Agenda - 03-09-1999 - III-B - Laserfiche WebLink

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• • • disciplines will change &reatly over the coming de- cade. It is likely that the growth of managed care will amplify the oversupply of specialist and sub- special- ist physicians .4.40 It will also magnify the need for new educational competencies for physicians, in- cluding a greater emphasis on population - based sciences such as those taught in schools of public health.'° Trend Explosion of information technologies. Evidence The proliferation of information technologies will continue to provide exciting opportunities and new approaches to public health and health care delivery. It has been estimated that the amount of information available to the public doubles every five years .29 The explosion in information technologies provides new ways in which to make information -based deci- sions—i.e., new and better methods of communica- tion, improved analysis tools, and improvements in presentation of knowledge .41 In the clinical setting, information -based decision making may involve electronic synthesis of complete patient histories, literature review to support diagnosis and treatment decisions, and computerized systems for prompting physicians and patients, and for measuring quality in the health care setting.42.49 Impact Persons working in all areas of public health in- cluding universities, state and local health depart- ments, and health care settings will have an unprec- edented array of information tools at their disposal. However, it is important to note that improved tech- nology does not necessarily result in improved and integrated information." In many areas of public health, information systems have been created that cannot "talk" to each other, making their use less than optimal. Trend Changing needs in the public health work force. Evidence Unlike professions such as medicine or law, no single educational degree is required for professional Future Trends Affecting Public Health 53 work in public health. The public health work force is estimated at one half million, yet less than one third of all employees in public health departments have formal training in public health.43 As health care reform proceeds at state and local levels, the necessary skills for public health professionals are likely to change and the boundaries between private and governmental sectors in health become less dis- tinct. Impact Public health is a rapidly changing discipline as noted earlier in discussions about managed care and changing demographics. Abilities. that are likely to be needed in the coming decade include stronger skills in community assessment, program evalua- tion, better understanding of the uses of information technologies, and stronger leadership skills.l,48 The consequences of an undertrained work force will be greater than in the past due to the rapidly changing nature of public health. Trend Growth in health- related partnerships. Evidence Many of the changes noted earlier are likely to lead to new opportunities for interdisciplinary partner- ships that can link the academic and public health practice settings. Several recent examples of such partnerships are the "community empowerment" projects funded by the Kellogg Foundation, large community-based trials to reduce chronic disease morbidity funded by NHLBI, and the Prevention Re- search Centers funded by the Centers for Disease Control and Prevention.47,48 Increasingly, researchers are recognizing that the most effective community- based research projects are those that involve a true partnership between academics and community groups."" Partnerships discussed earlier in this sec- tion, such as those between traditional public health agencies and managed care providers, are likely to increase in frequency and scope. Impact The growth in community-based partnerships and applied prevention research has the potential to greatly inform the methods for long -term mainte- nance of community interventions. Presently, there 93