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ePublic Health Campaign

In the Spotlight

newspaperIn the winter 2013 NACCHO Exchange, Robert Pestronk, NACCHO Executive Director, challenges local health officials to envision the future of local health departments and their use of ePublic Health.

ePublic Health is defined as the management and use of information through policy, standards, practice, governance, and technology that advance the United States’ ability to protect and improve public health. Featuring the use of decision-support tools such as syndromic surveillance, electronic health records, documentation systems, mobile devices, websites, and social media, ePublic Health improves access to and distribution of health information. These tools can improve the health and well-being of populations by enhancing preventative measures, informing policy and personal health behavior decisions, and clarifying issues such as access, quality, continuity, cost of care, and the social determinants of health. 

Now it is your turn. Can you help build this vision of the future? Create your own headlines and add them to the list. We’ll use this crowdsourcing to create an image for the future of ePublic Health at LHDs. 

A few examples:  

  • Local health department’s social networking and emergency notification software combined to alert residents of impending flood and successful evacuation.
  • Local health department system alerts physicians and police of toxic cloud; deaths prevented.
  • Local health department-hospital-physician collaboration results in 100% adoption of community and clinical preventive services; Medicaid and Medicare evaluation reports $200 million saved.
More »

What is your vision for the future?


Read the Article...
2013 NACCHO Exchange (winter): Executive Director’s Column
By Robert M. Pestronk, MPH, Executive Director, NACCHO

In a world gone digital and mobile, ePublic health is changing local health department (LHD) practice just as “e” has changed and will continue to change how other businesses do business and how people do business with business. ePublic health must be foundational to LHD infrastructure and practice.  

ePublic health includes electronic health records, telemedicine, consumer health informatics, health knowledge management, virtual healthcare teams, mHealth, using grid computing for medical and population health, and healthcare and health information systems. Such emerging technologies will blur boundaries among credentialed and non-credentialed public health workers and the public as technology places capacities and content from ePublic health within reach of nearly anyone. Widespread acceptance of ePublic health will depend in part on continued sensitivity to and laws protecting privacy and confidentiality. Blithe “checks” in app acknowledgment boxes and a new generation of people whose life stories are offered freely on digital sites may herald a revised sensibility to these issues. Will users become inured to the regular reports of unauthorized data breaches and releases of personal information? Will they simply become accepted as a cost of doing business as the world goes increasingly digital?  

Despite the importance of ePublic health to the ongoing practice of LHDs, and the excellent examples of LHD practice offered in this issue of NACCHO Exchange, hurdles block wider adoption of electronic technologies and practices nationwide. Among these are inconsistent and poorly documented business processes and standards; paltry funding appropriated specifically for LHDs to influence, upgrade, and link their electronic systems with those being designed for and adopted by, for example, clinical and social service organizations; lack of funding for LHDs to scale up successful pilot projects to nationwide implementation; low priority given to LHD “e” within larger governmental “e” re-enterprising; inadequate workforce capacity and capability to monitor, use, and link to emerging “e”nvironmental changes; and leadership from cross-sector partnerships that recognize the importance of governmental presence locally, statewide, and nationally to ensure that communities, regardless of location, are protected, healthy, and secure. 

For many reasons, the advancement and pace of adoption of ePublic health will vary by location. Time magazine (2) characterizes the “new” America as “not so much the old e pluribus unum—out of many, one—but as [Ralph Ellison] says, one and yet many.” This aptly describes the public health enterprise with its complicated responsibility framework across domains of federal, state, and local governmental and non-governmental organizations and practice.(3)

Can LHDs envision a more complete picture of the future to help construct a bridge to that future, to be insightful enough to pass the present “puck” to where future colleagues will need to be? (4)

I invite you to add your “e” public health headlines of the future below. Let’s “crowdsource” a practical vision from those most knowledgeable…you and those you know!


  1. Time. Richard Stengel. The Choice: TIME’s Person of the Year. December 31.2012/January 7, 2013. Accessed January 10, 2013.
  2. Nonetheless, federal and state governments, by remembering the extent to which LHD are an essential partner in their work to create the conditions for better health can do a better job crafting policies which assure connections between LHD and the clinical care system (for example by extending their own data sharing authorization agreement to them) and appropriating the funding for technology and workforce to make those connections meaningful. With respect to funding, one need only contrast the approaches through which the American Recovery and Reinvestment and Affordable Care Acts have injected billions of dollars to help physician and medical care organizations migrate into the digital world with the absence of such support for governmental public health organizations, which must analyze and communicate how policy and financial investments result in real-time health and efficiency.
  3. The creation of common business practices across the landscape of LHDs will simplify the development of technology for those connections and, thereby, with larger scale make a stronger business case for investment.
  4. With acknowledgment to the game of ice hockey and one of its famous practitioners, Wayne Gretsky.