November 25, 2008 By Patrick Michels
After watching hurricanes blow in from the Gulf of Mexico for so many years, Houston officials had a good sense of how the city's land reacts. They knew which areas will flood first, how severely and for how long.
But when it came to predicting how the population will be affected, they knew their data could be better. One major concern was identifying the people who, for health reasons, would need extra help during an evacuation. "Having data for who lives where, in terms of their vulnerabilities, gives you the ability to plan ahead for the type and quantity of supplies, and craft the messages that we need to get out to those folks," said Frank Levy, bureau chief of Public Health Preparedness at the Houston Department of Health and Human Services.
Though the city had already set up an emergency registry system, few of Houston's at-risk residents were signed up. Officials learned quickly that mapping the city's human landscape would require a more active effort. It would take an understanding of the community resources that could encourage people to sign up for the registry, and it would require a scientifically sound method for projecting that data across the entire population.
To analyze the data, the city found the right institution for the job in a unique school on the city's southwest side that's devoted to improving the way information is collected, analyzed and shared. Emergency preparedness officials teamed with the University of Texas School of Health Information Sciences at Houston, the only school in the nation devoted entirely to biomedical informatics, the science of handling medical information.
Studying Medical Informatics
Improving Houston's evacuation registry became just one part of a broad public health initiative called HealthQuilt, run by one of the school's professors, Dr. Kim Dunn. Dunn's project is a public health application. Along with preparing the medical support system for disasters, the project also aims to improve the exchange of health information and bring more specialty health care to the public health sector through telemedicine.
A guiding principle at the school is strengthening the medical system by working at the intersection of several different fields. The school itself is grounded in engineering, biomedicine, computer science and cognitive science. The school's academics say the flexibility to incorporate each area to varying degrees and also branch out into other fields, when appropriate, is something not possible at other universities with less-independent medical information science programs.
"Medical informatics is a unique discipline that has a set of tools that can be used in all these contexts," said Dr. Jack W. Smith, the school's dean. "I think we're certainly pioneers in creating a school that tries to tackle data info and knowledge problems across all these disciplines -- biomedical discovery, health care and public health. Because of the entrepreneurial and forward-looking culture of Texas, it's not surprising that the first school of this type would be in Texas."
In the years since the school's founding in 1997, the tools used to gather biomedical data have progressed so much that organizing and interpreting those numbers has emerged as a key growth area in medical research. Smith cited the Human Genome Project -- which decoded the map of human DNA -- as a prime example of the wealth of data available to researchers. "That's a tremendous challenge to manage and take advantage of that information. Increasingly vast storehouses of this information are digital," Smith said.
Focusing on Electronic Records
At the same time, the school is engaged in projects to improve the way patients' information is stored and passed along between health-care providers -- a chain at times as inscrutable as the blueprint of a DNA molecule. Electronic medical records (EMR) are a big cause that's gaining traction nationwide. "It's
This Digital Communities white paper highlights discussions with IT officials in four counties that have adopted shared services models. Our aim was to learn about the obstacles these governments have faced when it comes to shared services and what it takes to overcome those roadblocks. We also spoke with several members of the IT industry who have thought long and hard about these issues. The paper offers some best practices for shared government-to-government services, but also points out challenges that government and industry still must overcome before this model gains widespread adoption.