One of the goals of an expansion of Health Canada’s integrated Public Health System, or iPHIS, is being better prepared to handle a future SARS-type outbreak by getting better information to the right people.
developed by Calgary’s Pangaea Systems Inc. for the BC Centre for Disease Control, ownership of iPHIS was transferred to Health Canada in 2002 and transformed by Pangaea into a Web-based application.
The program is designed to automate the public health reporting system and assist in case management. It also manages laboratory results, immunization tracking and scheduling, outbreak reporting, public health services, communicable disease case management and surveillance, and contact tracking.
Dr. Jamie Hockin, director of public health training and application for the Centre of Surveillance Coordination at Health Canada, said iPHIS fits into their larger goal of improving health surveillance across the country, so local, provincial and federal public health people have better data to make better decisions.
“”It’s aimed at putting better information management technology in the hands of local public health people,”” said Hockin. “”It gives them the ability to use it to manage a paperless office for their jurisdiction.””
Health Canada has been funding application development and helped some jurisdictions with pilot projects, but implementation of the system is the responsibility of the provinces. Currently, iPHIS is widely used in B.C. and is growing across Canada.
Hockin said there are three main levels of benefit for iPHIS, at the local, provincial and federal levels. One example is in the case of a measles outbreak.
“”If there is an outbreak of measles, then the public health nurse can use iPHIS to record information on the cases that occur, can go in and check the immunization record, and query what local children haven’t been immunized, and help them plan their response,”” said Hockin.
At the provincial level, instead of having to phone five different health authorities for an update, the aggregation of data is easily accessible through iPHIS, and the provincial data can be transmitted electronically to Health Canada.
“”It’s really about creating a paperless office and cutting-down the effort and time required in doing surveillance down dramatically,”” said Hockin.
With a recently announced $6-million expansion of iPHIS, Pangaea will be enhancing the immunization registry and adding a module for tuberculosis case management.
“”There’s also a large piece being done around outbreak management and tracking of contacts and people under quarantine, in response to the kinds of IM requirements we found during the SARS episode last year,”” said Hockin.
Since it’s unlikely to expect every jurisdiction across Canada to sign on to iPHIS, Hockin said Health Canada is also developing common standards for the sharing of data for public health surveillance.
Tayo Runsewe, manager of Pangaea’s B.C. branch, said iPHIS is designed to extract public health data as a byproduct of public health workers going about their daily work, without creating any additional work.
“”You’re not asking people to re-invent their work processes or to have to double enter things, which tends to drive inefficiencies in the system,”” said Runsewe. “”We want to make sure public health jurisdictions have a consistent tool to use, without forcing the jurisdiction to modify the way they go about delivering their health care.””
A Web-based Java application, Runsewe said iPHIS is designed to run against an Oracle database or similar system. The front-line workers continue as before; the data is automatically pulled from their systems. There is no central repository of data, instead all data resides within each jurisdiction, but will seem seamless when accessed by the user.
“”The vision for iPHIS is to have a universal identifier, so the information pertaining to you can be pulled to a screen form multiple repositories,”” said Runsewe. “”The concern is that scares a lot of people, going out there and accessing all their information.””
To counter that, Runsewe said levels of access restrictions are being implemented, so that each user is only able to access the data they need. Runsewe adds all of the iPHIS modules comply with the Health Level 7 (HL7) standard for the management of health care data.
As part of the iPHIS expansion, Runsewe said iPHIS is also being reworked to tie into Canada Health Infoway’s blueprint for an electronic health record.