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Dixon BE, Staes C, Acharya J, Allen KS, Hartsell J, Cullen T, Lenert L, Rucker DW, Lehmann H. Enhancing the nation's public health information infrastructure: a report from the ACMI symposium. J Am Med Inform Assoc 2023; 30:1000-1005. [PMID: 36917089 PMCID: PMC10114045 DOI: 10.1093/jamia/ocad033] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/17/2023] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
The COVID-19 pandemic exposed multiple weaknesses in the nation's public health system. Therefore, the American College of Medical Informatics selected "Rebuilding the Nation's Public Health Informatics Infrastructure" as the theme for its annual symposium. Experts in biomedical informatics and public health discussed strategies to strengthen the US public health information infrastructure through policy, education, research, and development. This article summarizes policy recommendations for the biomedical informatics community postpandemic. First, the nation must perceive the health data infrastructure to be a matter of national security. The nation must further invest significantly more in its health data infrastructure. Investments should include the education and training of the public health workforce as informaticians in this domain are currently limited. Finally, investments should strengthen and expand health data utilities that increasingly play a critical role in exchanging information across public health and healthcare organizations.
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Affiliation(s)
- Brian E Dixon
- Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
- Regenstrief Institute, Inc., Indianapolis, Indiana, USA
| | - Catherine Staes
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Jessica Acharya
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Katie S Allen
- Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
- Regenstrief Institute, Inc., Indianapolis, Indiana, USA
| | - Joel Hartsell
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Theresa Cullen
- Pima County Public Health Department, Tucson, Arizona, USA
| | - Leslie Lenert
- Medical University of South Carolina, Charleston, South Carolina, USA
- Health Sciences South Carolina, Charleston, South Carolina, USA
| | - Donald W Rucker
- 1upHealth, Boston, Massachusetts, USA
- Department of Emergency Medicine, Ohio State University, Columbus, Ohio, USA
| | - Harold Lehmann
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Dixon BE, Dearth S, Duszynski TJ, Grannis SJ. Dashboards Are Trendy, Visible Components of Data Management in Public Health: Sustaining Their Use After the Pandemic Requires a Broader View. Am J Public Health 2022; 112:900-903. [PMID: 35446601 PMCID: PMC9137010 DOI: 10.2105/ajph.2022.306849] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Brian E Dixon
- Brian E. Dixon is with the Department of Epidemiology, Fairbanks School of Public Health, Indiana University, and the Center for Biomedical Informatics, Regenstrief Institute, Indianapolis. Shandy Dearth is with the Center for Public Health Practice and the Department of Epidemiology, Fairbanks School of Public Health, Indiana University. Thomas J. Duszynski is with the Department of Epidemiology, Fairbanks School of Public Health, Indiana University. Shaun J. Grannis is with the Indiana University School of Medicine and the Center for Biomedical Informatics, Regenstrief Institute
| | - Shandy Dearth
- Brian E. Dixon is with the Department of Epidemiology, Fairbanks School of Public Health, Indiana University, and the Center for Biomedical Informatics, Regenstrief Institute, Indianapolis. Shandy Dearth is with the Center for Public Health Practice and the Department of Epidemiology, Fairbanks School of Public Health, Indiana University. Thomas J. Duszynski is with the Department of Epidemiology, Fairbanks School of Public Health, Indiana University. Shaun J. Grannis is with the Indiana University School of Medicine and the Center for Biomedical Informatics, Regenstrief Institute
| | - Thomas J Duszynski
- Brian E. Dixon is with the Department of Epidemiology, Fairbanks School of Public Health, Indiana University, and the Center for Biomedical Informatics, Regenstrief Institute, Indianapolis. Shandy Dearth is with the Center for Public Health Practice and the Department of Epidemiology, Fairbanks School of Public Health, Indiana University. Thomas J. Duszynski is with the Department of Epidemiology, Fairbanks School of Public Health, Indiana University. Shaun J. Grannis is with the Indiana University School of Medicine and the Center for Biomedical Informatics, Regenstrief Institute
| | - Shaun J Grannis
- Brian E. Dixon is with the Department of Epidemiology, Fairbanks School of Public Health, Indiana University, and the Center for Biomedical Informatics, Regenstrief Institute, Indianapolis. Shandy Dearth is with the Center for Public Health Practice and the Department of Epidemiology, Fairbanks School of Public Health, Indiana University. Thomas J. Duszynski is with the Department of Epidemiology, Fairbanks School of Public Health, Indiana University. Shaun J. Grannis is with the Indiana University School of Medicine and the Center for Biomedical Informatics, Regenstrief Institute
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Yeager VA, Balio CP, McCullough JM, Leider JP, Orr J, Singh SR, Bekemeier B, Resnick B. Funding Public Health: Achievements and Challenges in Public Health Financing Since the Institute of Medicine's 2012 Report. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E244-E255. [PMID: 33605671 DOI: 10.1097/phh.0000000000001283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to review changes in public health finance since the 2012 Institute of Medicine (IOM) report "For the Public's Health: Investing in a Healthier Future." DESIGN Qualitative study involving key informant interviews. SETTING AND PARTICIPANTS Purposive sample of US public health practitioners, leaders, and academics expected to be knowledgeable about the report recommendations, public health practice, and changes in public health finance since the report. MAIN OUTCOME MEASURES Qualitative feedback about changes to public health finance since the report. RESULTS Thirty-two interviews were conducted between April and May 2019. The greatest momentum toward the report recommendations has occurred predominantly at the state and local levels, with recommendations requiring federal action making less progress. In addition, much of the progress identified is consensus building and preparation for change rather than clear changes. Overall, progress toward the recommendations has been slow. CONCLUSIONS Many of the achievements reported by respondents were characterized as increased dialogue and individual state or local progress rather than widespread, identifiable policy or practice changes. Participants suggested that public health as a field needs to achieve further consensus and a uniform voice in order to advocate for changes at a federal level. IMPLICATIONS FOR POLICY AND PRACTICE Slow progress in achieving 2012 IOM Finance Report recommendations and lack of a cohesive voice pose threats to the public's health, as can be seen in the context of COVID-19 emergency response activities. The pandemic and the nation's inadequate response have highlighted deficiencies in our current system and emphasize the need for coordinated and sustained core public health infrastructure funding at the federal level.
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Affiliation(s)
- Valerie A Yeager
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana (Dr Yeager); Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Dr Balio); College of Health Solutions, Arizona State University Phoenix, Phoenix, Arizona (Dr McCullough); Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota (Dr Leider); Kansas Foundation for Medical Care, Topeka, Kansas (Mr Orr); Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan (Dr Singh); University of Washington School of Nursing, Seattle, Washington (Dr Bekemeier); and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Resnick)
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Taylor HL, Yeager VA. Core Competency Gaps Among Governmental Public Health Employees With and Without a Formal Public Health Degree. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:20-29. [PMID: 31688737 PMCID: PMC7190420 DOI: 10.1097/phh.0000000000001071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the role of a formal public health degree as it relates to core competency needs among governmental public health employees. DESIGN This cross-sectional study utilizes the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). Bivariate relationships were analyzed by conducting χ tests of respondents' supervisory level and reported skill gaps. Multivariate logistic regressions of reported skill gaps were performed holding gender, age, race/ethnicity, highest degree attained, current employer, role type, tenure in current agency, and public health certificate attainment constant. SETTING Nationally representative sample of government public health employees. PARTICIPANTS A total of 30 276 governmental public health employees. MAIN OUTCOME MEASURE Self-reported competency skills gaps. RESULTS Among nonsupervisors, those with a public health degree had significantly lower odds of reporting a competency gap for 8 of the 21 skills assessed. Among supervisors/managers, those who had a formal public health degree had significantly lower odds of reporting a competency gap in 3 of the 22 skills assessed. Having a degree in public health was not significantly related to an executive's likelihood of reporting a skill gap across any of the 22 skills assessed. Regardless of supervisory level, having a public health degree was not associated with a reduced likelihood of reporting skill gaps in effective communication, budgeting and financial management, or change management competency domains. CONCLUSIONS Possessing a formal public health degree appears to have greater value for skills required at the nonsupervisor and supervisor/manager levels than for skills needed at the executive level. Future work should focus on longitudinal evaluations of skill gaps reported among the public health workforce as changes in public health curricula may shift over time in response to newly revised accreditation standards. In addition, public health education should increase emphasis on communication, budgeting, systems thinking, and other management skills among their graduates.
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Affiliation(s)
- Heather L Taylor
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
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Apathy NC, Yeager VA. Examining Training Motivations Among Public Health Workers. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 2, Public Health Workforce Interests and Needs Survey 2017:S157-S165. [PMID: 30720628 PMCID: PMC6519888 DOI: 10.1097/phh.0000000000000940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT As public health needs and priorities evolve, maintaining a trained public health workforce is critical to the success of public health efforts. Researchers have examined training needs in various contexts and subpopulations, but a nationally representative study of what motivates public health workers to seek out training has yet to be conducted. By understanding these motivations, public health agencies and policy makers can appeal to worker motivations in both training programs and organizational incentives. OBJECTIVE The purpose of this article was to describe overall training motivations and identify patterns of training motivations among public health workers. This study also explored whether or not training needs differ across prevalent motivational patterns. DESIGN AND PARTICIPANTS Using data from the 2017 Public Health Workforce Interests and Needs Survey (PH WINS), the study used latent class analysis (LCA) to identify motivational patterns and logistic regression to analyze associations with training needs. RESULTS The most prominent motivation to seek training was personal growth (82.7% of respondents). LCA identified 4 motivational classes of public health workers: those motivated by organizational pressure and requirements (31.8%), those motivated indiscriminately by all factors (28.4%), those motivated primarily by personal growth (21.7%), and those motivated by organizational accommodations and supports (18.2%). Motivational class was not associated with indicating training needs in any of 8 training domains, nor was it associated with indicating any training need in any domain. CONCLUSIONS Public health agencies should consider the different motivational classes present in the public health workforce. In particular, motivational classes that represent organizational choices suggest that public health agencies should both motivate workers with organizational requirements and pressure from managers and offer institutional support via paid travel and covered time for training.
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Affiliation(s)
- Nate C Apathy
- Health Policy & Management, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
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Public Health Informatics in Local and State Health Agencies: An Update From the Public Health Workforce Interests and Needs Survey. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 2, Public Health Workforce Interests and Needs Survey 2017:S67-S77. [PMID: 30720619 PMCID: PMC6519871 DOI: 10.1097/phh.0000000000000918] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective: To characterize public health informatics (PHI) specialists and identify the informatics needs of the public health workforce. Design: Cross-sectional study. Setting: US local and state health agencies. Participants: Employees from state health agencies central office (SHA-COs) and local health departments (LHDs) participating in the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). We characterized and compared the job roles for self-reported PHI, “information technology specialist or information system manager” (IT/IS), “public health science” (PHS), and “clinical and laboratory” workers. Main Outcome Measure: Descriptive statistics for demographics, income, education, public health experience, program area, job satisfaction, and workplace environment, as well as data and informatics skills and needs. Results: A total of 17 136 SHA-CO and 26 533 LHD employees participated in the survey. PHI specialist was self-reported as a job role among 1.1% and 0.3% of SHA-CO and LHD employees. The PHI segment most closely resembled PHS employees but had less public health experience and had lower salaries. Overall, fewer than one-third of PHI specialists reported working in an informatics program area, often supporting epidemiology and surveillance, vital records, and communicable disease. Compared with PH WINS 2014, current PHI respondents' satisfaction with their job and workplace environment moved toward more neutral and negative responses, while the IT/IS, PHS, and clinical and laboratory subgroups shifted toward more positive responses. The PHI specialists were less likely than those in IT/IS, PHS, or clinical and laboratory roles to report gaps in needed data and informatics skills. Conclusions: The informatics specialists' role continues to be rare in public health agencies, and those filling that role tend to have less public health experience and be less well compensated than staff in other technically focused positions. Significant data and informatics skills gaps persist among the broader public health workforce.
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Developing an Informatics-Savvy Health Department: From Discrete Projects to a Coordinating Program Part II: Creating a Skilled Workforce. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 23:638-640. [PMID: 28957904 DOI: 10.1097/phh.0000000000000658] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Data, Staff, and Money: Leadership Reflections on the Future of Public Health Informatics. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 23:302-310. [PMID: 28350627 DOI: 10.1097/phh.0000000000000580] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Health informatics can play a critical role in supporting local health departments' (LHDs') delivery of certain essential public health services and improving evidence base for decision support. However, LHDs' informatics capacities are below an optimum level. Efforts to build such capacities face ongoing challenges. Moreover, little is known about LHD leaders' desires for the future of public health informatics. OBJECTIVES Conduct a qualitative analysis of LHDs' future informatics plans, perceived barriers to accomplishing those plans, and potential impact of future advances in public health informatics on the work of the public health enterprise. METHODS This research presents findings from 49 in-depth key informant interviews with public health leaders and informatics professionals from LHDs, representing insights from across the United States. Interviewees were selected on the basis of the size of the population their LHD serves, as well as level of informatics capacity. Interviews were transcribed, verified, and double coded. RESULTS Major barriers to doing more with informatics included staff capacity and training, financial constraints, dependency on state health agency, and small LHD size/lack of regionalization. When asked about the role of leadership in expanding informatics, interviewees said that leaders could make it a priority through (1) learning more about informatics and (2) creating appropriate budgets for integrated information systems. Local health department leaders said that they desired data that were timely and geographically specific. In addition, LHD leaders said that they desired greater access to clinical data, especially around chronic disease indicators. CONCLUSIONS Local health department leadership desires to have timely or even real-time data. Local health departments have a great potential to benefit from informatics, particularly electronic health records in advancing their administrative practices and service delivery, but financial and human capital represents the largest barrier. Interoperability of public health systems is highly desirable but hardly achievable in the presence of such barriers.
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Succession Planning and Management Practice in Washington State Local Public Health Agencies. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018; 22:512-9. [PMID: 27682723 DOI: 10.1097/phh.0000000000000397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Turnover of top local public health officials is expected to be great, with 23% being 60 years of age or older, and another 42% being 50 to 59 years of age. Yet, we know little about the use of succession planning in public health agencies. OBJECTIVE Describe succession planning practices in local public health agencies. DESIGN We conducted a Web-based, cross-sectional survey of succession planning practices and followed the career paths of public health officials for 40 months. SETTING AND PARTICIPANTS The top local public health officials from Washington State's 35 local governmental public health agencies. MAIN OUTCOME MEASURES Twenty-five succession planning best practices. RESULTS All 35 agencies responded, resulting in a 100% response rate. Our study found evidence of succession planning practices in Washington State local public health agencies: 85% of agencies selected high-performing high potential employees for development, 76% sent them to formal technical and management/leadership training, 70% used cross-functional team projects, and 67% used stretch assignments to develop their employees. Impetuses to implement succession planning were discovering that large percentages of employees were able to retire soon and that national accreditation requires workforce development plans. Barriers to implementing succession planning included other competing demands for time, belief that the agency's workforce was too small for a formal program, and concerns that there would be union barriers. In 2012, 50% of the officials surveyed said that it would be at least possible that they would leave their current jobs within 5 years. Forty months later, 12 (34%) had left their positions. CONCLUSIONS We were encouraged by the level of succession planning in Washington State and recommend creating a greater sense of urgency by focusing on agency retirement profiles and emphasizing the need for workforce development plans for accreditation. Developing the public health leaders of tomorrow is too important to be left to chance.
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Massoudi BL, Chester KG. Public Health, Population Health, and Epidemiology Informatics: Recent Research and Trends in the United States. Yearb Med Inform 2017; 26:241-247. [PMID: 29063572 PMCID: PMC6239230 DOI: 10.15265/iy-2017-035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives: To survey advances in public and population health and epidemiology informatics over the past 18 months. Methods: We conducted a review of English-language research works conducted in the domain of public and population health informatics and published in MEDLINE or Web of Science between January 2015 and June 2016 where information technology or informatics was a primary subject or main component of the study methodology. Selected articles were presented using a thematic analysis based on the 2011 American Medical Informatics Association (AMIA) Public Health Informatics Agenda tracks as a typology. Results: Results are given within the context developed by Dixon et al., (2015) and key themes from the 2011 AMIA Public Health Informatics Agenda. Advances are presented within a socio-technical infrastructure undergirded by a trained, competent public health workforce, systems development to meet the business needs of the practice field, and research that evaluates whether those needs are adequately met. The ability to support and grow the infrastructure depends on financial sustainability. Conclusions: The fields of public health and population health informatics continue to grow, with the most notable developments focused on surveillance, workforce development, and linking to or providing clinical services, which encompassed population health informatics advances. Very few advances addressed the need to improve communication, coordination, and consistency with the field of informatics itself, as identified in the AMIA agenda. This will likely result in the persistence of the silos of public health information systems that currently exist. Future research activities need to aim toward a holistic approach of informatics across the enterprise.
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Affiliation(s)
- B. L. Massoudi
- Public Health Informatics Program, RTI International, Atlanta, GA, USA
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - K. G. Chester
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- C3 Informatics, Milton, GA, USA
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Addressing Urgent Public Health Workforce Needs: Building Informatics Competency and Strengthening Management and Leadership Skills. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 21 Suppl 6:S5-6. [PMID: 26422494 DOI: 10.1097/phh.0000000000000316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Drezner K, McKeown L, Shah GH. Assessing Skills and Capacity for Informatics: Activities Most Commonly Performed by or for Local Health Departments. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 22 Suppl 6, Public Health Informatics:S51-S57. [PMID: 27684618 PMCID: PMC5049942 DOI: 10.1097/phh.0000000000000459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe the informatics activities performed by and for local health departments. DESIGN Analysis of data from the 2015 Informatics Capacity and Needs Assessment Survey of local health departments conducted by the Jiann-Ping Hsu College of Public Health at Georgia Southern University in collaboration with the National Association of County & City Health Officials. PARTICIPANTS 324 local health departments. MAIN OUTCOME MEASURE(S) Informatics activities performed at or for local health departments in use and analysis of data, system design, and routine use of information systems. RESULTS A majority of local health departments extract data from information systems (69.5%) and use and interpret quantitative (66.4%) and qualitative (55.1%) data. Almost half use geographic information systems (45.0%) or statistical or other analytical software (39.7%). Local health departments were less likely to perform project management (35.8%), business process analysis and redesign (24.0%), and developing requirements for informatics system development (19.7%). Local health departments were most likely to maintain or modify content of a Web site (72.1%). A third of local health departments (35.8%) reported acting as "super users" for their information systems. A significantly higher proportion of local health departments serving larger jurisdictions (500 000+) and those with shared governance reported conducting informatics activities. CONCLUSION Most local health department informatics activities are completed by local health department staff within each department or a central department, but many state health departments also contribute to informatics at the local level. Larger local health departments and those with shared governance were more likely to perform informatics activities. Local health departments need effective leadership, a skilled workforce, strong partnerships, and policies that foster implementation of health information systems to successfully engage in informatics. Local health departments also face important training needs, including data analytics, project management, and geographical information systems, so they can adapt to the increasing availability of electronic data and changes in technology.
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Affiliation(s)
- Kate Drezner
- National Association of County & City Health Officials, Washington, District of Columbia (Mss Drezner and McKeown); and Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro (Dr Shah)
| | - Lisa McKeown
- National Association of County & City Health Officials, Washington, District of Columbia (Mss Drezner and McKeown); and Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro (Dr Shah)
| | - Gulzar H. Shah
- National Association of County & City Health Officials, Washington, District of Columbia (Mss Drezner and McKeown); and Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro (Dr Shah)
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Workforce Competencies in Syndromic Surveillance Practice at Local Health Departments. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 22 Suppl 6, Public Health Informatics:S75-S80. [PMID: 27684623 PMCID: PMC5049944 DOI: 10.1097/phh.0000000000000470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is Available in the Text. This study provides an assessment of self-reported knowledge and skills in syndromic surveillance tasks to effectively target technical assistance to different levels of local health department need. As the science and practice of syndromic surveillance (SyS) evolve, it has increasing utility for public health surveillance at the local level. Local health departments (LHDs) require specific organizational and workforce capabilities to use SyS data. In 2013, more than half of the LHDs reported using SyS, although little has been reported about LHD workforce capabilities in SyS.
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Investigating Informatics Activity, Control, and Training Needs in Large, Medium, and Small Health Departments. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 22 Suppl 6, Public Health Informatics:S63-S68. [PMID: 27684621 PMCID: PMC5049951 DOI: 10.1097/phh.0000000000000462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article investigates informatics training needs in local health departments of different jurisdictional sizes. A recent National Association of City & County Health Officials survey shed light on informatics workforce development needs. Local health departments (LHDs) of various jurisdictional sizes and control over informatics may differ on training needs and activity. Understanding the precise nature of this variation will allow stakeholders to appropriately develop workforce development tools to advance the field.
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Shah GH, Leider JP, Castrucci BC, Williams KS, Luo H. Characteristics of Local Health Departments Associated with Implementation of Electronic Health Records and Other Informatics Systems. Public Health Rep 2016; 131:272-82. [PMID: 26957662 PMCID: PMC4765976 DOI: 10.1177/003335491613100211] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Assessing local health departments' (LHDs') informatics capacities is important, especially within the context of broader, systems-level health reform. We assessed a nationally representative sample of LHDs' adoption of information systems and the factors associated with adoption and implementation by examining electronic health records, health information exchange, immunization registry, electronic disease reporting system, and electronic laboratory reporting. METHODS We used data from the National Association of County and City Health Officials' 2013 National Profile of LHDs. We performed descriptive statistics and multinomial logistic regression for the five implementation-oriented outcome variables of interest, with three levels of implementation (implemented, plan to implement, and no activity). Independent variables included infrastructural and financial capacity and other characteristics associated with informatics capacity. RESULTS Of 505 LHDs that responded to the survey, 69 (13.5%) had implemented health information exchanges, 122 (22.2%) had implemented electronic health records, 245 (47.5%) had implemented electronic laboratory reporting, 368 (73.0%) had implemented an electronic disease reporting system, and 416 (83.8%) had implemented an immunization registry. LHD characteristics associated with health informatics adoption included provision of greater number of clinical services, greater per capita public health expenditures, health information systems specialists on staff, larger population size, decentralized governance system, one or more local boards of health, metropolitan jurisdiction, and top executive with more years in the job. CONCLUSION Many LHDs lack health informatics capacity, particularly in smaller, rural jurisdictions. Cross-jurisdictional sharing, investment in public health informatics infrastructure, and additional training may help address these shortfalls.
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Affiliation(s)
- Gulzar H. Shah
- Georgia Southern University, Jiann-Ping Hsu College of Public Health, Statesboro, GA
| | | | | | - Karmen S. Williams
- Georgia Southern University, Jiann-Ping Hsu College of Public Health, Statesboro, GA
| | - Huabin Luo
- East Carolina University, Greenville, NC
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