Integrating Public Health Information Systems

Integrating Public Health Information Systems

Many public health programs have developed information systems to meet programmatic needs.  Most of these are “stand-alone” systems that cannot communicate with one another.   As many people are involved in more than one program, these silo systems can result in missed opportunities, loss to follow-up, duplicate data entry, and increased costs.  Additionally, many are populated as a result of program encounters, rather than being population-based, making it difficult for public health programs to properly carry out their population surveillance role.  Integrating public health information systems can alleviate these problems.  During the past 10 years, we have been involved in efforts to integrate child health information systems (CHIS), focusing initially on vital records, newborn dried bloodspot screening (NDBS), early hearing detection and intervention (EHDI), and immunizations.  This work has been supported by the Maternal and Child Health Bureau (Health Resources and Services Administration) and the Robert Wood Johnson Foundation.  Activities have included collaborative delineation of the core principles and functions of integrated CHIS, development of performance measures, development of a Business Case Model (BCM) identifying the costs and benefits of integrating CHIS, convening an ongoing Community of Practice of health departments involved in integrating CHIS, carrying out Business Process Analysis (BPA) of NDBS and related long-term follow-up, and assessing the degree of integration of CHIS.  A 2008 state survey indicated that 18 public health agencies are in process of integrating CHIS (up from 12 in 2003).  An additional 13 are planning to integrate CHIS in the next three years.  While progress is being made in integrating CHIS, remaining challenges include assuring their ability to exchange information with Electronic Medical Records (EMR) and through Health Information Exchanges (HIE).   Lessons learned from CHIS integration efforts should have broad applicability in integrating other public health information systems.