Governance's Role in Local Health Departments' Information System and Technology Usage

Vest, Joshua R.; Menachemi, Nir; Ford, Eric W.

doi:10.1097/phh.0b013e318226c9ef

Cited by 20 publications

(22 citation statements)

References 11 publications

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“…91, 92 While it is not intuitively obvious how smaller LHDs could modify the predictor status of their small jurisdictions, there is increasing evidence that cross-jurisdictional sharing and regionalization of multiple LHDs may provide opportunities to enhance A-EBPs in such settings. 28, 93 …”

Section: Discussionmentioning

confidence: 99%

Understanding Administrative Evidence-Based Practices

Brownson

Reis

Allen³

et al. 2014

American Journal of Preventive Medicine

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Background There are sparse data showing the extent to which evidence-based public health is occurring among local health departments. Purpose The purpose of the study was to describe the patterns and predictors of administrative evidence-based practices (structures and activities that are associated with performance measures) in a representative sample of local health departments in the United States. Methods A cross-sectional study of 517 local health department directors was conducted from October through December 2012 (analysis in January through March 2013). The questions on administrative evidence-based practices included 19 items based on a recent literature review (five broad domains: workforce development, leadership, organizational climate and culture, relationships and partnerships, financial processes). Results There was a wide range in performance among the 19 individual administrative evidence-based practices, ranging from 35% for access to current information on evidence-based practices to 96% for funding via a variety of sources Among the five domains, values were generally lowest for organizational climate and culture (mean for the domain = 49.9%) and highest for relationships and partnerships (mean for the domain = 77.1%). Variables associated with attaining the highest tertile of administrative evidence-based practices included having a population jurisdiction of 25,000 or larger (adjusted odds ratios (aORs) ranging from 4.4 to 7.5) and state governance structure (aOR=3.1). Conclusions This report on the patterns and predictors of administrative evidence-based practices in health departments begins to provide information on gaps and areas for improvement that can be linked with ongoing quality improvement processes.

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Section: Discussionmentioning

confidence: 99%

Understanding Administrative Evidence-Based Practices

Brownson

Reis

Allen³

et al. 2014

American Journal of Preventive Medicine

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“…Generally, increasing the number of data sources increases challenges around maintaining information quality [11]. Additionally, each LHD is often home to a variety of different data management approaches [12], which can include multiple or programmatic-specific information systems (IS) that are not capable of electronically sharing information in a standards-based structured fashion, or reliance on a combination of paper and IS [13-17]. This too creates complications as increasing the number of IS which an individual must use increases the complexity of work and negatively affects productivity [12].…”

Section: Introductionmentioning

confidence: 99%

Experience of Using Information Systems in Public Health Practice: Findings from a Qualitative Study

Vest

Issel

Lee

2014

OJPHI

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ObjectiveData collection and management by local health departments (LHDs) is a complex endeavor, complicated by system level and organizational factors. The purpose of this study was to describe the processes and use of information systems (IS) utilized for data collection, management, and sharing by LHD employees.MethodsWe interviewed a purposive sample of 12 staff working in the key public health practice areas of communicable disease control, immunizations, and vital records from three LHDs in different states. Our interview questions addressed job descriptions, daily activities, and the use and perceptions of both data and IS in support of their work. A content analytic approach was used to derive themes and categories common across programmatic areas.ResultsLocal public health involves the use of mix of state-supplied and locally implemented IS supported by paper records. Additionally, each LHD in this study used at least one shadow system to maintain a duplicate set of information. Experiences with IS functionality and the extent to which it supported work varied by programmatic area, but inefficiencies, challenges in generating reports, limited data accessibility, and workarounds were commonly reported.ConclusionsCurrent approaches to data management and sharing do not always support efficient public health practice or allow data to be used for organizational and community decision making. Many of the challenges to effective and efficient public health work were not solely technological. These findings suggest the need for interorganizational collaboration, increasing organizational capacity, workflow redesign, and end user training.

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“…First, public health IS very much a reflection of the public health system in the US: a federation of independent states with differing relationships with their respective LHDs, tasked with various aspects of data collection, storage, and dissemination 2,3. Second, the utilized information technologies (IT) and IS in local health departments may not stem from public health needs and requirements, but instead from a local government’s broader needs, resources and existing IT/IS decisions 4. Furthermore, last decade’s relatively high level of preparedness funds awarded to public health, while providing a much needed upgrade to the IT/IS capacities of state and local agencies, has not been sustained and pre-dated the more recent advances and focus on interoperability seen in the broader health IT arena.…”

Section: Introductionmentioning

confidence: 99%

“…Lastly, public health informatics is a relatively new specialty within public health and still has uneven uptake across public health agencies 5. All in all, public health organizations historically have not implemented IS or adopted IT that support efforts at efficient and effective storage and sharing of data 4,6,7…”

Section: Introductionmentioning

confidence: 99%

Quality and integration of public health information systems: A systematic review focused on immunization and vital records systems

Vest

Kirk

Issel

2012

OJPHI

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Objectives:Public health professionals rely on quantitative data for the daily practice of public health as well as organizational decision making and planning. However, several factors work against effective data sharing among public health agencies in the US. This review characterizes the reported barriers and enablers of effective use of public health IS from an informatics perspective.Methods:A systematic review of the English language literature for 2005 to 2011 followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format. The review focused on immunization information systems (IIS) and vital records information systems (VRIS). Systems were described according to the structural aspects of IS integration and data quality.Results:Articles describing IIS documented issues pertaining to the distribution of the system, the autonomy of the data providers, the heterogeneous nature of information sharing as well as the quality of the data. Articles describing VRIS were focused much more heavily on data quality, particularly whether or not the data were free from errors.Conclusions:For state and local practitioners to effectively utilize data, public health IS will have to overcome the challenges posed by a large number of autonomous data providers utilizing a variety of technologies.

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Governance's Role in Local Health Departments' Information System and Technology Usage

Cited by 20 publications

References 11 publications

Understanding Administrative Evidence-Based Practices

Understanding Administrative Evidence-Based Practices

Experience of Using Information Systems in Public Health Practice: Findings from a Qualitative Study

Quality and integration of public health information systems: A systematic review focused on immunization and vital records systems

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