Khan Saad, Shea Christopher M, Qudsi Hibah Khalid
Defense Health Agency, Falls Church, Virginia (Dr Khan); Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Dr Shea); and US Department of Health & Human Services, Washington, District of Columbia (Ms Qudsi).
J Public Health Manag Pract. 2017 May/Jun;23(3):e10-e17. doi: 10.1097/PHH.0000000000000465.
Health information exchanges (HIEs) offer potential data sources for public health agencies to improve chronic disease surveillance; however, public health has not yet capitalized on these data. This study identified barriers that public health departments participating in the Health Information Network of South Texas face regarding HIE and community-level surveillance of chronic diseases. This study focused on 2 health departments participating in the Health Information Network of South Texas. We administered a survey to inventory the technology infrastructure of health departments and conducted semistructured interviews of the local, state, and national officials. We identified 3 barriers to using HIE for disease surveillance: insufficient skilled staff, variation in how laws are interpreted, and lack of a coordinated public health information technology strategy. We provide 4 recommendations for policy and practice: personnel capacity development, interorganizational informatics collaboration, interim approaches to clarifying the legality of bidirectional HIE until overarching legislation is enacted, and development of an enterprise architecture plan.
健康信息交换（HIEs）为公共卫生机构提供了潜在的数据来源，以改善慢性病监测；然而，公共卫生领域尚未利用这些数据。本研究确定了参与南德克萨斯州健康信息网络的公共卫生部门在HIE和慢性病社区层面监测方面面临的障碍。本研究聚焦于参与南德克萨斯州健康信息网络的两个卫生部门。我们进行了一项调查，以清查卫生部门的技术基础设施，并对地方、州和国家官员进行了半结构化访谈。我们确定了利用HIE进行疾病监测的三个障碍：熟练工作人员不足、法律解释方式存在差异以及缺乏协调一致的公共卫生信息技术战略。我们为政策和实践提供了四条建议：人员能力发展、组织间信息学协作、在全面立法颁布之前明确双向HIE合法性的临时方法，以及制定企业架构计划。
