Vest Joshua R, Issel L Michele, Lee Sean
Center for Healthcare Informatics & Policy, Division of Quality and Medical Informatics, Department of Public Health, Weill Cornell Medical College.
Community Health Sciences Division, School of Public Health, University of Illinois at Chicago.
Online J Public Health Inform. 2014 Feb 5;5(3):227. doi: 10.5210/ojphi.v5i3.4847. eCollection 2014.
Data collection and management by local health departments (LHDs) is a complex endeavor, complicated by system level and organizational factors. The purpose of this study was to describe the processes and use of information systems (IS) utilized for data collection, management, and sharing by LHD employees.
We interviewed a purposive sample of 12 staff working in the key public health practice areas of communicable disease control, immunizations, and vital records from three LHDs in different states. Our interview questions addressed job descriptions, daily activities, and the use and perceptions of both data and IS in support of their work. A content analytic approach was used to derive themes and categories common across programmatic areas.
Local public health involves the use of mix of state-supplied and locally implemented IS supported by paper records. Additionally, each LHD in this study used at least one shadow system to maintain a duplicate set of information. Experiences with IS functionality and the extent to which it supported work varied by programmatic area, but inefficiencies, challenges in generating reports, limited data accessibility, and workarounds were commonly reported.
Current approaches to data management and sharing do not always support efficient public health practice or allow data to be used for organizational and community decision making. Many of the challenges to effective and efficient public health work were not solely technological. These findings suggest the need for interorganizational collaboration, increasing organizational capacity, workflow redesign, and end user training.
地方卫生部门（LHDs）的数据收集和管理是一项复杂的工作，受到系统层面和组织因素的影响。本研究的目的是描述LHD员工用于数据收集、管理和共享的信息系统（IS）的流程及使用情况。
我们对来自不同州的三个LHDs中从事传染病控制、免疫接种和重要记录等关键公共卫生实践领域工作的12名工作人员进行了有目的抽样访谈。我们的访谈问题涉及工作描述、日常活动以及数据和信息系统在支持他们工作方面的使用和看法。采用内容分析法得出各项目领域共有的主题和类别。
地方公共卫生工作涉及使用由纸质记录支持的州提供和本地实施的信息系统组合。此外，本研究中的每个LHD至少使用一个影子系统来维护一套重复的信息。信息系统功能的使用体验及其支持工作的程度因项目领域而异，但普遍报告存在效率低下、生成报告的挑战、数据可访问性有限以及变通方法等问题。
当前的数据管理和共享方法并不总是支持高效的公共卫生实践，也不允许数据用于组织和社区决策。有效和高效的公共卫生工作面临的许多挑战并非仅仅是技术方面的。这些发现表明需要进行组织间合作、提高组织能力、重新设计工作流程以及对最终用户进行培训。
