Public Health Information Technology Research Articles

Comparison of Public Health IT Reporting Capabilities Between a Large Network Hospital and Small Independent Hospital During Disaster Response

Introduction:Management of outbreaks rely on hospitals’ health information technology (IT) to electronically share data to public health systems. Studies show that half of non-federal hospitals reported a lack of capacity to exchange information with public health agencies, placing a variable burden on institutions to meet the government mandated reporting requirements. This study aims to contrast the impact of COVID-19 reporting requirements across two New York City institutions with disparate health IT capabilities.Method:A retrospective, qualitative study contrasting the impact of reporting requirements on a small independent hospital (SIH) with 198 staffed beds and a large, networked hospital (LNH) with eleven campuses during the COVID-19 pandemic. Researchers conducted 51 interviews with hospital leadership, clinical directors, and infection control personnel. Interviews were transcribed and coded using qualitative analysis software.Results:The LNH had a 50-person analytic team that handled reporting tasks, a centralized data warehouse that was automatically updated, electronically generated reports with universal access, and limited burden of clinical staff. The SIH had no dedicated analytic team. Seventeen departments were utilized to handle reporting tasks with no centralized place to share electronic data, limited capacity to create automatically updated reports, a daily manual information gathering processes, and significant need of clinical staff to collect data. Both SIH and LNH faced challenges associated with the distribution of responsibilities and resources with pressure to report in a timely fashion. However, the burden on the SIH was so onerous that it significantly impeded routine hospital work and patient care.Conclusion:The disparity in health IT capabilities highlights significant institutional inequities and variability in response during a pandemic. The findings have implications for how government and other regulatory bodies may adjust policies to equitably meet public health needs and not unfairly burden small hospitals.

Health Systems Need to Transform Data Collection to Advance Health Equity.

Health Systems Need to Transform Data Collection to Advance Health Equity.

Heterogeneity and Interoperability in Local Public Health Information Systems.

Heterogeneity and Interoperability in Local Public Health Information Systems.

Primary Care Doctor Characteristics That Determine the Use of Teleconsultations in the Catalan Public Health System: Retrospective Descriptive Cross-Sectional Study.

BackgroundeConsulta is a tele-consultation service involving doctors and patients, and is part of Catalonia's public health information technology system. The service has been in operation since the end of 2015 as an adjunct to face-to-face consultations. A key factor in understanding the barriers and facilitators to the acceptance of the tool is understanding the sociodemographic characteristics of general practitioners who determine its use.ObjectiveThis study aimed to analyze the sociodemographic factors that affect the likelihood of doctors using eConsulta.MethodsA retrospective cross-sectional analysis of administrative data was used to perform a multivariate logistic regression analysis on the use of eConsulta in relation to sociodemographic variables.ResultsThe model shows that the doctors who use eConsulta are 45-54 years of age, score higher than the 80th percentile on the quality of care index, have a high degree of accessibility, are involved in teaching, and work on a health team in a high socioeconomic urban setting.ConclusionsThe results suggest that certain sociodemographic characteristics associated with general practitioners determine whether they use eConsulta. These results must be taken into account if its deployment is to be encouraged in the context of a public health system.

Barriers to Local Public Health Chronic Disease Surveillance Through Health Information Exchange: A Capacity Assessment of Health Departments in the Health Information Network of South Texas.

Health information exchanges (HIEs) offer potential data sources for public health agencies to improve chronic disease surveillance; however, public health has not yet capitalized on these data. This study identified barriers that public health departments participating in the Health Information Network of South Texas face regarding HIE and community-level surveillance of chronic diseases. This study focused on 2 health departments participating in the Health Information Network of South Texas. We administered a survey to inventory the technology infrastructure of health departments and conducted semistructured interviews of the local, state, and national officials. We identified 3 barriers to using HIE for disease surveillance: insufficient skilled staff, variation in how laws are interpreted, and lack of a coordinated public health information technology strategy. We provide 4 recommendations for policy and practice: personnel capacity development, interorganizational informatics collaboration, interim approaches to clarifying the legality of bidirectional HIE until overarching legislation is enacted, and development of an enterprise architecture plan.

Blockchain Applications and Use Cases in Health Information Technology

Blockchain technology and the associated crypto currencies have the ability to transform industries including healthcare. We suggest the decentralized and programmable nature of the blockchain applications can be used to change health information technology to gain greater efficiency in public and private health care systems. Current public health information technology systems such as eligibility, enrolment and electronic health records have documented issues with interoperability and are slow to adapt to changing program and technology demands. We suggest that blockchain can potentially solve these issues. We argue that a public program such as the U.S. Medicaid program with $553 Billion in total program costs and over $25 Billion spent on health information technology and administration last fiscal year could benefit from the use of blockchain based distributed ledger and smart contracts. We finally argue that a decentralized benefits administration system can provide greater efficiency to enrolment, eligibility, claims payment and adjudication processes thus driving efficiency and reducing systemic fraud.

Control of the Public Health IT Physical Infrastructure: Findings From the 2015 Informatics Capacity and Needs Assessment Survey.

Despite improvements in information technology (IT) infrastructure in public health, there is still much that can be done to improve the adoption of IT in state and local health departments, by better understanding the impact of governance and control structures of physical infrastructure. To report out the current status of the physical infrastructure control of local health departments (LHDs) and to determine whether there is a significant association between an LHD's governance status and control of the physical infrastructure components. Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County and City Health Officials. A total of 324 LHDs from all 50 states completed the survey (response rate: 50%). Outcome measures included control of LHD physical infrastructure components. Predictors of interest included LHD governance category. The majority of the control of the physical infrastructure components in LHDs resides in external entities. The type of governance structure of the LHD is significantly associated with the control of infrastructure. Additional research is needed to determine best practices in IT governance and control of physical infrastructure for public health.

Hospital Adoption of Health Information Technology to Support Public Health Infrastructure.

Health information technology (IT) has the potential to improve the nation's public health infrastructure. In support of this belief, meaningful use incentives include criteria for hospitals to electronically report to immunization registries, as well as to public health agencies for reportable laboratory results and syndromic surveillance. Electronic reporting can facilitate faster and more appropriate public health response. However, it remains unclear the extent that hospitals have adopted IT for public health efforts. To examine hospital adoption of IT for public health and to compare hospitals capable of using and not using public health IT. Cross-sectional design with data from the 2012 American Hospital Association annual survey matched with data from the 2013 American Hospital Association Information Technology Supplement. Multivariate logistic regression was used to compare hospital characteristics. Inverse probability weights were applied to adjust for selection bias because of survey nonresponse. All acute care general hospitals in the United States that matched across the surveys and had complete data available were included in the analytic sample. Three separate outcome measures were used: whether the hospital could electronically report to immunization registries, whether the hospital could send electronic laboratory results, and whether the hospital can participate in syndromic surveillance. A total of 2841 hospitals met the inclusion criteria. Weighted results show that of these hospitals, 62.7% can electronically submit to immunization registries, 56.6% can electronically report laboratory results, and 54.4% can electronically report syndromic surveillance. Adjusted and weighted results from the multivariate analyses show that small, rural hospitals and hospitals without electronic health record systems lag in the adoption of public health IT capabilities. While a majority of hospitals are using public health IT, the infrastructure still has significant room for growth. Differences in hospitals' adoption of public health IT may exacerbate existing health disparities.

The Public Health Information Technology Maturity Index: An Approach to Evaluating the Adoption and Use of Public Health Information Technology

Background: Public health information technology (PHIT) has the potential to improve the effective and efficient use of information in achieving public health objectives. Information technology maturity models have been extensively used in other domains to guide information technology assessment and planning, but an information technology maturity model tailored for public health departments has heretofore been unavailable. Purpose: The purpose of this study was to develop a Public Health Information Technology Maturity Index. Methods: An extensive literature review and content analysis was conducted of information system adoption, use, and maturity in general and in the public health systems and services research context in particular. Primary data were collected through staff interviews (61), staff observations (16), patient focus groups (3), and staff surveys (3) over the course of a multi-year technology implementation, including preand postimplementation of an electronic health record system at a large suburban public health department. Data were analyzed using qualitative and quantitative methods to extract potential categories for inclusion in the index. A Delphi exercise whose panelists included experts from state and local public health departments and national multi-stakeholder groups was conducted. Results: A Public Health Information Technology Maturity Index, questionnaire, and scoring guide were created. The Maturity Index consisted of four primary categories: Scale and Scope of PHIT Use; PHIT Quality; PHIT Human Capital, Policy and Resources; and, PHIT Community Infrastructure, along with fourteen subdimensions. Implications: The PHIT Maturity Index represents a practical approach to aid public health system stakeholders, notably health departments, in the evaluation of their information technology deployment decisions. As benchmark data become available, it will enable comparative assessment and possible linking of information technology maturity and multi-agency interoperability to population health outcomes.

Designing an information technology system in public health: observations from India

The use of information technology in healthcare has seen varying success across states, due to differing institutional capacities. Despite isolated successes and partial gains, public health information technology systems in the country are unable to support integrated decision making at either district or state levels. An emphasis on technological advancements without significant attention to systems design has limited the potential gains from applications of information technology. This paper is an effort to describe the level of public health information technology systems development over the eleventh plan period and examine the architectural constraints that constitute a common problem across systems.

A Vision for More Effective Public Health Information Technology

Recently there has been a surge in dialogue both among public health partners and within the Centers for Disease Control and Prevention (CDC) regarding efforts to identify a consolidated set of best of software application development, specifically to fit the mold of public health information technology (IT). While the intentions behind these motivations are to be applauded -- such talk recognizes the truth that public health IT is a complicated and difficult field which attempts to provide workable, viable technology solutions for additional public health capacity -- intentions toward a single set of consolidated IT approaches risk surrendering the strength of public health to adapt and respond to unforeseen challenges, such as outbreaks or emergency scenarios. Not all areas of public health have the same set of requirements. Epidemiological response to a sudden disease outbreak, for example, will be quite different in its approaches and investigative methods from a response to an increase in chronic disease in a specific population group. Unique disease outbreaks each unfold differently. Similarly, laboratory methods for clinical specimens vs. environmental samples are not expected to follow precisely similar practices either, for each is a unique entity.

Using Information Technology to Improve the Public Health System

Information technology can be both a vital tool and critical link in the modern public health system. This article discusses the role of information technology in public health and the activities of the Information Technology Collaborative, one of the collaboratives that comprise the national Turning Point initiative. Data are presented from a nationwide survey investigating local health department information technology needs and information technology use. This data, and data from an investigation of state-level public health information technology, will be presented in a more complete format on the Information Technology Collaborative's online Public Health Information Systems Catalog, a free resource for individuals interested in public health informatics. Recommendations for future initiatives, policy changes, and information technology standards are discussed.