title: Critical issues in the development of health information systems in supporting environmental health: a case study of ciguatera.
abstract: BACKGROUND
  Emerging environmental pressures resulting from climate change and globalization challenge the capacity of health information systems (HIS) in the Pacific to inform future policy and public health interventions. Ciguatera, a globally common marine food-borne illness, is used here to illustrate specific HIS challenges in the Pacific and how these might be overcome proactively to meet the changing surveillance needs resulting from environmental change.
  
  
  OBJECTIVE
  We review and highlight inefficiencies in the reactive nature of existing HIS in the Pacific to collect, collate, and communicate ciguatera fish poisoning data currently used to inform public health intervention. Further, we review the capacity of existing HIS to respond to new data needs associated with shifts in ciguatera disease burden likely to result from coral reef habitat disruption.
  
  
  CONCLUSIONS
  Improved knowledge on the ecological drivers of ciguatera prevalence at local and regional levels is needed, combined with enhanced surveillance techniques and data management systems, to capture environmental drivers as well as health outcomes data.
  
  
  CONCLUSIONS
  The capacity of public HIS to detect and prevent future outbreaks is largely dependent on the future development of governance strategies that promote proactive surveillance and health action. Accordingly, we present an innovative framework from which to stimulate scientific debate on how this might be achieved by using existing larger scale data sets and multidisciplinary collaborations.
authors.affiliation: School of Population Health, University of Queensland, Herston, Queensland, Australia. sgoater.ecohealth@gmail.com
authors.forename: Sarah
authors.initials: S
authors.lastname: Goater
authors.forename: Bonnie
authors.initials: B
authors.lastname: Derne
authors.forename: Philip
authors.initials: P
authors.lastname: Weinstein
mesh_terms: D036841:Ciguatera Poisoning / Q000453:epidemiology*; D004782:Environmental Health; D005517:Foodborne Diseases / Q000453:epidemiology; D006801:Humans; D007256:Information Systems