Statewide Public Health Data Infrastructure Assessment: Local Health Department Survey Preliminary Analysis

The Office of Health Informatics (OHI) serves the Division of Public Health and partners in data-related access, infrastructure, analysis, and presentation. As they become available, updates and announcements from OHI will be shared here.

This message is being sent to local public health officers, Tribal health directors, and key DPH staff.

Executive summary

The Local Health Department (LHD) survey, conducted by the Division of Public Health’s Office of Health Informatics and part of the Statewide Public Health Data Infrastructure Assessment, was distributed to 84 LHDs in early June 2024. This effort is a foundational project for the Public Health Data Modernization Initiative, a multi-year effort aiming to improve public health data, informatics architecture, and analytics capabilities. For the LHD survey, 56 out of 83 LHDs submitted responses (67% participation rate). Participants included one Level I agency, 26 Level II agencies, and 29 Level III agencies. All five regions were represented.

This preliminary analysis serves to provide LHDs with an early look at major themes distilled from the free-text responses in the survey and offers LHDs an opportunity to provide feedback to OHI’s interpretations of the responses.

Key takeaways

There is a need to dig deeper into the following topic areas:

*Percentages represent respondents that highlighted each theme as a major gap or challenge.

• Too many systems and a lack of integration: 79%
  Almost all respondents noted that their staff juggle multiple systems and logins, including national, state, local, and healthcare systems, during their daily work. The lack of integration between these systems frequently drives duplicate workflows or data entry.
• Outdated technology and legacy systems: 79%
  Most respondents indicated that some of their systems or technology are outdated, including local data storage systems and both state and local legacy systems. Some noted that the antiquated design of these older systems inhibits interoperability and efficient workflows.
• State-provided Electronic Health Records (EHR) system: 70%
  Many jurisdictions stated a desire for a state-funded or single EHR system. This was mentioned as a possible solution to updating legacy systems, reducing the number of logins staff needed to maintain, and a decrease in duplicate work resulting from increased interoperability.
• Training: 70%
  Respondents shared a significant need for training in many areas, particularly emphasizing data exchange, interoperability, and standards; data governance and management; IT platforms, systems, and software; and programming, scripting, and data operations.
• Limited IT infrastructure, including a need for paper data collection and storage: 66%
  Many respondents reported that they use no or basic technology to manage their day-to-day public health workflows. Additionally, 62% of respondents shared that they are still storing at least some of their data on paper.
• Data sharing, privacy, and legal concerns: 46%
  Survey respondents shared that misinformation and lack of tools related to data sharing, legal, and HIPAA concerns are stumbling blocks in developing policies and procedures around data sharing.
• Data Governance: 41%
  There is a reported lack of knowledge or expertise in this area. Many respondents indicated that they had no staffing or capacity for data governance or delegated this task to their IT department.

Well documented challenges include budget and staffing.

Next steps

• We invite you to share your thoughts on the key takeaways identified above. If there are additional insights you feel we have missed or other feedback you would like to provide, please reach out to us at dhsdmiquest@dhs.wisconsin.gov. 
• Phase 2 of this project will focus on collaborating with you through site visits (in-person or virtual) to support additional data collection and inform data modernization strategic planning. This process will go beyond the initial survey questions, allowing for a deeper and more detailed exploration of the key issues and opportunities. Please keep an eye out for upcoming communications. 

Ultimately, a comprehensive Statewide Public Health Data Infrastructure Assessment report will be delivered in 2025 to capture results from both the survey and site visits.

Thank you for your participation and partnership in this effort.

Please do not reply directly to this email message. If you have a question, please email DHS DPHOPSCOMM.