Iyamu Ihoghosa, Haag Devon, Carson Anna, Wang Ivy, King Colin, Roe Ian, Kerr Kristy, Bartlett Sofia, McKee Geoffrey, Gilbert Mark
BC Centre for Disease Control, Vancouver, BC, Canada.
School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada, 1 604 707 5619.
JMIR Public Health Surveill. 2025 Aug 12;11:e72588. doi: 10.2196/72588.
The digital transformation of health services accelerated during the pandemic. While "digital health" strategies were created, they paid minimal attention to public health services like health promotion, disease surveillance, emergency preparedness, and health protection.
This study aimed to inform a digital public health (DPH) strategy at the British Columbia Centre for Disease Control (BCCDC) and explored public health practitioners' perspectives on challenges and opportunities of integrating digital technologies into public health functions within the organization.
In this qualitative description, we conducted 18 focus groups (FGs) between January and June 2023, drawing practitioners from 9 organizational subunits of the BCCDC including population and public health, environmental health, clinical services, vaccine-preventable diseases, communications, knowledge translation, data analytics, and Indigenous health (2 FGs per subunit). Discussions explored practitioners' application of digital technologies in their public health work, focusing on challenges encountered during implementation (current state FGs) and perceived opportunities (future state FGs). Sessions were audio-recorded, and detailed field notes were taken. Thematic analysis was conducted, comparing perspectives across groups using constant comparative techniques.
We identified 3 themes. First, "bridging existing inequities-an opportunity and a challenge contingent on public trust" described participants' excitement about opportunities for DPH to disrupt historical inequities if centered on trust and reconciliation, while recognizing current digital transformation efforts risk exacerbating existing inequities with the digital divide. Second, "a sense of disconnect between "digital" and "public health" functions" described perceptions of DPH as being out of scope of core public health duties, requiring new competencies and navigation of complex organizational policies for which support is suboptimal. Third, "balancing the need for responsive DPH with necessary reactivity" highlighted practitioners' yearnings for a proactive DPH strategy rather than current issue-based reactive approaches. Participants suggest that a centralized systematic program can help achieve this goal.
A cohesive, systematic, and proactive organizational strategy for DPH is critical to enable equity-focused digital transformation. Such a strategy can bridge perceived disconnects between digital and public health functions through organizational supports like competency development and streamlined policies that can better support public health practitioners to integrate digital technologies into their work.
疫情期间，卫生服务的数字化转型加速。虽然制定了“数字健康”战略，但它们对健康促进、疾病监测、应急准备和健康保护等公共卫生服务关注甚少。
本研究旨在为不列颠哥伦比亚疾病控制中心（BCCDC）制定数字公共卫生（DPH）战略提供信息，并探讨公共卫生从业者对将数字技术融入该组织公共卫生职能的挑战和机遇的看法。
在这项定性描述研究中，我们于2023年1月至6月期间开展了18个焦点小组（FGs），参与者来自BCCDC的9个组织子部门，包括人口与公共卫生、环境卫生、临床服务、疫苗可预防疾病、通信、知识转化、数据分析和原住民健康（每个子部门2个焦点小组）。讨论探讨了从业者在公共卫生工作中对数字技术的应用，重点关注实施过程中遇到的挑战（现状焦点小组）和感知到的机遇（未来状态焦点小组）。会议进行了录音，并做了详细的现场记录。采用主题分析方法，使用持续比较技术比较各小组的观点。
我们确定了3个主题。第一，“弥合现有不平等——基于公众信任的机遇与挑战”描述了参与者对DPH以信任与和解为核心、打破历史不平等机遇的兴奋之情，同时认识到当前的数字转型努力可能因数字鸿沟而加剧现有不平等。第二，“‘数字’与‘公共卫生’职能之间的脱节感”描述了将DPH视为超出核心公共卫生职责范围的看法，这需要新的能力以及应对复杂组织政策的能力，而目前的支持并不理想。第三，“平衡响应式DPH的需求与必要的反应能力”强调了从业者对积极主动的DPH战略的渴望，而非当前基于问题的被动应对方法。参与者建议，一个集中的系统项目有助于实现这一目标。
一个凝聚性、系统性和积极主动的DPH组织战略对于实现以公平为重点的数字转型至关重要。这样的战略可以通过能力发展和简化政策等组织支持措施，弥合数字与公共卫生职能之间的明显脱节，从而更好地支持公共卫生从业者将数字技术融入其工作。
