The Status of LHD Information Systems: Results from the 2010 NACCHO Informatics Needs Assessment

1. The Status of LHD Information Systems:Results from the 2010 NACCHO Informatics Needs Assessment Wednesday, May 26, 2010 Alastair Matheson Senior Analyst, Informatics

2. Overview of Webinar • Goals of the webinar • Purpose of the project • Overview of the project • Topics covered • Key findings • Implications • Questions

3. Five Things First… • This webinar will be recorded and available on NACCHO’s website • The slides will also be available for download • Please complete the evaluation when you receive the link • Type your questions in the box as we go • Quick poll…

4. Poll—Knowledge and Experience with PHI • Please rate your knowledge and experience of public health informatics (PHI): • 1 (I have barely heard of PHI) • 2 (I have some knowledge of PHI but little experience) • 3 (I am familiar with some PHI terms and uses) • 4 (I have fairly extensive knowledge and experience with PHI) • 5 (I am very knowledgeable about PHI)

5. Goals of Webinar • To show why NACCHO undertook this initiative • To present some of the key findings of the study • To discuss implications of the findings • To make you want to read the reports

6. Purpose of the Project • Focus on health informatics due to HITECH Act • To fill the gap in knowledge about LHDs’ use of informatics • To guide NACCHO’s programs  better serve LHDs • To inform and influence national and state policy and decision-makers

7. Overview of the Project • Web survey Nov 2009 to Jan 2010 (42% response rate) • Focus groups in Feb and Mar 2010 (41 participants) • Data analysis from Jan to April 2010 • Two reports: • Full version contains all the findings (http://eweb.naccho.org/prd/?na334pdf) • Summary version with key findings (http://eweb.naccho.org/prd/?na335pdf) • Many potential future analyses

8. Topics • Nomenclature • Physical infrastructure • Skills and capacity within LHDs • Informatics workforce needs • System development and implementation • Electronic health records • Surveillance

9. Topics (cont.) • Other information systems • Barriers to implementation • ARRA/HITECH funding • Health information exchange • Knowledge management • Web 2.0 • Ways NACCHO can help

10. Some LHDs well advanced in their informatics use Most LHDs have areas for significant improvement Key Findings

11. Nomenclature • Many people have not heard the term informatics • Some think it pertains to data and information flow • It can be difficult to communicate informatics concepts to general workforce

12. Control of Physical Infrastructure

13. Skills and Capacity in LHDs • Most LHDs have staff who can extract, use and interpret data • About a third of LHDs rely on SHDs for some to provide some or all of their informatics activities • 31% LHDs do not use GIS • 14% rely on contractors to maintain their web site

14. Workforce Needs

15. Poll—What Aspect of MS Office? • What aspect of using MS Office do you think people need training on? • How to use word processing • How to add and manipulate data in spreadsheet software • How to build databases • How to output data in a meaningful way • How to make flashy presentations • Something else

16. Barriers to Informatics Training

17. System Development and Implementation • Development of systems is driven by funding opportunities • Funding opportunities relate to external agencies priorities (may not match LHD’s) • “Development is driven by what gets attention” • Focus group participants positive about SHDs consulting with LHDs • LHDs use informatics to positively impact health

18. LHDs’ Use of EHRs

19. Challenges when Implementing EHRs

20. Electronic Surveillance Systems

21. Other Information Systems • Many LHDs (usually 30–50%) collect data on paper • Office computers are the other main mechanism for collection • Between 50 and 75% LHDs store data on paper • Web-based databases are also common storage sites • Data are often mailed or faxed • In other instances other people have access to the database • LHDs will use different methods for the same data

22. System Compatibility

23. Poll—Ways to Achieve Internal Interoperability • Which of the following is the most important activity for achieving internal interoperability? • Coordinating grants at CDC (and other federal partners) • Ensuring that statewide HIEs deal with all LHDs’ needs (e.g. infectious diseases, case management, environmental health, planning and assessment) • Building on Common Ground to standardize LHDs’ business processes/workflow • Developing better connectivity among state information systems • Develop an information system that meets LHDs’ needs (e.g. infectious diseases, case management, environmental health, planning and assessment) • Something else

24. Barriers to System Development

25. Plan to Seek Stimulus Resources

26. Planning to Work with SHD on HIE

27. Electronic Exchange of Health Data

28. Health Information Exchange • Is this accurate or does it reflect LHDs’ lack of engagement?

29. Health Information Exchanges • “What you enter today you can see tomorrow, so all that information will be accessible to the local health department in real time. And that is one of the biggest bonuses for public health” • —LHD focus group participant

30. Knowledge Management

31. Web 2.0

32. Poll—Length of Time Using Web 2.0 • How long has your organization been using Web 2.0 technologies • Never used Web 2.0 at all • Used to use Web 2.0 but no longer do • Less than 6 months • Between 6 and 12 months • Between 1 and 2 years • More than 2 years

33. Implications • Health outcomes are affected by LHD use of informatics • Better communication with LHDs required • Informatics concepts • National opportunities such as EHR and HIE funding • Tools and resources that can help • Understanding which systems should be linked • LHDs need dedicated informatics funding and staff to overcome barriers

34. Implications • LHDs need dedicated informatics funding and staff to overcome barriers • LHDs need support with informatics skills, possibly through RECs • LHDs could benefit from improved tools for handling data • Challenges cannot just be solved at a local level • Let’s start with interoperability of LHD information systems

35. Before You Hang Up • Please complete the (very) short evaluation of this webinar • Both reports available in NACCHO’s bookstore very soon • Hard copies of summary report available • Tell all your colleagues about public health informatics

36. Questions? Comments?