Finding Solutions for Local Public Health Services Spanning Population, Non-Population, Environmental, and Behavioral Health
Local public health departments face a wide range of community needs. These include large-scale population health initiatives, individualized non-population health services, the critical area of behavioral health, and the foundational work of environmental health. Effective service to the community requires integrated public health solutions that reflect their interconnectedness. A fully unified system across all areas is still in the future. However, there are better options than using multiple, unconnected systems—some of which still rely on paper.
At its core, whether we’re tackling community-wide disease prevention (population health), providing direct clinical care (non-population health), addressing mental health and substance use (behavioral health), or ensuring safe water and air quality (environmental health), the overarching goal remains the same: to improve the health and well-being of individuals and the community as a whole.
Crucial features these interconnected public health areas share
Focus on Holistic Well-being
- An individual’s health isn’t defined by a single category. Their physical health is influenced by their environment, their mental and emotional state, and the broader community factors. Effective public health interventions, regardless of their primary focus, must acknowledge these interdependencies.
- For instance, lead exposure (environmental health) can impact a child’s development (non-population health) and potentially contribute to behavioral health challenges.
Emphasis on Prevention and Early Intervention
- Proactive strategies are vital across all these domains.
- Population health inherently focuses on prevention.
- Non-population health services often include preventative screenings.
- Behavioral health emphasizes early intervention for mental health and substance use.
- Environmental health’s core mission is preventing environmental hazards that can lead to illness.
Addressing the Social and Environmental Determinants of Health
- The American Public Health Association (APHA) offers this description “Environmental health centers on the relationships between people and their environment.”
- Factors like poverty, housing, education, access to healthy food, and exposure to environmental hazards profoundly impact health outcomes across all service areas. Local public health’s role often involves addressing these underlying determinants, whether through policy advocacy, community partnerships, or direct service provision.
- For example, addressing food insecurity (a social determinant) can impact chronic disease rates (non-population health) and mental well-being (behavioral health).
Data-Driven Decision Making for Targeted Action
- Effective local public health practice relies on data to understand community needs, identify emerging issues (like environmental contamination or a rise in mental health crises), implement targeted interventions across all service areas, and evaluate their impact.
The Imperative for Coordinated Care and Information Sharing
- Individuals and families often interact with the health department across multiple service areas.
- A child receiving immunizations (non-population health) might also be part of a lead poisoning prevention program (environmental health) and whose parents might benefit from mental health resources (behavioral health).
- Seamless transitions and secure information sharing among public health professionals are crucial for comprehensive care.
How do local health departments document and manage overlapping, programs in a single public health system?
Today, while there are companies offering solutions, most states still require some subset of data to be entered into state-level data silos. There is not a single solution available that meets all the needs of each program really well. Where does that leave local public health?
Two key factors can dramatically ease the burden and reduce the number of disparate systems.
1. Standardized taxonomy that works across the continuum of care and care settings.
The Omaha System taxonomy proves invaluable for local public health. Its inherent flexibility, as omahasystem.org details, allows for documenting client needs, interventions, and outcomes at the individual, family, and community levels across all four of these crucial service areas.
Imagine a public health nurse using the Omaha System to document a home visit for a new mother (non-population health), while also noting environmental concerns in the home and connecting the family with resources for substance use (behavioral health) and monitoring the non-vaccinated family as part of a growing measles outbreak (population health).
2. Reducing the number of software and paper documentation solutions as much as possible.
State data systems will exist for a long time. Fortunately, software that can integrate with state systems, manage individual, family and community records provides a single source of information for a large portion of the health department’s documentation and reporting.
For a local public health department striving to meet the diverse needs of its community across population, non-population, environmental, and behavioral health, an Electronic Health Record (EHR) needs to be more than just a repository of individual medical records. Therefore, it requires a community health management system that is inherently flexible and interconnected. Such a system must offer:
- Adaptable Workflows: Recognizing that the processes for conducting a lead inspection (environmental health) differ significantly from providing mental health counseling (behavioral health) or organizing a community flu clinic (population health), the EHR must allow for customizable workflows tailored to each service area.
- Customizable Data Capture Across Domains: The specific data points needed for an environmental health investigation will differ from those required for a behavioral health assessment or a population health survey. The EHR should enable the creation of customizable data fields and forms relevant to each service type.
- Integrated Electronic Forms: Creating and managing tailored electronic forms in one system streamlines data collection and boosts efficiency—from environmental reports to mental health intakes and health surveys.
- Secure and Interoperable Records: Maintaining the confidentiality of sensitive information (especially in behavioral health) in compliance with HIPAA is paramount. However, the EHR must also facilitate the secure and appropriate sharing of relevant information among authorized staff across different service areas to ensure holistic and coordinated care.
- For instance, knowing about a client’s anxiety (behavioral health) might inform the approach to their environmental health concerns about mold in their home.
Move Beyond Data Silos
A secure, HIPPA-compliant system designed to accommodate the diverse documentation requirements of population, non-population, environmental, and behavioral health services, moves a health department beyond silos. By embracing such flexible and integrated systems, local public health departments can enhance collaboration, improve efficiency, and ultimately provide more comprehensive and effective services to the communities they serve.
To share your challenges with a team who has partnered with local health departments for more than 40 years and is willing to transparently share what is and isn’t possible to bring together into a single system, reach out to Champ Software. You can book a free 30 minute call to share your challenges or learn more about their products.
References:
Us, Unite. “Whole-Person Care and the Impact of SDoH.” Uniteus.Com, 20 Dec. 2024, uniteus.com/blog/impact-of-social-determinants-of-health/.
