Often local health departments (LHDs) are stretched in multiple directions. This is in large part due to the traditionally stove piped and programmatic funding of our organizations.
In our recent blog entry – A Vision For ePublic Health & Informatics – featuring Dr. David Ross Director of the Public Health Informatics Institute, LHDs are urged to have a visible and future vision for their informatics solutions. While that is very important, there is so much happening that folks are often asking, “Where should I start?” Well I believe you should attempt to find some focus. It is important to have an overarching vision for informatics so, as Dr. Ross says in the video, you can “be prepared to use emerging technologies when they come”. But I think once you have that broad vision, it is important to focus your resources on the project you will tackle right now. Of course you must be flexible as new opportunities and challenges may come along, but you have to practice good project management and can’t be too distracted in your approach.
This takes a very high level of executive sponsorship. You will have to devote personnel time, money, and may have to ration resources from other projects. Start with getting leadership to ask the organization to really reflect on the question “What is our business? “Or “What do we want our business to be?” With the competitive pressures of ACOs, FQHCs, HIEs, and other aspects of health care reform, it is more important than ever that local health departments know what our business is. Healthcare partners should know when it comes to [Enter Your Health Department Name Here], organizations should contract with you to provide certain services. These services could be things like Care Coordination, Home Health Visits, Specialty Care (HIV, STD, Dental, TB, Hepatitis, MCH), Primary Care for indigent populations, Surveillance, Environmental Health, Community Health Assessment, etc.
This understanding of your business will play a major part in defining where you should focus your informatics energy – but it isn’t everything. You now have to account for other pressures like technical infrastructure, workforce, Meaningful Use Requirements, funding etc. For example, do you have the right staff available for a project, can you receive Medicaid 90/10 funding through your state or Meaningful Use incentives, etc? And ask yourself, how long will this project take? Set realistic timelines, while being cognizant of any time limitations on your funding.
So now you know what your business focus is, what stressors are constraining you, and what resources may be available. You should be prepared to make an informed decision on where to focus your informatics efforts. Like a laser you can develop a meaningful resource for your department that can enhance the work you do and improve efficiencies in your agency. You can be a valued partner in the community and stake a claim on the work you do. You can meet or exceed expectations and that will likely produce new resources for your health department in the future.
Let me give you an example. Let’s say your overall vision for your health department involves creating a dashboard that provides real time information necessary for decision makers. It may be unlikely that you are able to build this tool all at once to serve every information need of the department. However, you do the assessment described above – survey your resources and environment to understand who is best suited to begin this project, which information is most needed right now, and which program may have some funding to support the project. Though you will build the infrastructure of the system to easily accommodate future data source additions, you will have to decide where to focus first. Let’s say you’ve decided to become a valued partner in the community by helping hospitals meet their IRS required community health assessments and you want the results of those assessments to be dynamically updated, near real time, and available to all pertinent decision makers in the health department, community, and hospitals. The IRS requirement means your service is likely valuable and may support a line of funding from hospitals or other community partners. You can now be focused on this project, get it accomplished in proper fashion – with Stakeholder participation and governance, project and risk management, and financing (see NACCHO’s tool – All Systems Go). In 12 to 18 months you’ll have a success and then be ready to focus on the next part of your vision.
Be visionary, be organized, be realistic, be focused, and you’ll be successful.
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