209598 Rationale, model and practice experience for local public health leadership in developing community-level electronic health information systems

Wednesday, November 11, 2009: 9:30 AM

William Livingood, PhD , Center for Health Equity & Quality Research & JPHsu COPH, Duval County Health Department & Univ of Florida & Georgia Southern Univ, Jacksonville, FL
Robert G. Harmon, MD, MPH , Director, Duval County Health Department, Jacksonville, FL
Radley Remo, MPH , Institute for Health, Policy and Evaluation Research, Duval County Health Department, Jacksonville, FL
Susan Coughlin, MPH , Institute for Health, Policy and Evaluation Research, Duval County Health Department, Jacksonville, FL
Anita Davis, BA , Institute for Health, Policy and Evaluation Research, Duval County Health Department, Jacksonville, FL
Major resources are being dedicated to electronic health records (ehr) and information (ehi) exchange. While larger health care systems have adopted ehr and ehi, local community-based private physician offices and hospitals lag behind the earlier adopters. Gaps in adoption of these systems at the community level, the national consensus on the need for these systems, and unprecedented resources being dedicated to developing these systems present major challenges and opportunities for both public health and health care.

Challenges to developing ehi networks for either heath care or public health are increasingly recognized as social and political, rather than technological. Fragmentation and competition at virtually all levels present major challenges to coordination and collaboration necessary for the development of effective ehi exchange. Competition for market share among major hospitals, physician groups, software vendors, and insurance companies reflect many of these challenges. Competing efforts to establish RHIOs exacerbate the challenges. Greater Jacksonville provides an example of unique leadership and critical support provided by a local health department to overcome an extensive array of these barriers and challenges. Successes in obtaining grants shared by multiple partners, designation as a CMS demonstration site, and progress in advancing and maintaining ehi within the community are examples of LHD leadership in the diffusion of ehr and development of ehi within the Jacksonville community.

The benefits of LHD leadership in the public-private sector initiative, compelling reasons for LHD involvement in the development of ehi, examples of applying the theories and practices of community engagement and coalition and consortium development, and the successes in promoting ehr and developing ehi will be discussed. This model and lessons learned have important implications for: development of the national public health information network (PHIN), building local public health system capacity, and enhancing the connections between clinical/hospital systems and public health systems.

Learning Objectives:
Following the presentation, participants will be able to: Identify major challenges to the development of community-level electronic health information exchange, Describe key components of a model for overcoming barriers and challenges to developing health information exchange systems, Discuss the potential roles of local health departments in developing health information exchange systems.

Keywords: Health Information Systems, Local Public Health Agencies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: PhD degree, Director of Institute for Health, Policy & Evaluation Research for LHD, and Co-Dircetor of University of Florida College of Medicine-Jacksonville Center for Health Equity and Quality Research, and extensive work in this area for last three years
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.