A Framework for Public Health Monitoring, Analytics and Research

This paper presents a framework for public healthcare data acquisition and management model based on standard protocol for its easy adoption by any country or international health organizations. The model assumes basic digitization of electronic health record (EHR) at basic health facilities. Thus far, the models in the literature have utilized EHR in multiple secondary contexts; however, there is a gap in developing an integrated and comprehensive framework that addresses the use of EHR in a standardized way for public health, privacy issue by anonymizing patient specific information, fusing multiple records with slight changes in the same information, augmenting a broad spectrum of contextual data, and so on. We present a framework that can be used in the context for acquisition and transmission of EHR from multiple sources as an evidence base for addressing public health-related activities, including surveillance, registries, and immunization record keeping while addressing all the gaps we have identified in the literature that are critical for developing countries. In addition, EHR data are also effectively processed to serve as a knowledge base for building artificial intelligence-based research models. We, in our model, utilize Health Level Seven (HL7) as an interoperability health standard and recommend creation of specialized data marts to support public health and research-related knowledge bases. The proposed framework in its adoption provides a very effective platform for generating alerts and alarms along with providing statistics for better planning of healthcare-related issues at national, district, or at any level of administrative hierarchy. It is applicable to any country even when there is no standard EHR and has hospitals working in silos with limited digitalization. We have validated this framework for its mapping to a national level public health hierarchy in Pakistan.