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The Public Health Information Affinity Domain


Leveraging the same technology IBM used to deliver a prototype Healthcare Information Exchange for a Clinical Affinity Domain, PHIAD is an Standards based information exchange for public health. A standard electronic health record (EHR) will be the foundation for any solution to successfully ensure access to health care and control spiraling costs. Just as a Health Information Exchange can help physicians and patients to gather clinical data across silos, it can also help public health officials protect entire populations. By state law, laboratories and a broad array of health care providers must report notifiable diseases to their local health department; yet reporting tends to be overlooked or an added burden on clinical caregivers because it is done through an independent, and often manual, process.

Diseases do not stop at borders, nor do they recognize the physical or institutional boundaries established by people. PHIAD is designed to support international disease surveillance. The system is based on the premise that the SAME standards required to support patient health records can also support the needs of public health. The world needs one information network for healthcare (and not two). The PHIAD project demonstrates that by connecting the silos of information that exist in healthcare today, we can improve disease detection and patient care. The technology, standards and privacy protecting tools required for a secure "healthcare internet" connecting clinics to public health agencies exist today. Many of the required tools are already available as open source. It is merely a matter of adoption and implementation.

middle east phiad

PHIAD was first developed in collaboration with the Nuclear Threat Initiative s Global Health and Security Initiative, a nonprofit organization based in Washington, DC, adapted the emerging standards for EHRs to public health requirements. The system, which supports national disease surveillance and cross-regional exchange of anonymized data, was donated to the Middle Eastern Consortium on Infectious Disease Surveillance (MECIDS), including the Ministries of Health of Israel, the Palestinian Authority, and the Kingdom of Jordan whose common goal is to protect the lives and well being of their populations by sharing data on foodborne and infectious diseases. Prototype systems have now also been donated to the Mexico Federal Ministry of Health, the Mexico City Ministry of Health and to IMSS in Mexico.

The system relies heavily on HL7 standards and Integrating the Healthcare Enterprise (IHE) interoperability specifications. The HL7 Clinical Document Architecture provides several benefits for resource poor governments seeking solutions to improving their population health programs. First, documents closely mirror traditional paper-based reporting workflows still commonly in use. Second, simple style sheets provide for much improved report appearance and documents are easily printed. Third, documents are not locked into a particular system or proprietary vendor solution. Future system implementations can import standardized content from the machine readable document section. Fourth, simple sharing policies can implement nullFlavor masking enabling politically feasible data sharing.

Project Contact: Sondra Renly

patient data
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