by Gulzar H. Shah, PhD, MStat, MS

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This special issue on local public health informatics is an inclusive collection of articles, highlighting the current landscape of informatics needs and capacities of local health departments (LHDs). Gibson and colleagues note in their editorial “Urgent Challenges for Local Public Health Informatics,” that good informatics can improve public health practice, but LHDs face challenges in successfully harnessing informatics. They argue that improved quality and access to relevant data “can create more opportunities to improve health through partnerships, greater accountability, and improved efficiency.” At the same time, growing expectations for accurate and timely information present LHDs with urgent challenges obstructing full utility of informatics. These challenges include: (1) building informatics capabilities in smaller LHDs, (2) ensuring informed and consistent leadership, and (3) establishing effective training.

Chester, Massoudi, and Shah, note in their article “Control of the Public Health IT Physical Infrastructure…” that a central challenge is LHDs’ lack of control of their informatics infrastructure. For a large majority of LHDs, the control resides with external entities such as a state health agency or a city/county information technology (IT) department, resulting in disconnects between LHDs’ needs/challenges and resources. The article found that only a small proportion of LHDs have control of their IT system security and data. LHDs that are in centralized governance arrangement with respect to state health department authority had the least amount of control over their IT infrastructure. The authors argue that despite improvements in IT infrastructure in public health, there is still much that can be done to improve the adoption of IT, by better understanding the impact of governance and control structures of IT physical infrastructure.

Three case studies by Lovelace and Shah provide instances of innovations in informatics by LHDs serving three different sizes of population in their jurisdictions: small (50,000 people), medium (50,000 to 499,999 people), and large (500,000+). These case studies will be of interest to many practitioners in that case studies are underleveraged in public health. LHDs with similar challenges as those highlighted by a particular case will be able to easily relate with the story, challenges, lessons, and innovations.

Massoudi and colleagues highlight specific areas of training needed for public health staff in their article “Public Health Staff Development Needs in Informatics…” The article concludes that “substantial training needs exist for LHDs across many areas of informatics ranging from very basic to more specialized skills.” Because of the negative impact of the unfilled needs related to core public health practice skills, the authors advocate for capacity building efforts for LHDs, if they “are to function effectively in the information age.”

Shah and colleagues in their article “Local Health Departments’ Partners and Challenges in Electronic Exchange of Health Information” show that LHDs participate in health information exchanges (HIE) more commonly with some partners while needing to improve exchange relations with others. The authors argue that “unprecedented amounts of data are produced by health care and other sectors, presenting opportunities for local health departments (LHDs) to access these data.” The article highlights common challenges to HIE, and underscores the need for addressing these challenges, if LHDs are to benefit from big data.

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Gulzar H. Shah, PhD, MStat, MS, is serving as the Associate Dean for Research, and Associate Professor of Health Policy and Management, at the Jiann-Ping Hsu College of Public Health, Georgia Southern University. He may be reached at gshah@georgiasouthern.edu.