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The Public Health Uniform National Data System (PHUND$)

A Platform for Monitoring Fiscal Health and Sustainability of the Public Health System

Honoré, Peggy A., DHA; Zometa, Carlos, PhD; Thomas, Craig, PhD; Edmiston, Ashley, MPH

Journal of Public Health Management and Practice: July/August 2019 - Volume 25 - Issue 4 - p 366–372
doi: 10.1097/PHH.0000000000000838
Research Reports: Practice Full Report

Context: Leaders of government agencies are responsible for stewardship over taxpayer investments. Stewardship strengthens agency performance that is critical to improving population health. Most industries, including health care, and public enterprises, such as education, have policies for uniform data reporting and financial systems for the application of theoretical analytical techniques to organizations and entire systems. However, this is not a mainstreamed practice in local and state government public health.

Program: The Public Health Uniform National Data System (PHUND$) is a financial information system for local health departments that advances the application of uniform practices to close financial analytical gaps. A 10-year retrospective overview on the development, implementation, and utility of PHUND$ is provided and supported by documented program and agency improvements to validate the analytical features and demonstrate a best practice.

Results: Benefits found from utilizing PHUND$ included reducing financial risks, supporting requests for increased revenues, providing comparative analysis, isolating drivers of costs and deficits, increasing workforce financial management skills, enhancing decision-making processes, and fostering agency sustainability to support continuous improvements in quality and population health. The PHUND$ financial data definitions in the data dictionary provided the structure needed for standardized data collection and confirmed the feasibility of a standardized public health chart of accounts.

Conclusion: PHUND$ analysis provided evidence on the relationship between financial and operational performance, as well as informing strategies for managing risks and improving quality. Such analysis is critical to identifying financial and operational problems and essential to mitigating financial crisis, avoiding disruption of services, and fostering agency sustainability. PHUND$ additionally serves as an instrument that can guide development of standards that measure for agency sound financial management systems.

Louisiana State University Health Sciences Center School of Public Health & School of Medicine, New Orleans, Louisiana (Dr Honoré); Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Zometa and Thomas); and National Association of County & City Health Officials, Washington, District of Columbia (Ms Edmiston).

Correspondence: Peggy A. Honoré, DHA, Louisiana State University Health Sciences Center School of Public Health & School of Medicine, 2020 Gravier St, Room 317, New Orleans, LA 70112 (

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

The authors declare no conflicts of interest.

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