2 Nov 2007

An article by Kevin P Balanda in HINT: Health Information News and Thinking. Volume 5, Issue 2 November 2007

The article is downloadable from our publication section.

We all need comprehensive and accurate information to help us in our efforts to improve the population’s health and reduce health inequities. But health-related information and knowledge tend to be distributed across different organisations and locations, and many different types of knowledge resources may be relevant. These include policy and strategy documents, data (quantitative and qualitative), research and evaluation reports, clincal guidelines, details of programmes and interventions, etc.

How to effectively and efficiently manage such knowledge resources is the subject of much ongoing debate in both international and national arenas. It was a major theme in the Review of the Public Health Function in Northern Ireland (1) and the National Health Information Strategy in the Republic of Ireland (2).

A first step is to make it easier for people to bring together the information they require. Ireland and Northern Ireland’s Population Health Observatory (INIsPHO) – housed in the Institute of Public Health in Ireland (IPH) – aims to do this by developing the All-Ireland electronic Health Library (AIeHL).

What is the AIeHL?

The AIeHL aims to

1. make it easier for people to bring together the health-related knowledge resources they require and;
2. to provide a platform for the rational management of such resources wherever they may be stored.

The AIeHL is a network of inter-operable websites from across the island of Ireland (see Figure 1). Each member website contains a range of health-related knowledge resources, and the AIeHL allows a visitor to any one of these websites to simultaneously search all or some of the other websites using a single search.

Figure 1: Main elements of the All-Ireland electronic Health Library

The current members of the AIeHL are:

Archive of Irish Health Publications (HSE); Healthdata (HSE); INIsPHO Institute of Public Health in Ireland Online Library; National Documentation Centre on Drug Use (Health Research Board) and; Wellnet (Investing for Health, Eastern Health and Social Services Board).

To date, these members have contributed over 5,300 health-related knowledge resources to the AieHL. A significant number of other organisations across the island are currently working to join the Library.

Benefits of AIeHL

Users can visit any member website and use a single search engine to simultaneously search the whole Library.
Structured coding schemes – such as the National Public Health Language (NPHL) and the Public Health Resource Type Encoding Scheme (PHRTES) - have been used to tag the knowledge resources. A search can thus be quite specific so that it returns only those resources that are required.

There is no cumbersome central repository of all the knowledge resources - the central cache stores metadata and not data. Each member of the Library, therefore, retains control of their resources. They decide which resources are to be “shared” and which ones are to remain “local”. And if a visitor to any other member website wishes to view a
resource, the resource provider decides how it can be accessed. Furthermore, there is no “AIeHL” website – the
Library is only accessible from its members’ sites. All members contribute metadata and all member websites are able to offer access to the AIeHL to people who visit their website.

How does the AIeHL work?

All member websites routinely send the agreed metadata for their “shared” knowlege resources to the AIeHL’s central metadata cache (See Figure 1). Each member website also incorporates an agreed iFrame into their website. Visitors to one of these websites use this iFrame to enter the search parameters and these are sent to the web service which searches the AIeHL’s central metadata cache. The search results and associated metadata are returned to the iFrame, with different types of resources grouped together for the user to peruse. If, after looking at the metadata, a user wants to results and associated metadata are returned to the iFrame, with different types of resources grouped together, for the user to peruse. If, after looking at the metadata, a user wants to look at a particular resource they are redirected to it on the resource provider’s website. A number of important pieces of information infrastructure support the Library’s interoperability and underpin its continuing development:

1. The AIeHL uses agreed metadata standards that have been adapted from those used by INIsPHO. The metadata elements that are stored on the AIeHL central metadata cache for each “shared” resource are its Title, Creator, Subject, Description, Date, Type, and Rights. 
2. A refinement of the metadata element ”Subject” includes terms from the National Public Health Language. NPHL is a public health thesaurus that is currently being mapped to SNOMED - the Systematised Nomenclature of Medicine - which will greatly increase its applicability in clinical settings.
3. The AieHL includes knowledge resources whose “Type” is tagged using the Public Health Resource Type Encoding System (PHRTES).

Management of the AIeHL

The AIeHL Advisory Group, with membership drawn from across the island of Ireland, is chaired by Professor Jane
Grimson, Trinity College Dublin. The Advisory Group’s remit is:

1. to develop governance arrangements, editorial policy, procedures and quality assurance processes for the Library;
2. oversee its future development. An AIeHL Members’ Working Group, consisting of representatives from the member websites, has also been established. If you would like to know more about the AIeHL, please contact us at info@inispho.org.

References

1. Department of Health and Children. (2004). National Health Information Strategy. Dublin, Stationary Office. Available from: http://www.dohc.ie/publications/pdf/nhis.pdf?direct=1.
2. Department of Health, Social Services and Public Safety. (2006). Review of the Public Health Function in Northern Ireland, Interim report. Belfast, Health Improvement and Knowledge Management Subgroup. Available from: http://www.dhsspsni.gov.uk/ph_hikminterim_report_-_final_sg.pdf.

Kevin Balanda is Associate Director of the Institute of Public Health in Ireland