Improving the development of public health informatics systems: Lessons from the trenches

Recent advances in the Internet and health information technology suggest a strong potential for public health informatics systems as a strategic investment vehicle for improvements in public health. Historically, the nature of our health care system has promoted proprietary computer systems with significant limitations relative to their ability to consistently collect and share patient level data. This issue is exacerbated in public and community health sectors due to technology, financial and other resource limitations. Over the past several years, regional health information organizations (RHIOs) have made significant advances in forming coalitions of healthcare providers that have built health information exchanges (HIEs) to support sharing personal health information for direct patient care as well as public health oversight purposes. These efforts have been supported by government and private sector investments in technology and best practices to promote effective capture, management, and access to health information. While the results of these efforts have been mixed, they suggest a strategic framework for the development of public health informatics systems and supporting HIEs. Using lessons learned from HIE engagements in Wyoming, Delaware, Colorado, and Massachusetts, the author will specify an approach for the development of public health informatics systems and supporting HIEs. The approach highlights organizational requirements, policy guidelines, best practices, and a technology architecture which specifically supports public health informatics and public health centric health information exchange. The resulting technical architecture and public health RHIO strategically support evolving public health oversight responsibilities. Following this session, the attendees will be able to a) list the major steps associated with developing a public health informatics system, b) list the barriers to developing public health informatics systems as a strategic and sustainable investment, and c) discuss the approaches that best suit public health organizations to overcome these barriers.