Making a Powerful Connection: the Health of the Public and the National Information Infrastructure. 8.5 Organizational and Financing Issues


The fragmented organization of public health programs plays an important role in limiting applications of the NII to population health. Public health programs are frequently funded through categorical grants, which are often associated with categorical information systems dedicated to the reporting needs of each particular program. Because these systems speak different languages (in terms of vocabulary, software and data standards), it is extremely difficult to link information across programs, even when such linkages could substantially reduce administrative work, enhance customer service, and strengthen analytic capacity. Equally important, many grants prohibit the use of categorical funds for developing or maintaining information systems that benefit other programs in addition to the one for which the funds were appropriated. As long as these restrictions (and their concomitant political and managerial barriers) apply, it is difficult for states to move forward with logically integrated information systems that could give their public health officials and policymakers a more holistic view of public health problems and resource needs.

Intergovernmental and public/private partnerships are key to public health applications of the NII for a variety of reasons, including the range of expertise that is required, the need for information from diverse sources, community-wide benefits and use, and demands for a broad base of financing. Currently, however, most states and communities have neither the policy framework nor the structural mechanisms to bring potential partners in health-oriented information systems together. Without adequate incentives to collaborate or a forum for social interaction, feasible NII projects to support population health may not get started or may falter before implementation.