Clinical Data Systems to Support Public Health Practice: A National Survey of Software and Storage Systems Among Local Health Departments.
BACKGROUND
Numerous software and data storage systems are employed by local health departments (LHDs) to manage clinical and nonclinical data needs. Leveraging electronic systems may yield improvements in public health practice. However, information is lacking regarding current usage patterns among LHDs.


OBJECTIVE
To analyze clinical and nonclinical data storage and software types by LHDs.


METHODS
Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County and City Health Officials.


METHODS
A total of 324 LHDs from all 50 states completed the survey (response rate: 50%).


METHODS
Outcome measures included LHD's primary clinical service data system, nonclinical data system(s) used, and plans to adopt electronic clinical data system (if not already in use). Predictors of interest included jurisdiction size and governance type, and other informatics capacities within the LHD. Bivariate analyses were performed using χ and t tests.


RESULTS
Up to 38.4% of LHDs reported using an electronic health record (EHR). Usage was common especially among LHDs that provide primary care and/or dental services. LHDs serving smaller populations and those with state-level governance were both less likely to use an EHR. Paper records were a common data storage approach for both clinical data (28.9%) and nonclinical data (59.4%). Among LHDs without an EHR, 84.7% reported implementation plans.


CONCLUSIONS
Our findings suggest that LHDs are increasingly using EHRs as a clinical data storage solution and that more LHDs are likely to adopt EHRs in the foreseeable future. Yet use of paper records remains common. Correlates of electronic system usage emerged across a range of factors. Program- or system-specific needs may be barriers or facilitators to EHR adoption. Policy makers can tailor resources to address barriers specific to LHD size, governance, service portfolio, existing informatics capabilities, and other pertinent characteristics.
School for the Science of Health Care Delivery, College of Health Solutions, Arizona State University, Phoenix (Dr McCullough); and Maricopa County Department of Public Health, Phoenix, Arizona (Dr McCullough and Ms Goodin).
J Mac
JM
McCullough
Kate
K
Goodin
AMIA Annu Symp Proc. 2014 Nov 14;2014:795-804
25954386
Health Aff (Millwood). 2012 Mar;31(3):505-13
22392661
Public Health Rep. 2014 Jul-Aug;129(4):335-41
24982536
Public Health Rep. 2016 Mar-Apr;131(2):272-82
26957662
Annu Rev Public Health. 1995;16:239-52
7639873
Online J Public Health Inform. 2014 Dec 15;6(3):e199
25598871
J Public Health Manag Pract. 2000 Nov;6(6):67-75
18019962
MMWR Morb Mortal Wkly Rep. 2016;65(3):ND-38
27220123
Am J Public Health. 2011 Apr;101(4):616-23
21330598
J Am Med Inform Assoc. 2001 Nov-Dec;8(6):535-45
11687561
J Public Health Manag Pract. 2015 Jan-Feb;21(1):E20-8
25271385
Health Aff (Millwood). 2012 May;31(5):1092-9
22535503
J Public Health Manag Pract. 1996 Fall;2(4):58-60
10186699
BMC Health Serv Res. 2014 Sep 21;14:415
25240718
Online J Public Health Inform. 2015 Jul 01;7(2):e216
26392846
Health Aff (Millwood). 2013 Aug;32(8):1470-7
23840050
J Public Health Manag Pract. 2012 Mar-Apr;18(2):160-8
22286285
J Public Health Manag Pract. 2013 Jul-Aug;19(4):383-5
23719392
Health Aff (Millwood). 2013 Aug;32(8):1478-85
23840052