Modernizing Our Nation's Public Health Information System: Toward an Integrated Approach

Abstract

Public health is an information business. This maxim is most recently and dramatically evident in how all levels of the public health system require information to understand and respond to the COVID-19 pandemic. Furthermore, information is central to the fight against other public health threats and emergencies and to improving health equity.Unfortunately, public health suffers from the lack of a sufficiently funded, well-coordinated, and methodically organized approach to guiding, building, and maintaining the information systems it needs to accomplish multijurisdictional health challenges. As the COVID-19 pandemic painfully demonstrated, lack of timely and accurate information compounded the challenges and increased the difficulty of an effective public health system response. Furthermore, progress on health equity will require more complete, granular, multidomain (ie, justice, child welfare, transportation, etc), and timely data, thereby allowing for useful insights into both health and social determinants of health.In this column, we summarize the key findings and recommendations of a recent report from the Public Health Informatics Institute (PHII) supported by the Robert Wood Johnson Foundation designed to capture the present opportunity to strengthen the public health system in preparation for whatever the future may hold. 1 In addition, we add our own insights based on decades of experience in public health informatics and capacity building.

The Public Health National Center for Innovations: An Initial Qualitative Evaluation

“…For example, supporting COVID-19 recovery, facilitating the modernization of information systems and data, and addressing health inequities are 3 of several priority areas where health departments require continued support to ensure that they meet population health needs. 3,18 Similarly, guiding public health frameworks such as the Public Health 3.0 model speaks to ongoing and future needs in the public health field (eg, deepening its cross-sector work and strengthening its use of data) and, in turn, illuminates future opportunities for PHNCI. Furthermore, innovative efforts in the public health field to support COVID-19 recovery, modernize data systems, and address health inequities play a direct role in working to dismantle structural racism.…”

“…To address ongoing and emerging challenges, the public health field is ripe for innovation on specific topics. For example, supporting COVID-19 recovery, facilitating the modernization of information systems and data, and addressing health inequities are 3 of several priority areas where health departments require continued support to ensure that they meet population health needs 3,18. Similarly, guiding public health frameworks such as the Public Health 3.0 model speaks to ongoing and future needs in the public health field (eg, deepening its cross-sector work and strengthening its use of data) and, in turn, illuminates future opportunities for PHNCI.…”

A Brief History of Public Health Informatics—Lessons for Leaders and a Look Into the Future

“…Past history of rigid categorical funding established highly functional single-purpose programs (aka silos) and prevented more logical cross-functional system development. As a result, the public health system now faces a new decade of investment in public health data and information infrastructure, beginning with a laser focus on essential surveillance systems 1. Leaders should make the most of it by being a constructive part of the national partners coalition formed by the CDC and by helping your health agency work toward forging, accepting, and adopting standards-based systems and adopting cloud-based solutions that your IT department does not own and control.…”

“…As the public health enterprise embarks on a Data Modernization Initiative (DMI), a national effort designed to modernize public health surveillance and related information systems,1 a brief review of the recent history of public health informatics with attention to leadership lessons is in order. In this, we will highlight the history of a series of initiatives designed to improve the capacity of the public health system to manage information.…”

Supporting Evidence-Based Care Through Informatics Innovation to Address the Overdose Epidemic

“…In this column, we review leadership practices including facilitators, barriers, lessons learned, and guiding principles leading to informatics innovation and partnership development to address the challenges of the drug overdose crisis. We highlight examples from health system pilot projects that support closer linkages between public health and the health care system, which build from a model of data system modernization,4 as discussed in previous Management Moment columns in this journal.…”