Health Policy & Community Health: Faculty Publications
Document Type
Article
Publication Date
3-4-2026
Publication Title
Informatics
DOI
10.3390/informatics13030040
Abstract
Background: The COVID-19 pandemic revealed persistent gaps in local health department (LHD) health informatics capacity. This study examines organizational characteristics of LHDs associated with the adoption of six health information systems: electronic case reporting (eCR), electronic disease reporting systems (EDRS), electronic health records (EHR), electronic lab reporting (ELR), health information exchange (HIE), and immunization registries (IR). Methods: We used a mixed-methods design, including multinomial or binary logistic regression analyses of quantitative data from the 2022 NACCHO National Profile of Local Health Departments (n = 441) and thematic analysis of semi-structured interviews with five LHD staff members. Results: About half (49.9%) of LHDs had implemented eCR, while higher proportions had implemented EDRS (78.0%), EHR (62.4%), ELR (57.2%), HIE (92.6%), and IR (92.6%). Workforce size was associated with the implementation of eCR, EHR, and IR. The number of vacant staff positions was associated with a lower odds of IR implementation; compared with medium-sized LHDs, both small and large LHDs had higher odds of IR implementation. Shared-governance LHDs had higher odds of adopting ELR and HIE than state-governed LHDs. Qualitative themes highlighted challenges, including staff burnout, high turnover, pay inequities, role ambiguity, political pressures, rapid changes in informatics, and interoperability problems. Conclusions: Findings underscore the need to improve LHD workforce capacity and governance structures to support a resilient public health informatics infrastructure.
Recommended Citation
Shafik, Nardeen, Gulzar H. Shah, Timothy C. McCall, Bettye A. Apenteng, Mansoor Abro, William A. Mase.
2026.
"Organizational Characteristics Associated with Health Information Systems Adoption in Local Health Departments During the COVID-19 Pandemic."
Informatics, 13 (3): MDPI.
doi: 10.3390/informatics13030040
https://digitalcommons.georgiasouthern.edu/hpmb-facpubs/349
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Creative Commons License
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Comments
Georgia Southern University faculty members, Gulzar H. Shah, Bettye A. Apenteng, and William A. Mase co-authored "Organizational Characteristics Associated with Health Information Systems Adoption in Local Health Departments During the COVID-19 Pandemic."