Interoperability of Information Systems Managed and Used by the Local Health Departments.
BACKGROUND
In the post-Affordable Care Act era marked by interorganizational collaborations and availability of large amounts of electronic data from other community partners, it is imperative to assess the interoperability of information systems used by the local health departments (LHDs).


OBJECTIVE
To describe the level of interoperability of LHD information systems and identify factors associated with lack of interoperability.


METHODS
This mixed-methods research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling design. A total of 324 completed responses were received (50% response rate). Qualitative data were used from a key informant interview study of LHD informatics staff from across the United States. Qualitative data were independently coded by 2 researchers and analyzed thematically. Survey data were cleaned, bivariate comparisons were conducted, and a multivariable logistic regression was run to characterize factors associated with interoperability.


RESULTS
For 30% of LHDs, no systems were interoperable, and 38% of LHD respondents indicated some of the systems were interoperable. Significant determinants of interoperability included LHDs having leadership support (adjusted odds ratio [AOR] = 3.54), control of information technology budget allocation (AOR = 2.48), control of data systems (AOR = 2.31), having a strategic plan for information systems (AOR = 1.92), and existence of business process analysis and redesign (AOR = 1.49).


CONCLUSIONS
Interoperability of all systems may be an informatics goal, but only a small proportion of LHDs reported having interoperable systems, pointing to a substantial need among LHDs nationwide.
Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia (Drs Shah and Kaur); de Beaumont Foundation, Bethesda, Maryland (Dr Leider); and Department of Public Health, Brody School of Medicine, East Carolina University, North Carolina (Dr Luo).
Gulzar H
GH
Shah
Jonathon P
JP
Leider
Huabin
H
Luo
Ravneet
R
Kaur
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