Online Program

Characterizing the informatics capacities and needs of local health departments in a post-Affordable Care Act landscape

Tuesday, November 3, 2015 : 4:30 p.m. - 4:50 p.m.

Gulzar Shah, PhD, MStat, MS, Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
JP Leider, PhD, de Beaumont Foundation, Bethesda, MD
Karmen Williams, MSPH, MA, DrPH(c), Health Policy and Management, Jian-Ping Hsu College of Public Health, GSU, Statesboro, GA
Akrati Gupta, BDS, MPH, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA
Brian Castrucci, MA, deBeaumont Foundation, Bethesda, MD
Background:  Health informatics realities of local health departments (LHDs) are profoundly influenced by dramatic gains in health informatics functionality in healthcare, a call for integration of public health and healthcare, and impacts of Affordable Care Act (ACA).

Research objectives/purpose:  (1) Characterize information systems used by LHDs, their level of interoperability and related issues. (2) Examine the impact of Affordable Care Act on the informatics needs and responsibilities of LHDs.

Methods: Primary data were collected from key informant interviews in late 2014 from 50 leaders of LHDs across the US. Data were coded thematically and independently in batches by two researchers.

Principal Findings: Results show wide variability in the types of systems LHDs utilize, as well as the availability of formal data collection and management technologies. This was a function of LHD size, statutory responsibilities, local county context, and governance. Interoperability of information systems is the exception, not the rule. Lack of interoperability results in duplication of efforts in data entry and is caused by incremental development of health information systems, system development in silos.  Majority of LHDs had not seen any direct impact of the ACA policies on their informatics capacity. However, indirect impacts were unavoidable and often desirable.  Benefits included changed informatics needs and functionality as greater exchange of information is happening between the hospital and the health department, and greater interaction between hospitals and LHDs, leading to opportunities for building trust and exchanging data for better syndromic surveillance and health needs assessments.


Even with significant constraints, a reasonably bright, if uncertain, future for public health informatics is eminent in the post ACA era. Uptake of more advanced systems and analytic strategies appears contingent on funding, training, and good partnerships by public and private organizations are available to protect and improve population health.

Learning Areas:

Administer health education strategies, interventions and programs
Communication and informatics
Other professions or practice related to public health
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Analyze variation in information systems used by local health departments (LHDs), Discuss level of interoperability across information systems used by LHDs and challenges due to lack of interoperability. Discuss the impact of Affordable Care Act on the informatics needs and responsibilities of LHDs.

Keyword(s): Affordable Care Act, Information Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have multi-sector work experience that spans over 19 years, with appointments in both academia and public health practice agencies, nationally and internationally. Currently, I am serving as the Associate Dean for Research at the Jiann-Ping Hsu College of Public Health, Georgia Southern University (GSU).I have numerous funded grants and have authored over 150 publications/presentations on national and international professional forums. Currently, I am the senior associate editor for two peer reviewed journals.
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.