Public Health Informatics in Local and State Health Agencies: An Update From the Public Health Workforce Interests and Needs Survey

Abstract

Objective: To characterize public health informatics (PHI) specialists and identify the informatics needs of the public health workforce. Design: Cross-sectional study. Setting: US local and state health agencies. Participants: Employees from state health agencies central office (SHA-COs) and local health departments (LHDs) participating in the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). We characterized and compared the job roles for self-reported PHI, "information technology specialist or information system manager" (IT/IS), "public health science" (PHS), and "clinical and laboratory" workers. Main Outcome Measure: Descriptive statistics for demographics, income, education, public health experience, program area, job satisfaction, and workplace environment, as well as data and informatics skills and needs. Results: A total of 17 136 SHA-CO and 26 533 LHD employees participated in the survey. PHI specialist was self-reported as a job role among 1.1% and 0.3% of SHA-CO and LHD employees. The PHI segment most closely resembled PHS employees but had less public health experience and had lower salaries. Overall, fewer than one-third of PHI specialists reported working in an informatics program area, often supporting epidemiology and surveillance, vital records, and communicable disease. Compared with PH WINS 2014, current PHI respondents' satisfaction with their job and workplace environment moved toward more neutral and negative responses, while the IT/IS, PHS, and clinical and laboratory subgroups shifted toward more positive responses. The PHI specialists were less likely than those in IT/IS, PHS, or clinical and laboratory roles to report gaps in needed data and informatics skills. Conclusions: The informatics specialists' role continues to be rare in public health agencies, and those filling that role tend to have less public health experience and be less well compensated than staff in other technically focused positions. Significant data and informatics skills gaps persist among the broader public health workforce.

COVID-19 Case Investigation and Contact Tracing in the US, 2020

“…We observed that all 14 HDs in this assessment, regardless of the sophistication of their data collection and informatics systems, faced hurdles. 32 , 33 These challenges included missing and incomplete data, paper-based records, disparate digital databases without common identifiers, and insufficient personnel to maintain, improve, or implement new systems. Most data systems were rapidly designed and were primarily intended to prioritize individual patient care and follow-up, rather than produce summary data describing the HD’s case investigation and contact tracing performance.…”

Barriers to Dissemination of Local Health Data Faced by US State Agencies: Survey Study of Behavioral Risk Factor Surveillance System Coordinators

“…We hypothesize that these findings are indications of a favorable assessment of the cost-benefit ratio of implementation of technology-based systems relative to low-cost health data systems. Adequate staffing and funding for state health data systems is lacking, which has impeded or slowed progress or halted data dissemination efforts in these states [ 25 , 26 ]. Our findings are more important than ever, given the reliance of society on trusted, reliable, and accurate public health data [ 27 , 28 ].…”

Delaware’s My Healthy Community Data Platform:

“…Public health informatics has long been recognized as a critical need in state and local health agencies; however, recent research estimates that informatics positions account for only 1% of state health agency workforces. 3 Although historically the distinction between the role of informatics and information technologists has not been well understood, national efforts to clearly define the roles and skills of informatics professionals have provided a clearer picture of how these two branches of information science are distinct yet complementary. 3 , 4 Informatics is categorized as a core science of public health where informaticians serve as the knowledge architects of public health information systems.…”

“… 3 Although historically the distinction between the role of informatics and information technologists has not been well understood, national efforts to clearly define the roles and skills of informatics professionals have provided a clearer picture of how these two branches of information science are distinct yet complementary. 3 , 4 Informatics is categorized as a core science of public health where informaticians serve as the knowledge architects of public health information systems. 4 Informaticians use their knowledge of data security, standards, and policy to translate public health program system needs into functional requirements for public health information and surveillance systems.…”