HIM381

Sue Feldman — May 16, 2009 - 7:22am

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Public Health Informatics

Sue Feldman — May 9, 2009 - 10:32am

Comment on "Sue Feldman IS302" by "Sue Feldman

Sue Feldman — Dec 3, 2008 - 11:57pm

This class came during a very opportune time for me as I was doing a system analysis and design project for the World Bank in Andhra Pradesh, India (AP). The Government of AP (GoAP) recognizes that persons with disabilities (PWD) have difficulty accessing education and employment and often incur additional expenses. Moreover, they believe that the current social security pension for PWD is not enough. Therefore, the GoAP proposes to enact a new pension schedule and they have announced the increase to existing pensioners from a flat Rs200 to a three-tier pension ranging from a minimum Rs500 to a maximum Rs700 monthly and expanding eligibility to all age groups. This will require reassessment of the disability status of nearly 600,000 pensioners across 1100 mandals. Since India requires a disability certificate for disability pension eligibility, the government would like to eliminate/validate previously given certificates that might have been provided in an arbitrary manner while expanding coverage to those who remain currently uncertified. The GoAP wants a transparent and reproducible system of certification that will accomplish three goals: 1) for current pension recipients, eliminate those ineligible and validate certificates such that pension adjustments are commensurate with table 1 2) develop a centralized statewide electronic registry for PWD for quality assurance and services delivery 3) for future pension recipients, indicate appropriate pension levels based on scientific examinations and data electronically input with subsequent certificate generation. An additional goal is to create a sustainable and generalizable model for statewide assessment camps. These three goals are key components of this project and intersected with course content. Simply stated, GoAP wanted a database that would facilitate data input, support searches, deliver reports, and illicit alerts. My second assignment to AP came during the semester and, as such I was able to utilize a lot of the high level information learned in class during my visit and to write my final report. During the visit I felt more confident in the questions that I asked and my understanding of the answers was much clearer. Overall, this course combined with system analysis and design provided a good one-two punch for the type of work expected from me at the World Bank. However, it is clear to me that this knowledge will not end there. During the summer, I did an internship at the Social Security Administration (SSA) as part of the disability systems team during the pilot of a data exchange system between Beth Israel Deaconess Medical Center (BIDMC) and SSA called MEGAHIT . It is hypothesized that electronic systems infused with intelligence, such as that of MEGAHIT, will lead to less consultative exams (CE), faster and more accurate collection of medical evidence, and ultimately faster determinations. This system has the potential to bring benefits to the person with disabilities (PWD), the providers (especially bulk providers), the Social Security Administration, and society as a whole. Additionally, a system such as MEGAHIT will standardize the request, collection, processing, and payment of medical evidence. Lastly, with database technologies, there exists the potential for population health data collection and research with such a system in place, especially as the exchange of health-related data becomes more widespread. During this internship, the database developers were very giving with information and my appreciation of the intricacies of solid database design was validated. While it would have been nice to have had this course prior to the internship, it will serve me well as this interorganizational exchange of unstructured data for disability determination is central to my dissertation. This database system takes unstructured data and %u201Cmatches%u201D it to preidentified data codes to determine disability benefit eligibility bringing about an automation to the process previously thought unattainable. Currently, the process takes anywhere from 30 to 500 days, depending the case. But even assuming the best case scenario of 30 days, the pilot system has successfully completed this process in 52 seconds. This certainly makes a case for the organizational and social benefits of database systems. It is very tempting to take database functionality for granted. And perhaps I have been one of those who subscribes to that way of thinking. However, through a cascade of events, my work in India, my work at SSA, and more importantly this class, I can see that solid database design and maintenance is not something to trivialize. These two projects cited here, both require %u201CFort Knox%u201D level security as there are HIPAA laws to abide by and there is collection of health information. Interestingly enough, while India was concerned with security, they do not have HIPAA laws and the security concerns were not on the alarm level of those of SSA. Irrespective of security concerns GoAP, SSA, and BIDMC sees the collection and storage of data as a valuable asset and eventual resource where the information becomes knowledge that will reap cost savings and efficiencies. Looking back now on the intersection of this course with the varied projects on which I have worked, it is clear to me that I now have a more solid understanding of database systems. While I do not do database architecture, design, or administration for a living, I have a high level of understanding in which to better formulate questions and better understand the answers. In looking forward to how I plan to use the information gained in this course, my work with GoAP may or may not continue, however, my work with SSA will definitely continue. And as I head out to Boston in two weeks to conduct interviews with those integral to MEGAHIT, including John Halamka (CIO of BIDMC), I feel that my questions will be better focused. Furthermore, this will lead to a more solid write up of those interviews as my understanding of the foundational concepts is much more solid.

IS 302

Sue Feldman — Dec 3, 2008 - 3:56pm

This page holds work for the Fall 2008 IS 302 course with Dr. Ruben Quinonez. You can view other people's portfolios by clicking on the IS302 tag on the bottom of this page, or by editing this page and looking in the sidebar.

Guidelines

Every student is required to post at least one entry to her/his Claremont Conversation Online portfolio for each class they take. The post is to reflect something that the student learned in the class. Please note that no grade other than "Incomplete" (or "Unsatisfactory" if applicable) will be issued to any student who has not posted a suitable entry to her/his portfolio by the end of the term. For this class, you will write a one-thousand word essay reflecting on the significance/importance of database technology in today's society. Please insert the text of the essay in the below box, or upload a Word document with your essay in it.

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Sue Feldman IS302

Sue Feldman — Dec 3, 2008 - 3:55pm

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Sue Feldman — Dec 3, 2008 - 3:53pm

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