文章基本信息

标题：A Ride in the Time Machine: Information Management Capabilities Health Departments Will Need
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作者：Seth Foldy ; Shaun Grannis ; David Ross 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2014
卷号：104
期号：9
页码：1592-1600
DOI：10.2105/AJPH.2014.301956
语种：English
出版社：American Public Health Association
摘要：We have proposed needed information management capabilities for future US health departments predicated on trends in health care reform and health information technology. Regardless of whether health departments provide direct clinical services (and many will), they will manage unprecedented quantities of sensitive information for the public health core functions of assurance and assessment, including population-level health surveillance and metrics. Absent improved capabilities, health departments risk vestigial status, with consequences for vulnerable populations. Developments in electronic health records, interoperability and information exchange, public information sharing, decision support, and cloud technologies can support information management if health departments have appropriate capabilities. The need for national engagement in and consensus on these capabilities and their importance to health department sustainability make them appropriate for consideration in the context of accreditation. What information management capabilities will be needed by tomorrow’s US health departments? The Public Health Accreditation Board establishes standards and provides accreditation to US local, tribal, and state health departments. Because we are experienced in local, state, and federal public health informatics (the systematic application of information and computer science and technology to improve public health practice, research, or education), 1 a Public Health Accreditation Board think tank asked us to predict the effects of emerging trends on requirements for future accreditation standards. The Patient Protection and Affordable Care Act (ACA) may radically change the functions of US health departments. New developments in health information technology (technology standards, applications, and hardware for health data) will profoundly change how information is managed and exchanged. Different predictions about these changes may produce markedly different predictions of required health department capabilities. Some have asserted that ACA reforms (more people insured, preventive services covered, and provider incentives) may lead health departments to stop delivering individual services, such as immunizations. 2 Meanwhile, some predict that digitization and the exchange of health care data will produce “distributed access to information without exposing the details of the underlying data . . . collect[ing] only summarized data . . . or key results.” 3 Taken together, these trends suggest that health departments may eliminate direct services and consume rather than create health information products, thus minimizing their management of sensitive health information. We predict, rather, that health departments will struggle with managing more information to improve service cost efficiency, collaborate on prevention with a leaner health care system, and meet demands for unbiased population health statistics. Competitive pressures will emerge rapidly over the next 5 years. Health departments that cannot manage information appropriately may become vestigial—to the detriment of their communities (and especially to vulnerable underserved populations). The pace of change will challenge many health departments. Emerging advances in health information technology can help meet these challenges, but only if health departments develop needed capabilities.