieval to an entire community?

Todd Park: There are actually going to be apps and services on Thursday along those lines as well. For example, there’s an application service called Network of Care for healthy communities. It’s a service that can set up a public website for any community that allows citizens to easily see where they are in terms of health status on key indicators versus where they wanted to be. They can find out what other communities are doing to help improve performance on that particular indicator. The web site also makes resources available online to individuals who are looking for help on particular health issues. And ESRI is going to be debuting a new tool called Community Analyst, which is also meant for people looking at health at the community level.

Read previous NewPublicHealth.org Q&As with newsmakers and difference makers in public health.

How healthy is your smartphone?

There are thousands of health apps available on the market. A few free ones from national public health organizations are definitely worth checking out:

• An American Association of Poison Control Centers app that links users to a local poison control center (currently available on iPhone only, but in development for Android, Blackberry and Windows-based smartphones).
• An NYC Condom Finder app, from the New York City Department of Health and Mental Hygiene, that helps reduce the spread of sexually transmitted diseases by showing users the nearest place to get free condoms (available for iPhone and iPad).
• An app from the American Heart Association that lets users find and track walking paths (available for Android, coming soon for iPhone).
• UPDATED: A commenter let us know about the Harvard Public Health School app: "With the HSPH Public Health News app members of the Harvard School of Public Health community and others can connect with each other and stay up-to-date on breaking public health news and research, plus events and activities going on around the School." Great addition!
• UPDATED: The CDC is engaging the public health community to come up with an app that promotes healthy behaviors to help prevent the flu. The agency has launched the CDC Flu App Challenge, which closes May 27th. The CDC will be giving out $35,000 in prizes for the most innovative apps that use CDC flu data. Winners will be announced on June 8.

Though it will take time to determine what sort of health apps are most effective, health organizations will definitely continue to develop the smartphone tools, says Lorien Abroms, Sc.D., an assistant professor at the School of Public Health and Health Services at George Washington University in Washington, D.C.

Abroms recently published a study in the American Journal of Preventive Medicine that reviewed 47 smoking cessation smartphone apps available two years ago on the iTunes app store. The study looked at how well the apps complied with the U.S. Public Health Service’s 2008 Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Most of the apps fell short. Three that complied with at least one guideline could not be recommended due to poor “ease of use” or poor breadth of content. But Abroms says she expects better-executed public health apps to make their way to the market soon.

Abroms offers criteria for judging public health apps:

• They should be developed from evidence-based guidelines for behavior change in that area (e.g., the U.S. Public Health Service Clinical Practice Guidelines)
• They should offer periodic messaging/alerts to guide behavior change (Abroms says that while we have little evidence about guiding behavior change with smartphone apps, through research on text messaging we know that periodic messages can help with smoking cessation, weight loss and diabetes management)
• The app should offer the opportunity to get social support for behavior change
• If possible, the apps should provide links to other proven services (e.g. a quitline)

Weigh In: What's your favorite public health app? Tell us in the comments.