Field experiences from five Health Systems Integration Program fellows
Health systems integration is defined as the collaborations between public health and clinical health sectors. The Institute of Medicine’s call to integrate public health and clinical health sectors to improve and promote better population health and public health’s emphasis on prevention emphasizes the need to develop leaders intersecting public health and clinical health sectors. Health systems integration professionals are needed to complement discipline-specific expertise and work across program or disease-specific public health practice.
Recognizing a need for health systems integration professionals, the Centers of Disease Control and Prevention (CDC), Council of State and Territorial Epidemiologists (CSTE), and the National Association of County and City Health Officials (NACCHO) collaboratively offered a one-year training program, the Health Systems Integration Program (HSIP). HSIP was the only national program to train health systems integration professionals at state and local health departments. HSIP placed experienced public health or clinical health practitioners with a masters or doctoral degree into state and local health departments. Fellows provided a service to the host agencies, and received training through the fellowship program, such as leadership, project management and public health informatics. Determined together with the host sites, fellows worked on data-driven projects that address community-level health concerns and improve population health. These projects were rooted in the HSIP core competencies. These competencies included five domains: analysis, assessment and evaluation; policy development and program planning; communication and cultural competency; public health sciences; and health systems.
Since 2013, 24 fellows have participated in the training and provided a service to seven local and nine state health departments. HSIP Class II (2015-2016) had eight fellows matched to four state and four local health departments. Five Class II fellows’ experiences (Marion Tseng, Ekaette Joseph-Isang, Bree Allen, Koneng Lor and Crystal Boston-Clay) were utilized to examine the skills required for health systems integration professionals. For this report, fellows selected one project from fellowship assignments, and summarized the project outcomes and impacts from their activity reports. Fellows’ selected project summaries were analyzed to identify common skills required for successful health systems integration.
These five fellows selected projects covering areas ranging from disease surveillance, population health assessment to policy. Fellows identified public health informatics skills as the most critical in accomplishing health systems integration projects. Public health informatics is defined as, “the systematic application of information, computer science and technology to public health practice.” Having skills to practice public health informatics is fundamental to ensuring the robust use of data to guide public health actions. The fellows found that public health informatics skills were important to many of the health systems integration competencies. For example, public health informatics skills helped fellows describe how evidence-based approaches and linking public health and health care perspectives can be used to improve the population’s health care needs and delivery.
| Pictured: CSTE’s Class II Health System Integration Program fellows in 2016.
At Chicago Department of Public Health, Marion led a project to establish an electronic provider reporting interface for chlamydia and gonorrhea cases. Public health informatics skills helped Marion to understand requirements for this electronic provider reporting interface, and ensure the interface meets data needs of all stakeholders. Ekaette established an Informatics Workgroup at the Kentucky Department for Public Health. She presented and led group brainstorming sessions to help participants understand how public health informatics could enhance data use to guide public health practice. In Minnesota, Bree connected local public health departments and health care providers to encourage the use of electronic health records data for community population health assessments. She applied public health informatics skills, such as communication and systems thinking, to engage stakeholders to gather lessons learned and developed an informatics framework and toolkit. In Marion County, Indiana, Crystal improved community partnerships and enhanced timeliness of electronic laboratory reports to Indiana Health Information Exchange. She exercised public health informatics skills rooted in the project management methodology to conduct business process analysis and communicate with stakeholders regarding project milestones. Koneng completed a pilot stakeholder survey and made recommendations for improving an existing information mapping system at Washington State Department of Health. She engaged stakeholders by frequently communicating project progress, and connected with subject matter experts to inform the recommendations.
Public health informatics skills are critical for health systems integration professionals to leverage actionable data-driven information to engage and collaborate with partners. The HSIP fellows built and strengthened multi-disciplinary and cross-sector partnerships, and facilitated data exchange among these partners. Public health needs health systems integration professionals to collaborate with non-traditional multisector stakeholders to implement data-driven solutions that improve population health. Health systems integration professionals can be trained through on-the-ground experiential learning, such as the HSIP fellowship
This blog post was supported in part by appointments to HSIP administered by CSTE and funded by CDC Cooperative Agreement 3U38-OT000143-01S3. The authors would like to thank all HSIP Class II host sites, mentors and fellows: April Moreno, Anna Oberste and Michael Ray for their contribution to this blog post.