Public health and clinical medicine have different models of care. While little similarities exist between them, health IT may finally present a common thread.
The core principles of public health are focused on preventing and reducing the burden of disease on communities or entire populations. Public health is concerned with health and wellness; prevention of disease; reduction of morbidity and mortality; and identifying and isolating health threats to populations.
The most recent example of public health in action is the identification, control and prevention of the H1N1 (“Swine Flu”) pandemic. Public health professionals must identify and track each case of H1N1 to first, determine how the disease is spreading; second, ascertain how to isolate it; and third, strategize the development and deployment of a vaccine.
Clinical medicine is more concerned with individual health. A physician might receive a rationed number of H1N1 vaccines and disperse the vaccine as a prevention strategy to high-risk patients. Most of clinical medicine is focused on diagnosing and treating disease. If a patient presents to the physician with symptoms of H1N1, they do the blood testing to confirm the diagnosis, and if the results are positive, provide drug therapy to treat the H1N1 virus.
As you can see, it takes both public health professionals and clinical medicine practitioners to both PREVENT and TREAT disease. But because they have different models of care, it’s sometimes difficult for the two disciplines to play nicely together. However, looking at a case study of Rhode Island’s health IT developments, it seems technology in e-prescribing has brought them into accord.
Rhode Island is setting precedent for health IT. It is the first state to connect 100 percent of its retail pharmacies for e-prescribing; and now, Rhode Island is the first in the nation to use e-prescribing data in partnership with Surescripts for tracking H1N1 (Swine Flu). Surescripts and the state’s pharmacies are providing epidemiologists at the Rhode Island Department of Health with weekly updates of prescription data from retail pharmacies throughout the state. The epidemiologists can use this de-identified data to surveillance H1N1 and identify spikes in prescriptions of Tamiflu or other antiviral medications.
It is hoped that this tracking system will provide public health officials and medical professionals with insight into the course, severity, and treatment of H1N1.
Says Rhode Island’s Governor Carcieri: “E-prescribing has been a priority of my administration because of its potential to improve patient safety, increase quality of care and reduce healthcare costs. It has tremendous value for monitoring and protecting public health, and for increasing efficiencies in our health care system.”
In the case of the Swine Flu and Rhode Island’s recent health IT advances, one e-prescribing system is providing a systematic and efficient means of prescribing H1N1 treatments for physicians, and providing the timely reporting of vital epidemiologic data to public health officials. Herein lies the proof: health IT may be the bridge needed to connect and harmonize public health and clinical medicine.