Towards E-Government 2.0: An Assessment of Where E-Government 2.0 Is and Where It Is Headed

The aim of electronic government (e-government) is to increase the convenience and accessibility of government services and information. E-government's past emphasized the automation of routine government operations. Modern e-government centers on Web-based delivery of information and services. As the Internet moves away from version 1.0, the author examines the literature for evidence and best practices on the adoption and use to date of Web 2.0 technologies in government. Despite evidence that Web 2.0 technologies have the potential to enhance knowledge management and citizen engagement, there remains a weak body of evidence on its adoption and usage. The essay explores the early evidence and suggests a path towards realization of the promise that e-government 2.0 holds. The path involves support and collaboration from a diverse set of stakeholders to study the impact of, as well as develop best practices for, using Web 2.0 technologies to improve government services and public administration

Enhancing the Informatics Evaluation Toolkit with Remote Usability Testing

Developing functional clinical informatics products that are also usable remains a challenge. Despite evidence that usability testing should be incorporated into the lifecycle of health information technologies, rarely does this occur. Challenges include poor standards, a lack of knowledge around usability practices, and the expense involved in rigorous testing with a large number of users. Remote usability testing may be a solution for many of these challenges. Remotely testing an application can greatly enhance the number of users who can iteratively interact with a product, and it can reduce the costs associated with usability testing. A case study presents the experiences with remote usability testing when evaluating a Web site designed for health informatics knowledge dissemination. The lessons can inform others seeking to enhance their evaluation toolkits for clinical informatics products

Public Health and Epidemiology Informatics: Recent Research and Trends in the United States

Objectives To survey advances in public health and epidemiology informatics over the past three years. Methods We conducted a review of English-language research works conducted in the domain of public health informatics (PHI), and published in MEDLINE between January 2012 and December 2014, where information and communication technology (ICT) was a primary subject, or a main component of the study methodology. Selected articles were synthesized using a thematic analysis using the Essential Services of Public Health as a typology. Results Based on themes that emerged, we organized the advances into a model where applications that support the Essential Services are, in turn, supported by a socio-technical infrastructure that relies on government policies and ethical principles. That infrastructure, in turn, depends upon education and training of the public health workforce, development that creates novel or adapts existing infrastructure, and research that evaluates the success of the infrastructure. Finally, the persistence and growth of infrastructure depends on financial sustainability. Conclusions Public health informatics is a field that is growing in breadth, depth, and complexity. Several Essential Services have benefited from informatics, notably, “Monitor Health,” “Diagnose & Investigate,” and “Evaluate.” Yet many Essential Services still have not yet benefited from advances such as maturing electronic health record systems, interoperability amongst health information systems, analytics for population health management, use of social media among consumers, and educational certification in clinical informatics. There is much work to be done to further advance the science of PHI as well as its impact on public health practice

Information technologies that facilitate care coordination: provider and patient perspectives

Health information technology is a core infrastructure for the chronic care model, integrated care, and other organized care delivery models. From the provider perspective, health information exchange (HIE) helps aggregate and share information about a patient or population from several sources. HIE technologies include direct messages, transfer of care, and event notification services. From the patient perspective, personal health records, secure messaging, text messages, and other mHealth applications may coordinate patients and providers. Patient-reported outcomes and social media technologies enable patients to share health information with many stakeholders, including providers, caregivers, and other patients. An information architecture that integrates personal health record and mHealth applications, with HIEs that combine the electronic health records of multiple healthcare systems will create a rich, dynamic ecosystem for patient collaboration

Pulling Back the Covers: Technical Lessons of a Real-World Health Information Exchange

Several nations and local communities are striving to achieve widespread, secure exchange of clinical data between various health care providers and public health organizations. Most of the literature on health information exchange focuses on the financial, political, and privacy aspects of these initiatives. Perhaps just as important are the technical and organizational factors that have influenced development of data exchange methods and results. One mature network in the Midwestern United States has had success in establishing consistent, secure exchange of clinical data for more than ten years. Presented here are the technical lessons learned and design decisions made from this initiative with the hope that they can be used by others striving to connect disparate clinical information systems for the improvement of health care quality and safety

Public Health Informatics in Local and State Health Agencies: An Update From the Public Health Workforce Interests and Needs Survey

OBJECTIVE: To characterize public health informatics (PHI) specialists and identify the informatics needs of the public health workforce. DESIGN: Cross-sectional study. SETTING: US local and state health agencies. PARTICIPANTS: Employees from state health agencies central office (SHA-COs) and local health departments (LHDs) participating in the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). We characterized and compared the job roles for self-reported PHI, "information technology specialist or information system manager" (IT/IS), "public health science" (PHS), and "clinical and laboratory" workers. MAIN OUTCOME MEASURE: Descriptive statistics for demographics, income, education, public health experience, program area, job satisfaction, and workplace environment, as well as data and informatics skills and needs. RESULTS: A total of 17 136 SHA-CO and 26 533 LHD employees participated in the survey. PHI specialist was self-reported as a job role among 1.1% and 0.3% of SHA-CO and LHD employees. The PHI segment most closely resembled PHS employees but had less public health experience and had lower salaries. Overall, fewer than one-third of PHI specialists reported working in an informatics program area, often supporting epidemiology and surveillance, vital records, and communicable disease. Compared with PH WINS 2014, current PHI respondents' satisfaction with their job and workplace environment moved toward more neutral and negative responses, while the IT/IS, PHS, and clinical and laboratory subgroups shifted toward more positive responses. The PHI specialists were less likely than those in IT/IS, PHS, or clinical and laboratory roles to report gaps in needed data and informatics skills. CONCLUSIONS: The informatics specialists' role continues to be rare in public health agencies, and those filling that role tend to have less public health experience and be less well compensated than staff in other technically focused positions. Significant data and informatics skills gaps persist among the broader public health workforce

Enhancing a Taxonomy for Health Information Technology: An Exploratory Study of User Input Towards Folksonomy

The U.S. Agency for Healthcare Research and Quality has created a public website to disseminate critical information regarding its health information technology initiative. The website is maintained by AHRQ's Natiomal Resource Center (NRC) for Health Information Technology. In the latest continuous quality improvement project, the NRC used the site's search logs to extract user-generated search phrases. The phrases were then compared to the site's controlled vocabulary with respect to language, grammar, and search precision. Results of the comparison demonstrate that search log data can be a cost-effective way to improve controlled vocabularies as well as information retrieval. User-entered search phrases were found to also share many similarities with folksonomy tags

Event Notification in Support of Population Health: The Promise and Challenges from a Randomized Controlled Trial

Event notifications are real-time, electronic alerts that have the promise of improving population health by exchanging critical information to a patient's extended care team. In a trial of event noficiations in U.S. Veterans Affairs facilities, we seek to understand the impact of notifications on health care utilization within 30 and 90-days. Lessons from the trial have implications beyond the evidence by informing strategies to develop and implement event notifications in other health systems