Information Architecture

Abstract

Public health information today is spread across many programs, most with their own method for identifying people and related data elements, a program-level data model, nonstandard vocabulary, program specific vertical workflow, and customized reports. A single office may use multiple processes to manage workflow information, including paper, fax, spreadsheets, electronic documents, and proprietary databases. If needed data resides in another database silo, the process may include a custom interface that then must be maintained as another step in the process to capture and manage public health information.

These disparate data silos translate to fragmented and redundant public health data and workflow and the inability to present a complete picture of an individual or population, further distancing care coordination and the achievement of best outcomes. An effective information architecture must address the issue of interoperability between data silos and serve as a guide for transitioning to shared data and optimized workflow. A shared data model using standards-based metadata tags and attributes is the best option for public health to begin this transition.

Adopting a shared metadata model enables exchange of information with other standards-based systems, such as electronic health records, without redundant data entry. It enables care to be coordinated across programs and agencies according to best practice evidence and reinforced with alerts and reminders to individuals and providers. A shared metadata model is extensible to other disciplines in the public sector, such as education and child welfare, by populating the model with content from those domains. Standard terminology practices are facilitated and the model becomes scalable to large populations. Given public health funding and workload realities, moving toward a shared metadata model will occur in a phased approach with programs joining the process over time, and according to priority assigned by a governance body of stakeholders.