Growing Informatics Capabilities at Local Health Departments Can Effectively Address Poor Health Outcomes and Improve Efficiency

This entry, originally posted in NACCHO Voice, is the first in a series of “NACCHO Annual preview” blog posts, which feature interviews with presenters ahead of NACCHO Annual 2017. Joseph Gibson, MPH, PhD, Director of Epidemiology at Marion County Public Health Department in Indiana, highlights the importance of acquiring informatics capabilities in his upcoming presentation, “From Top to Bottom: Building Informatics Skills throughout Your Agency,” and offers advice to other local health departments working to obtain these skills.

Joe Gibson

Why is it important for LHDs to have informatics capabilities?
Public health is information-intensive. We need good information to set priorities. Timely, accurate information allows us to focus our resources where the needs are greatest and helps us assess and adjust our efforts to make them increasingly effective. People with informatics skills can make information increasingly available, accurate, and timely. They implement tools and processes that increase productivity, allowing public health agencies to provide more services. Informaticians also identify and automate simple tasks, giving staff more time for the more satisfying activities that require their special skills.

In what ways has informatics benefitted your health department?
Good informatics practices have resulted in years of strategic, stakeholder-driven development of how we manage information here at Marion County. The result is that we have near-real-time tracking of important issues like mortality, opioid abuse, surface water quality, and our various direct service operations. We are no longer developing our infant mortality strategies on information that is two years old. Records from a client encounter at one of our sexually transmitted infections clinics are immediately available, so if the client shows up the next day at our adolescent clinic, our staff have the relevant information. Also, when the media or an elected official call for information about an issue, like the prevalence of smoking in pregnant women or the prevalence of asthma in some small area within our county, we can provide them with relevant, timely information within hours.

The informatics building blocks that led to all that include a consistent vision and support from our agency leadership, attention to user training, good communications and trust between stakeholders, and an IT department committed to getting user input to drive priorities, system selection, and development. Underlying that is an understanding that creating good information management takes time and commitment from staff throughout the agency.

What are some barriers to building informatics capacity in LHDs?
Local health departments need people with informatics skills. There are proven ways to identify and address opportunities to improve public health informatics, and we should be using them, rather than making it up as we go along. With those skills and our ingenuity and resourceful management, we can solve these problems. We also need to recognize that establishing effective information processes and systems takes time and skill – we should not expect plug and play solutions that do not involve stakeholder input and testing.  There are always challenges around skills and resources but with consistency, we find ways to keep moving forward. It takes resourceful management but that is nothing new for public health.

But if I could remove just one barrier, it would be the low expectation we have for informatics in public health. People working in public health are often resigned to having to deal with poor information systems, inefficient processes, and not having access to important information. We can do much better. Some public health departments are making great strides in improving informatics but we will all move much faster if our workforce, as a whole, has higher expectations. Higher expectations will do three things: (1) create the demand that will drive development; (2) generate the ideas we need to create improvements; and (3) better assure that we set the right priorities.

What advice do you have to offer other LHDs in building their informatics skills?
The December 2016 issue of the Journal of Public Health Management and Practice has some great case studies of how small and medium-size local health departments accomplished impressive development of their informatics capabilities with limited resources. Some success factors that emerged were consistent leadership, strategic planning, and using an incremental, opportunistic approach. I would also suggest the following:

  1. Informatics is a skill. Learn it, don’t wing it. Learn and use proven processes for developing information systems and improving information flow. A great place to start is the Public Health Informatics Institute’s web page.
  2. Expect to get the information you need to do your job effectively. Keep asking for, and looking for, ways to get it.
  3. Cultivate persistent, consistent leadership. Informatics improvements do not come quickly, especially in resource-poor environments. But if someone with some influence within the department consistently looks for opportunities to improve the availability, quality, and timeliness of information throughout the department, opportunities will appear and important progress can be made.
  4. Start small, but start. Think strategically and work incrementally.
  5. Don’t shortchange stakeholder involvement. Don’t underestimate the time and input needed for requirements development, system selection, development and testing, ongoing maintenance. When getting a new system, insist on good data access and interoperability functions.

What value do you find in attending NACCHO Annual?
I try to attend the NACCHO Annual conference every year. It always provides highly concentrated, practical information that is very relevant to the work I do every year. I get to see creative, effective things that other local health departments are doing and talk in depth to the folk who are doing them. I always leave with a bunch of information to share with folks back at my health department and a too-long list of things to try from my role here.

To learn more about how to build informatics skills in your health department, participate in Dr. Gibson’s session at NACCHO Annual 2017. For more information on this session and to register for NACCHO Annual 2017, visit www.nacchoannual.org.

About Kim Rodgers

Kim Rodgers serves as a Communications Specialist at NACCHO. Her work includes promoting local health departments' best practices, as well as partner tools and resources, in infectious disease and preparedness through NACCHO's communications channels, storytelling, and outreach to various audiences.

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