Epidemiology refers to the study of the frequency of occurrence of diseases among different types of people within a given period of time. It can also be defined as a branch of medicine that deals with possible control, distribution and incidence of diseases including other factors relating to health. Information from epidemiology is used to evaluate and plan strategies to prevent illness and also in management of patients who are already victims of a disease. The purpose of this paper is to explain what epidemiology is all about and importance of epidemiology for HIM professionals. To address better what epidemiology is all about, the paper will explain the history of epidemiology, the definition of terms used in epidemiology, application of epidemiology and finally outline opportunities of doing epidemiology as HIM professional and areas where HIM professional can work after specializing in epidemiology (Merrill, 2018).
According to our study on epidemiology, it was explained that the father of medicine Hippocrates was the first epidemiologist. The relationship between environmental influence and the occurrence of disease was first examined by him. He believed that imbalance of four humors caused sickness in the human body. His belief in the occurrence of diseases led to dieting in medicine and bloodletting. He then came up with the word endemic to describe diseases which are found not all in all places but in specific areas. He then came up with an epidemic to describe diseases which occur at some time but not other periods (Anderson, 2018).
Epidemiology was thereby defined as the study of how determinants of health and distribution patterns relate to the state of populations. This study was thereby used to address health problems leading to the conclusion that the causes of diseases were associated with human luxury (Laskaris & Morabia, 2015).
In the middle of the 16th century, Girolamo Fracastoro a doctor from Verona was among the first people to propose a theory on unseeable, and small particles which cause diseases. According to his theories, diseases were spreading by air, destroyed by fire and multiply by themselves (Bellamy, 2010).
Scientist and a professional haberdasher John Graunt published on political and natural observation 1662. The publication was about upon bills of mortality which was used to analyze mortality rolls before great plague in London. He came up with more evidence on theories of diseases to support some of the theories (Kiple, 2008).
Prevention refers to an early stage of reducing the risk of occurrence of disease through modification of exposure patterns, behaviors, and lifestyle. Prevention aims at making changes in lifestyle and encouraging healthy behaviors to reduce the risk of developing a disease. On the other hand, treatment can be defined as a medical care or use of drugs in eliminating an infectious disease from the human body. Disease treatment can also be the use of drugs such as anti-inflammatory drugs or antibiotics to eliminate the pathogen from the human body (Bhopal, 2016).
Primary Prevention. It is concerned with minimizing the onset of a disease. It involves interventions to reduce the incidence of disease or injury. For example the use of vaccine to protect against disease agents. Primary prevention can also include behavior change, for example, diet management or cigarette smoking which can lead to occurrence of a disease..
Secondary Prevention. It involves detecting a disease within early stages of development. Symptoms of a disease can be observed through screening tests. Screening is used to detect the presence of a disease agent in a human body. For example, Pap test to detect cancer of the cervix. Screening is used in secondary prevention because some diseases can be detected through tests before their symptoms appear.
Tertiary Prevention. This level of prevention involves interventions designed to arrest the progress of a disease and minimize negative consequences. Various interventions can be used to control and arrest the progress of a disease which includes: to reduce disability and complications of a disease and to minimize suffering caused by a departure from good health, for example, unhealthy eating or lack of physical activities. Tertiary prevention also involves treatment of the disease and recovery process; reducing symptoms of existing disease with an aim of improving quality of life.
Endemic. This refers to a disease that occurs frequently within a specific region or a population. Example of endemic disease includes malaria disease which occurs in some areas of Africa and chicken pox which occurs among young school children.
Epidemic. This refers to a sudden severe outbreak of an infectious disease which affects many people and spreads easily across the population at the same time. An example of an epidemic disease is an outbreak of AIDS.
Pandemic. This refers to a type of disease which affects people across a wide geographic location such as across countries or continents. For example the outbreak of HIV/AIDs and influenza.
Incident. This refers to the number of newly diagnosed cases of a disease in the population within a specific period of time.
Prevalence. This refers to a total number of existing and new cases in a population; both new and existing. It can also be referred to as the burden of a disease within the society.
Mortality rate. This refers to a total number of deaths within a specified area at a given period of time.
Validity. This refers to accurate measure by research instrument on what was supposed to be measured.
Reliability. Refers to the degree of consistency in the result on a scale produces when repeated measurements are made.
Cholera is a diarrhoeal infection caused by ingestion of Vibrio Cholerae bacterium from contaminated water or food. The common symptom for cholera include acute watery diarrhoea with severe dehydration. Cholera outbreak (epidemic) can occur in endemic areas both in regions where it does not regularly occur and where it occurs. It is associated with inadequate access to sanitary facilities and clean water. Prevention of cholera involves interventions such as oral cholera vaccines, treatment, social mobilization, food and water hygiene, and surveillance. Cholera surveillance is conducted through rapid diagnostic tests. This helps in planning and control measure when an outbreak occurs to minimize on transmissions.
Study of epidemiology goes beyond specialization in population health to the application of knowledge from the study to community-based practice. The practice of epidemiology is both an art and science just like the practice of medicine. Clinicians apply epidemiological concept when diagnosing a patient to understand the patient, make a clinical judgment and prescribe appropriate treatment for a patient. Epidemiologist will also use scientific methods of analytic and descriptive epidemiology in understanding and making an epidemiological judgement of local conditions. This helps epidemiologist in diagnosing and proposing acceptable and practical public health interventions in the prevention and control of diseases in the community (Dale, 2011).
Although direct health care providers and epidemiologists are both concerned with control and occurrence of diseases, there is a slight difference with how each professional view the patient. Epidemiologist profession will be concerned with the general health of a community or a specific population while a clinician or direct health care provider will be concerned with the health of an individual. This means that in epidemiology, they are concerned with the general population and find out the causes of diseases among the population while clinicians will only be concerned with an individual patient infected with a disease. Similarly, the same way a clinician will focus on treating a patient infected with a disease, an epidemiologist will be concerned with identifying the source or exposure that caused disease and even identify risk predisposing factors and populations at risk of being infected with infectious diseases (Goodman, 2015).
Specialization in epidemiology as Health Information Management Professional has wider roles and opportunities such as; health services project administrator, director quality accountability initiatives, business development, and assistant administrator. Health Information Management Professional may also work in areas such as; health insurance organizations, health associations, hospitals, clinics, consulting firms, nursing homes and hospitals (Gordis, 2009).
According to American Health Information Management Association, the study of epidemiology provides other opportunities such as research and clinical data specialist. HIM professional conduct studies concerned with administration, financial and clinical aspect of health information management. Epidemiological knowledge by HIM professionals in statistics, database management, and healthcare data and structure provides advantages to researchers at all levels.
HIM professionals play an important part in many epidemiological studies, including health services, chronic diseases, nutritional factors, environmental factors, cancer, and other infectious diseases. Their participation in policy and public health research help in determining community health status and program outcomes. Information collected by HIM professionals helps in guiding program decision making and policy development.
HIM specialization in epidemiology helps them to partner with public health research persons when addressing disparities in healthcare among priority population. For example the low-income groups, residents of rural areas, children, women, ethnic minorities and racial. Information from their participation in public health research help in disease reporting and tracking.
Knowledge of epidemiology helps HIM profession in recording, storing reliable data and standardized health information which is timely and accurate. HIM professional help in ensuring data is standardized and can support multiple end users through retrieval as well as developing mechanisms for data query. They help in managing public health database which contains population-based research on health issues affecting community members. The information they handle varies from data collected from the medical record, vital statistics and population data collected through interview. These data contain information on the true definition of disease within a given population at a specified period of time.
HIM professional specialization in epidemiology serves vital roles ranging from management to project management, assessment, and data collection. This may include querying and obtaining medical records which have been collected by health facilities to check on record accuracy, checking completeness and coding for research purposes for epidemiologists and research persons. They may also serve as data analysts specializing their epidemiology knowledge working with outcome coordinators, population-based longitudinal data or working with national disease control and prevention organizations in data analysis and coding for research purposes (Shepheard, 2010).
References
Anderson, W. (2018). The history in epidemiology. International Journal Of Epidemiology. doi: 10.1093/ije/dyy247
Bellamy, R. (2010). Susceptibility to infectious diseases. Cambridge: Cambridge University Press.
Bhopal, R. (2016). Concepts of epidemiology. Oxford: Oxford University Press.
Dale, C. (2011). Epidemiology: A Very Short Introduction. Rodolfo Saracci. International Journal Of Epidemiology, 40(2), 529-530. doi: 10.1093/ije/dyr016
Goodman, M. (2015). Epidemiology Matters: a new introduction to methodological foundations. Annals Of Epidemiology, 25(2), 138-139. doi: 10.1016/j.annepidem.2014.11.003
Gordis, L. (2009). Epidemiology. Philadelphia: Saunders Elsevier.
Kiple, K. (2008). The Cambridge world history of human disease. Cambridge: Cambridge University Press.
Laskaris, Z., & Morabia, A. (2015). Should the History of Epidemiology be Taught in Epidemiology Training Programs?. Epidemiology, 26(1), 133-135. doi: 10.1097/ede.0000000000000211
Merrill, R. (2018). Introduction to Epidemiology. [S.l.]: Jones & Bartlett Learning.
Shepheard, J. (2010). Editorial: Health Information Managers Have a Role to Play in the Transformation of Data. Health Information Management Journal, 39(2), 4-6. doi: 10.1177/183335831003900201
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