Document Type

Presentation

Presentation Date

4-2015

Abstract or Description

Background: Information technology and information systems (IT/IS) play a critical role in the daily operation of local health departments (LHDs). Assessing LHDs’ informatics capacities is important, especially within the context of broader, system-level health reform efforts.

Research Objective: This study assesses a nationally representative sample of LHDs’ level of adoption of information systems, technology, and the factors associated with adoption/implementation. Specifically, five areas of public health informatics were examined: electronic health records (EHRs), health information exchange (HIE), immunization registry (IR), electronic disease reporting system (EDRS), and electronic lab reporting (ELR).

Data Sets and Sources: Data from NACCHO’s 2013 National Profile of LHDs was used. Descriptive statistics and multinomial logistic regression were performed for the five implementation-oriented outcome variables of interest, with three levels of implementation. Independent variables included infrastructural capacity, financial capacity, and other characteristics theoretically associated with informatics capacity.

Study Design: This study uses a cross-sectional survey research design.

Principal Findings: Thirteen percent of LHDs had implemented HIEs. About 22 % had implemented EHRs, 47% ELR, 72.2% EDRS, and 82% had implemented Immunization Registry. Significant determinants of health informatics adoption included provision of greater number of clinical services, greater per capita public health expenditures, having health information system specialists on staff, having larger population size, having decentralized governance system, having one and more local boards of health, and having top executive with greater number of years in the job.

Conclusions: The capacity of LHDs to use real-time, local data and information is critical. Many LHDs do not have this capacity. This may be due to lack of specialized staff, availability of data systems, or a host of other political or organizational constraints. This is especially the case for smaller jurisdictions. Cross-jurisdictional sharing or regionalization of some informatics and surveillance functions may be a reasonable approach to address these shortfalls.

Implications for Public Health Practice and Policy: A combination of investment in public health informatics infrastructure, additional training of new informatics staff and existing epidemiologists, and better integration with healthcare systems is needed to augment LHD informatics capacity and ensure governmental public health can meet the information needs of the 21st century.

Additional Information

Reproduced with permission of the National Coordinating Center for PHSSR and the Robert Wood Johnson Foundation, Princeton, N.J. Presentation obtained from the Keeneland Conference site.

Sponsorship/Conference/Institution

Keeneland Conference for Public Health Systems and Services Research

Location

Lexington, KY

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