Public health shared services model: Applying public health standards to health department services and functions

Information management of public health programs is characterized by database silos that were created without regard to standardized knowledge representation or common identifiers for providers or patients, and without the intention of sharing data or technological resources. We offer a different approach - a shared services model that is based on the ten essential services of Public Health as defined by the Institute of Medicine and the standards and measures specified by the Public Health Accreditation Board. The model specifies roles within those ten essential functions and draws on nationally-recognized information standards and best practice protocols while allowing programs the flexibility to tailor their unique aspects through a shared metadata knowledge base.

To identify the common set of services, a qualitative analysis of 142 database applications was undertaken in the State of Oregon Division of Public Health. From that analysis, 36 common services and functionality were identified. Results of the analysis reveal the depth of duplicative effort that is common in Public Health departments, with each service recreated and operated independently an average of 25 times. Moreover, the lack of standards in knowledge representation or patient and provider identification make it difficult to put the data together in a meaningful and cost effective way. The shared services model is an attainable alternative to the siloed approach.