Background: Electronic Health Records (EHRs) are changing the operations within local health departments (LHDs). The collection of EHRs allow for information analysis, reporting, sharing, transmission, and processing. The barriers in implementing EHRs can prevent and challenge LHDs in experiencing the benefits and efficiency of their use.

Research Objective: Analyze the status, benefits, barriers, and ways of overcoming challenges of implementing EHRs in LHDs. .

Methods: This project used primary, key-informant interview based study design of 50 leaders from local health departments across the United States. These qualitative interviews were about current practices, capacities, and needs in the realm of public health informatics in the fall of 2014. Qualitative data analysis focused on major drivers of EHR implementation, or lack of implementation.

Principal Findings: Preliminary results exhibit variability in implementation status, benefits, and barriers of EHRs in LHDs. Implementation status varied from fully implemented in clinical settings, investigated or planning to implement, and no implementation but use of electronic medical records (EMRs). The barriers included costs, low capacity, lack of trained staff, staff resistance, complexities in current systems, and concerns about past investments in technology. Benefits were acknowledged by LHDs that have implemented and those who had not implemented EHRs as the ability to pull and have accurate records, ease of reading records, ability to share with partners, ease of searching, time saving, simplicity of budgeting and estimating revenues, staff satisfaction, and HIPAA compliance.

Conclusions and Implications: Despite financial, capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Implementation of EHRs tends to be easier to implement with resources, staff buy-in, and leadership involvement. EHRs have multiple benefits that impact the operations and delivery of care in LHDs, affecting the health of the populations they serve.