Local Public Health leadership and community efforts to obtain ARRA stimulus funding

ARRA stimulus funding has dramatically accelerated national, state and local efforts to increase the adoption of electronic health record (EHR) systems and develop health information exchange (HIE). Requirements for “meaningful use” of these systems, initially supported by incentives for physicians and hospitals, will be followed by penalties for failure to adopt as early as 2015. Other initiatives such as funding to support HIT workforce training, Regional Extension Centers to support EHR adoption in Rural and Underserved areas, and cooperative agreements with state agencies to provide support for statewide health information exchange are intended to increase EHR adoption and the development of HIE. These electronic information systems could have profound implications for public health related to syndromic surveillance, chronic disease management, reductions in accidental death, and reductions in health disparities. However, these EHR and HIE systems frequently emerge at the local level, particularly in the larger more populous states, primarily involving local health care providers and insurers with very little representation of public health. This presentation covers a case history of a local health department providing primary leadership for a community's effort to enhance EHR adoption and HIE including major efforts to obtain ARRA stimulus funding for EHR and HIE. The Duval County Health Department had a primary role in mobilizing Jacksonville community efforts to partner with other regions of the state for a REC cooperative agreement and submitted a Beacon Community proposal. These efforts were preceded by successful efforts to: 1) develop grant proposals for health information exchange, 2) manage and facilitate a greater than 10 fold increase in utilization of a health information exchange for uninsured and the underinsured, and 3) use electronic health information systems to document health disparities and health issues.