| Abstract: | Objective: Little is known about the nationwide patterns in the use of publichealth informatics systems by local health departments (LHDs) and whether LHDstend to possess informatics capacity across a broad range of informationfunctionalities or for a narrower range. This study examined patterns andcorrelates of the presence of public health informatics functionalities withinLHDs through the creation of a typology of LHD informatics capacities.Methods: Data were available for 459 LHDs from the 2013 National Association ofCounty and City Health Officials Profile survey. An empirical typology wascreated through cluster analysis of six public health informaticsfunctionalities: immunization registry, electronic disease registry, electroniclab reporting, electronic health records, health information exchange, andelectronic syndromic surveillance system. Three-categories of usage emerged(Low, Mid, High). LHD financial, workforce, organization, governance, andleadership characteristics, and types of services provided were explored acrosscategories.Results: Low-informatics capacity LHDs had lower levels of use of eachinformatics functionality than high-informatics capacity LHDs. Mid-informaticscapacity LHDs had usage levels equivalent to high-capacity LHDs for the threemost common functionalities and equivalent to low-capacity LHDs for the threeleast common functionalities. Informatics capacity was positively associatedwith service provision, especially for population-focused services.Conclusion: Informatics capacity is clustered within LHDs. Increasing LHDinformatics capacity may require LHDs with low levels of informatics capacity toexpand capacity across a range of functionalities, taking into account theirnarrower service portfolio. LHDs with mid-level informatics capacity may needspecialized support in enhancing capacity for less common technologies. |
