APHIF Duval: A Collaborative Model for Local Health Informatics Infrastructure Capacity Building Through an Academic Health Department

BACKGROUND:   The CDC sponsored CSTE/ASTHO-administered Applied Public Health Informatics Fellowship (APHIF) was hosted in Jacksonville, Florida by a collaborative between the Institute for Public Health Informatics and Research (IPHIR) of the Duval County Health Department (DCHD) and the Center for Health Equity, Quality and Research (CHEQR) in the College of Medicine, University of Florida (UF-COM), Jacksonville. The DCHD, an Academic Health Department, has an on-going formal partnership with UF-COM, Jacksonville. The achievements of the fellowship in the context of local health informatics infrastructure capacity-building are presented here and imply that the collaborative model provided for significant bridging of Public Health and Primary Care.

METHODS: IPHIR leveraged its written agreements for data exchange and analysis, joint research and evaluation projects, and primary care delivery with CHEQR, UF-COM, Jacksonville in the hosting of the APHIF program. The cross-cutting nature of the fellowship created unique opportunities for collaboration, some of which are reviewed here. The fellow successfully convened a Patient-Centered Medical Home IT Working Group starting with key stakeholders from the Jacksonville Health Equity Research Organization Practice Based Research Network (JaxHERO PBRN) clinics to facilitate the development of a community-wide Diabetes Disease Registry, paving the way for other chronic disease registries and patient-care dashboards. The IT Working Group was quickly expanded to include major informatics leadership of the Academic Health Center.

RESULTS:   A plan to integrate a diabetes registry with the transition from Allscripts to EPIC EHR is a major outcome of fellowship.  This registry will serve patient care outcomes research, quality improvement functions and Public Health chronic disease surveillance.  The fellow also worked with CHEQR leadership, to develop a proposal for a General Preventive Medicine Residency Program to be jointly hosted by the DCHD and UF-COM, Jacksonville with a particular emphasis on population health, health equity and informatics, targeting current health reform grants for funding. Other achievements included working with the HMS-EMR implementation committee to roll out the state EMR in DCHD primary care clinics, contributing to the selection process of a vendor for a homeless management information system, providing meaningful resources to a local initiative for the development of a community health network and facilitating the development of a local Health Information Exchange pilot, working with major regional health systems.  

CONCLUSIONS:   The collaborative model of an Academic Health Department maximizes cross cutting opportunities like the APHIF for infrastructural development, providing opportunities for a true integration of Public Health and Primary Care.