The State of Informatics in Local Health Departments

In order to ascertain the state of public health informatics in local health departments (LHDs), the National Association of County and City Health Officials (NACCHO) conducted an informatics needs assessment. The needs assessment consisted of two components: a quantitative survey that covered a wide variety of informatics related topics, and a series of focus groups. This presentation will focus on the results from the survey, and in particular the questions relating to informatics infrastructure and workforce capacity. Building on questions from previous surveys, including the Profile study, NACCHO sampled about a quarter of the 2800 LHDs (n=724) throughout the country, stratified for population served by that LHD. Respondents used a web-based survey tool to enter their answers. A response rate of approximately 33% was achieved, with higher rates among LHDs that serve larger populations. Results showed that LHDs have low levels of information systems use. For example, of the LHDs that provide primary health care through clinics, almost half rely solely on paper records and a majority of the remainder uses a mix of paper and electronic systems. A lack of funding was identified as one of the major barriers to implementing information systems, along with a lack of time or resources able to be diverted for implementation.

This is a unique time for health information technology, with large-scale investment resulting from the stimulus legislation. As it currently stands, a significant proportion of this investment will need to be directed towards LHDs in order for them to fully take advantage of HIT, or else they will fall behind the broader healthcare industry. The findings from the survey will be used to advocate for LHDs at a national level and to guide NACCHO’s informatics programs.