Improving Local Public Health Capacity Through a Health Information Exchange in South Texas: Policy Implications for Health Leaders

Three out of four deaths in the state of Texas are caused by chronic diseases with hospital discharges in 2008 alone costing more than $10 billion. Chronic disease surveillance systems are needed for the identification and tracking of diseases in order to target prevention and treatment activities. However, the IOM has reported inconsistencies in surveillance of chronic illnesses caused by a lack of standardized methods for measuring complex attributes and determinants of health along with insufficient public health system resources to perform this function. The use of health information exchanges (HIE) offer important new and rich potential data sources for public health to improve our ability to monitor and track chronic diseases. But the ability of public health agencies to manage and act on these new electronic data streams has been identified as a challenge due to their limited current capacities. This study aimed to understand the challenges in using HIE for community level surveillance of chronic diseases and reviewed the capacity of public health departments participating in a Corpus Christi based HIE, Health Information Network of South Texas (HINSTX). The study used a qualitative approach that combined a survey of health departments and semi-structured key informant interviews of health department, state, and national officials to supplement and provide context for survey data. Three key themes were identified: need for skilled staff; clearly articulated regulations to enable effective use of HIE; and development of an integrated public health IT strategy. Recommendations included, personnel capacity development, inter-organizational informatics collaboration, interim legal bridge for using HIE for public health surveillance and health department enterprise architecture plan development.Doctor of Public Healt