Background: Information technology and information systems (IT/IS) play a critical role in the daily operation of local health departments (LHDs). Assessing LHDs informatics capacity is important within the context of broader health reform efforts.

Purpose: This research is to assess the trends, pattern of utilization by LHDs and factors associated with utilization of six informatics systems: electronic health records (EHRs), health information exchange (HIE), immunization registry (IR), electronic disease reporting system (EDRS), electronic lab reporting (ELR), and electronic syndromic surveillance system (SSS).

Methods: Data from NACCHO’s 2010 and 2013 National Profile of LHD Surveys were used, for which the detailed methodology is available at www.naccho.org/Profile. Descriptive statistics and Poisson regression were used for the outcome variable, “number of activities” (between 0 and 6).

Results: Seven percent of LHDs had implemented HIEs in 2010, and the use of HIEs was still very low in 2013 (14 percent). EHRs had been implemented by 19 percent and 23 percent of LHDs respectively in 2010 and 2013. Slightly over 62 percent of LHDs had used electronic SSS in 2013 whereas 56 percent had implemented SSS in 2010. Immunization registry had been implemented by 86 percent of LHDs in 2013, an increase from 76 percent in 2010. EDRS had been implemented by 75 percent whereas ELRs were implemented by 50 percent in 2013 (data not gathered in 2010). After controlling for other variables in the model, having a nurse or an information systems specialist on staff, top executive with MD degree, per capita expenditures, expenditures per full time employee (FTE), having completed community health assessment, community health improvement plan, and an agency-wide strategic plan were significantly and positively associated with having implemented greater number of informatics activities.

Conclusions: Being well funded and having staff in certain categories are important determinants of health informatics capacity.