Public health practice is an information business. Public health workers operate in an information-rich environment, which has become increasingly rich and complex. This requires enhanced skills and sophisticated levels of expertise in the management of information as a core strategic resource of the public health enterprise. The strategic use of information and information system management must be core competencies for the public health workforce if public health organizations are to maintain and enhance their role in leading disease prevention and health promotion efforts in communities across the nation. Now more than ever, leaders and managers of public health organizations must sharpen their skills as customers and providers of health information as they seek to form strategic partnerships with all of those who seek to promote and protect the health of the public.
As noted in many articles in this special supplement, the practice of public health faces extraordinary challenges and opportunities driven by a new policy environment (eg, health system change driven by the Patient Protection and Affordable Care Act [ACA]) and the advent of new technologies (eg, electronic health records).1 In reflecting on the messages that these articles send, two central themes emerge:
- There exists an urgent need for enhanced commitment to informatics as a core competency for all public health workers, and particularly the small percentage of public health workers who are “informatics specialists.”
- There exists an urgent need to enhance management and leadership skills and practices central to the “business of public health.”
As noted in the excellent article by Dixon and his Indiana colleagues2 in this issue, public health informatics represents a crucial workforce need. As electronic health information exchange methods increase in scale and scope, public health organizations are increasingly dependent on the skills of public health informatics specialists, who now constitute only 1% of the public health workforce. This relatively small component of the workforce will play a disproportionately large role in the future of public health practice. These public health workers have become central to the ongoing transformation of public health agencies into “informatics-savvy organizations.”3 , 4 Informatics specialists will continue to meet increasingly challenging business needs as they design and manage public health information systems, thereby supporting public health leaders and managers who require quality, timely information to guide public health practice and policy development.
The findings of Dixon and colleagues are particularly useful in guiding future efforts related to informatics training and workforce development. They accurately trace the evolution of the field of public health informatics from its early emphasis on improving surveillance systems (which continues to be a core informatics responsibility) through the current emphasis on enhanced interaction with health care information systems in areas such as immunization registries, electronic laboratory result reporting, and electronic death record recording and transmission. Of interest is the study's encouraging finding that informatics specialists are younger and report greater job satisfaction than other comparable members of the workforce. Also, as noted by Dixon and colleagues, future workforce development efforts should be targeted toward recruitment and retention of this critical workforce component, as well as broadening informatics skills among all public health workers.
Several successful informatics training and development programs deserve particular attention. For example, the de Beaumont Foundation has played a pivotal role in its sponsorship of the Public Health Informatics Institute's Informatics Academy as a unique training resource in public health informatics; the Informatics Academy has served hundreds of public health workers with online informatics training in the design and management of public health information systems. The Centers for Disease Control and Prevention are also to be praised for an ongoing commitment to address the developmental needs in public health informatics through intensive fellowship programs designed to develop the next generation of leaders in public health informatics. Despite these important steps, much more needs to be done to strengthen the informatics competence of the public health workforce.
In addition to informatics skills and expertise, public health agencies require highly skilled and well-trained managers and leaders. The excellent article in this issue by Kornfeld and her University of Miami colleagues5 sheds important light on the state of management knowledge and skills in the public health workforce and points the way to future approaches to addressing the lifelong learning needs of this central component of the public health workforce. Kornfeld and colleagues note that financial management skills, change management proficiency, and quality improvement knowledge are correlated with job satisfaction; development of these skills requires a supportive training environment in which access to quality, online learning resources is in place. The authors correctly point to past very successful leadership and management institutes—eg, Public Health Leadership Institutes and the Management Academy for Public Health (which received crucial support from the de Beaumont Foundation following start-up funding from the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and other national foundations); they also note the need to maintain and enhance opportunities for future management and leadership development experiences, including the use of online learning techniques, to equip leaders to address the many complex challenges that confront public health agencies. Much more needs to be done to ensure that lifelong learning is a reality for public health leaders and managers.
As others have mentioned, the unprecedented scale and scope of the Public Health Workforce Interests and Needs Survey (PH WINS) provides uniquely valuable insights into the state of the current public health workforce and points the way to emerging trends and needs for continuing to strengthening the workforce. The project team for PH WINS, including staff from the de Beaumont Foundation and the Association of State and Territorial Health Officials, are to be congratulated for their impressive vision and commitment in securing a comprehensive assessment of the current state of the public health workforce.
More broadly, the de Beaumont Foundation deserves particular praise for its dedicated commitment to supporting the training and development needs of the public health workforce. Our nation's health has directly benefitted from the visionary leadership of this increasingly important national foundation. Other key partners also deserve praise, including the Association of State and Territorial Health Officials, Centers for Disease Control and Prevention, Health Resources and Services Administration, National Association of County & City Health Officials, and Association of Schools and Programs of Public Health, which contribute in myriad ways to strengthening the public health workforce. The challenges that lie ahead are great and will require a redoubling of effort and close collaboration if the learning needs of the public health workforce are to receive the attention they richly deserve.
1. Hunter EL. Rebooting our boots on the ground. J Public Health Manag Pract. 2015;21(suppl 6):S1–S2.
2. Dixon B, McFarlane T, Dearth S, Grannis SJ, Gibson PJ. Characterizing informatics roles and needs of public health workers: results from the Public Health Workforce Interests and Needs Survey. J Public Health Manag Pract. 2015;21(suppl 6):S130–S140.
3. LaVenture M, Brand B, Ross DA, Baker EL. Building an informatics-savvy health department, part I: vision and core strategies. J Public Health Manag Pract. 2014;20(6):667–669.
4. LaVenture M, Brand B, Ross DA, Baker EL. Building an informatics-savvy health department, part II: operations and tactics. J Public Health Manag Pract. 2015;21(1):96–99.
5. Kornfeld J, Sznol J, Lee D. Characterizing the business skills of the public health workforce: practical implications from the Public Health Workforce Interests and Needs Survey (PH WINS). J Public Health Manag Pract. 2015;21(suppl 6):S159–S167.