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Public Health Perspectives on the Importance of Leadership in Health Informatics at Local Health Departments

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The importance of strong leadership and having issue-specific ‘champions’ is a well-noted driver of organizational change. Within public health, research has shown the leadership of local health departments as a major driver of change within governmental public health. In the arena, of health informatics, this may also be the case. This project draws on interview data from 50 leaders of local health departments across the United States, employing a key-informant based study design, where leaders from local health departments across the country were interviewed about current practices, capacities, and needs in the realm of public health informatics in fall 2014.Data were coded thematically and independently in batches by two researchers. After each batch of interviews was coded, coding was compared, differences were resolved iteratively, and all interviews were re-coded using the consensus definitions.

Participants identified several ways leaders can make HIT a priority, including: advocating for more money, building bridges with the health care community to aid data sharing, build staff capacity around HIT, advocate for state health agencies to fill in HIT gaps at the local level, invest in systems-level infrastructure and not project-by-project, making HIT a budget priority, partnering with universities, and requiring use of HIT. Major barriers to using more HIT include financial constraints, staff capacity, and a lack of time to develop new systems. Some interviewees said HIT decisions were in the hands of their state agency and they had limited control. Additionally, a number of participants from smaller jurisdiction said that their size made it impractical to pursue high-level HIT use. The majority of leaders from small LHDs said they didn’t think they would be able to analyze most new electronic health information that might be accessible in the future due to challenges with human capital.


American Public Health Association Annual Meeting (APHA)


Chicago, IL