Patterns and correlates of public health informatics capacity among local health departments: an empirical typology.

J Mac Mccullough,Kate Goodin

doi:10.5210/ojphi.v6i3.5572

Abstract

Objective: Little is known about the nationwide patterns in the use of public health informatics systems by local health departments (LHDs) and whether LHDs tend to possess informatics capacity across a broad range of information functionalities or for a narrower range. This study examined patterns and correlates of the presence of public health informatics functionalities within LHDs through the creation of a typology of LHD informatics capacities.Methods: Data were available for 459 LHDs from the 2013 National Association of County and City Health Officials Profile survey. An empirical typology was created through cluster analysis of six public health informatics functionalities: immunization registry, electronic disease registry, electronic lab reporting, electronic health records, health information exchange, and electronic syndromic surveillance system. Three-categories of usage emerged (Low, Mid, High). LHD financial, workforce, organization, governance, and leadership characteristics, and types of services provided were explored across categories.Results: Low-informatics capacity LHDs had lower levels of use of each informatics functionality than high-informatics capacity LHDs. Mid-informatics capacity LHDs had usage levels equivalent to high-capacity LHDs for the three most common functionalities and equivalent to low-capacity LHDs for the three least common functionalities. Informatics capacity was positively associated with service provision, especially for population-focused services.Conclusion: Informatics capacity is clustered within LHDs. Increasing LHD informatics capacity may require LHDs with low levels of informatics capacity to expand capacity across a range of functionalities, taking into account their narrower service portfolio. LHDs with mid-level informatics capacity may need specialized support in enhancing capacity for less common technologies.

Highlights

Public health informatics and information systems have long been cited as a way to strengthen the work of public health departments [1,2]
Rather than informatics capacity being somewhat evenly dispersed across the spectrum of local health departments (LHDs), there is clear evidence of a substantial difference between the lowest- and highest-informatics capacity LHDs that is consistent across functionality types
State and national public health informatics leaders may want to consider how best to coordinate their efforts to target LHDs with low-informatics capacity across the range of functionalities explored and LHDs with mid-informatics capacity in need of additional support for specific functionalities. In considering where such support might be targeted, we identified multiple LHD characteristics that were significantly associated with informatics capacity

Summary

Introduction

Public health informatics and information systems have long been cited as a way to strengthen the work of public health departments [1,2]. Adoption of health information technologies by hospitals and providers in the clinical sector [8,9] may present an even greater opportunity for public health departments to leverage informatics to improve population health [10]. A large proportion of the work to assure, assess, and develop policies to promote population health is undertaken by local health departments (LHDs) [11]. The science of systematically applying information technology and information systems to public health practice, research, and learning is known as public health informatics [12,13]

Methods

Results

Discussion

Conclusion