Local public health agencies' involvement in electronic health records and syndromic surveillance systems

Background: Local health departments (LHDs) are the building blocks of grass-roots level public health system, because they perform essential public health functions at community level. Assessing their informatics capacity is important within the context of broader health reform efforts, large-scale investments of resources supporting health information technology, and the ability for LHDs to support relevant data exchange. This research will examine LHDs' informatics capacity as it relates to electronic health records (EHRs), use of health information exchanges (HIEs or RHIOs), and use of electronic syndromic surveillance systems. Objective/purpose: (a) Assess LHD's informatics capacity concerning electronic health records (EHRs), use of health information exchanges (HIEs) and use of electronic syndromic surveillance systems; and (b) Variation in such capacity by important LHD characteristics. Methods: This study uses data from NACCHO's 2010 National Profile of Local Health Departments (Profile) Survey completed in November of 2010. The Profile is a survey of all LHDs in the country. Results: Our preliminary analysis shows that currently 21 percent of LHDs have implemented EHRs. Seventeen percent of LHDs are Planning to implement EHRs and 27 percent are investigating or have investigated development of EHR capacity. The remaining 34 percent have had no activity in this area or thought it was not applicable. Use of health information exchanges is not very prevalent among LHDs – eight percent have implemented , and six percent are planning to implement. Slightly less than 60 percent of LHDs use electronic syndromic surveillance systems. Discussion/conclusion: Examining and geographically displaying variation in LHD's engagement in assessing and addressing gaps in community level access to healthcare have important implications for local public health practice and policy.