Public Health Information Network

The Public Health Information Network (PHIN) is a national initiative, developed by the Centers for Disease Control and Prevention (CDC), for advancing fully capable and interoperable information systems in public health organizations. The initiative involves establishing and implementing a framework for public health information systems.

PHIN Design
PHIN is designed to do the following:
 * Enable the consistent exchange of health data
 * Protect the security of the health data exchanged
 * Ensure that the network will be available at all times

PHIN Structure
The 5 Functional Areas of PHIN:
 * 1) Detection and Monitoring
 * 2) Data Analysis
 * 3) Knowledge Management
 * 4) Alerting
 * 5) Response

The PHIN Framework
"PHIN will elevate and integrate the capabilities of public health information systems across the wide variety of organizations that participate in public health and across the wide variety of interrelated public health functional needs. PHIN is both a response to the needs for better integration among public health systems and a plan for developing systems and infrastructure to better support public health activities and improve public health outcomes. PHIN targets the support and integration of systems for disease surveillance, national health status indicators, data analysis, public health decision support, information resources and knowledge management, alerting and communications and the management of public health response. PHIN includes a portfolio of software solutions and artifacts necessary in building and maintaining interconnected information systems throughout public health at the local, state and federal levels. PHIN advances the National Health Information Infrastructure and federal E-Gov agendas by working with the Federal Health Architecture (FHA) and implementing the Consolidated Health Informatics (CHI) standards for reducing the burden of private sector reporting through the automated use of electronic clinical data for public health purposes as an alternative to manual reporting. It is consistent with other private sector initiatives such as Connecting for Health and e-Health as well as the industry standards for clinical data messaging such as HL7. PHIN also aligns with the federal e-Gov technical architecture standards such as ebXML and public key infrastructure (PKI). See Standards Development Organizations for more information on national standards."

PHIN’s Impact on Public Health
PHIN attempts to provide the public health sector with continuous access to health care information necessary. Access to near real-time data attempts to improve community based interventions that are implemented as a result of terrorism or disease outbreaks.

PHIN provides supports and helps improve the outcomes of various public health programs including the following:


 * The U.S. Department of Health and Human Services
 * Desired outcome: improving public health information systems.
 * The Secretary of the U.S. Department of Health and Human Services
 * Supports: Terrorism Defense, Healthcare Delivery Improvement, and IT Enhancements.
 * Healthy People 2010
 * Supports: Focus area 23 - ensure that public health agencies have the adequate infrastructure to effectively provide essential public health services.
 * Partners in public health
 * Desired outcome: "Roadmap" for establishing national capacity for public health systems.

Budget and Funding
PHIN first received funding in 2004 through the Department of Health and Human Services and the Centers for Disease Control and Prevention. Between 25% and 30% of the $849 million of funding received through the Public Health Response and Preparedness Cooperative Agreement was to be used to focus on improving public health preparedness in all 50 states, 4 metropolitan areas and 8 US territories. In 2004 the initiative of the program was to “ensure that all public health partners have, or at least will have, access to a system or systems to accomplish established preparedness functions.” For year 2005, additional finances will be available to states through the terrorism cooperative agreement. This agreement will support the development of current and new systems, in state health and public health departments, which will meet the PHIN standards and specifications.

Partnerships
In order to collect and assess information system requirements for PHIN, the CDC works with public health partners, some of which include:
 * NACCHO - National Association of County and City Health Officials
 * ASTHO - Association of State and Territorial Health Officials

With the assistance of these partners, PHIN can target the following functional areas regarding preparedness:
 * 1) Early Event Detection
 * 2) Outbreak Management
 * 3) Connecting Laboratory Services
 * 4) Partner Communications and Alerting
 * 5) Countermeasure/Response Administration

Governance
The approval of technical and data standards for PHIN is completed by two working groups in the CDC Information Council (CIC). The following organizations are represented on each working group by 2 members of its staff: Association of State and Territorial Health Officials (ASTHO), National Association of County and City Health Officials (NACCHO), and Centers for Disease Control and Prevention (CDC). By regulation the standards conform to Department of Health and Human Services (HHS) requirements and the Federal Health architecture.

CIC also ensures that the following standards are met:
 * E-Gov activities, which includes all regulations contained in the Government Paperwork Elimination Act (GPEA) goals
 * Consolidated Health Informatics (CHI) initiative
 * Federal Geographic Data Committee standards required by Office of Management and Budget (OMB) Circular A-16
 * Public Health line of business and Public Health Monitoring Sub-function of the Federal Enterprise Architecture Business Reference Model

For more information on these standards, refer to the PHIN Conceptual Diagram provided by PHIN and the CDC.

Early Event Detection
In the realm of preparedness, the PHIN has developed systems to promote early event detection. Information systems that connect health care providers to the PHIN allow for rapid reporting of cases that may lead to public health emergencies. These information systems include call reporting systems, web-based systems, and other electronic case reporting systems. The PHIN has set up technical requirements so that facilities can be equipped to participate in these rapid reporting systems. These requirements also ensure that facilities can protect patient privacy in their reports and ensure integration with outbreak management.

Outbreak Management
Another component in preparedness, the PHIN has a division of outbreak management which allows public health agencies to be adequately prepared for true outbreaks. The outbreak management system is integrated with the early event detection systems to ensure rapid, smooth awareness of outbreaks. The CDC and PHIN currently employ an Outbreak Management System software application to effectively manage data related to outbreaks. OMS demonstration

Connecting Laboratories
Another component of PHIN is connecting laboratories through a set of computer communication standards called HL7. This allows specimen receipts and laboratory results to be exchanged between health organizations and agencies. This is especially useful in times of a health outbreak or other disaster.

Countermeasure and Response Administration
The PHIN also works to track and support the supply of vaccinations and as well as the administration of these tasks. As part of this functionality, the PHIN allows limited supplies of vaccines and other needed drugs to be allocated properly when they are in short supply. Some vaccines and drugs will be traceable to clinics and drug administrators. PHIN also supports response administration by allowing adverse events to be monitored and quarantined populations to be monitored if necessary.

Standards and Specifications
PHIN has a set of Vocabulary Standards and Specifications that:
 * 1) Supports the development and deployment of standards-based public health information systems.
 * 2) Seeks to promote the use of standards-based vocabulary
 * 3) Fosters the use and exchange of consistent information among public health collaborators.
 * 4) Ensures that the vocabularies are aligned with PHIN and CHI standards.

Training
If you are interested in training, CDC offers online trainings on different topics such as: Outbreak Management, Countermeasure and Response Administration, Certification and it also offers PHIN Roadshow Webinairs. Please check calendar of available trainings at:

http://www.cdc.gov/phin/webinars-and-training.html