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Updated: Jul 14, 2025
A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
Published on: September 20, 2018
Navigating the Landscape: Barriers and Facilitators in Electronic Case Reporting Implementation Across Public Health
Joel D Hartsell1, Catherine Staes, Katie S Allen
1Author Affiliations: Department of Population Health Sciences (Drs Hartsell, Wilson), Department of Health Economics (Dr Wilson), Department of Internal Medicine (Dr Samore), Division of Public Health (Dr Shoaf), and College of Nursing, Department of Biomedical Informatics (Dr Staes), University of Utah, Salt Lake City, Utah; Epi-Vant, LLC, Salt Lake City, Utah (Dr Hartsell); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Ms Allen); Richard M. Fairbanks School of Public Health, IUPUI, Indianapolis, Indiana (Ms Allen); Salt Lake County Health Department, Salt Lake City, Utah (Dr Dunn); Matheson Center for Health Care Studies, University of Utah Health, Salt Lake City, Utah (Dr Wilson); and Veteran Affairs, Salt Lake City, Utah (Dr Samore).
Objective:
The objectives were to identify barriers and facilitators for electronic case reporting (eCR) implementation associated with "organizational" and "people"-based knowledge/processes and to identify patterns across implementation stages to guide best practices for eCR implementation at public health agencies.
Design:
This qualitative study uses semistructured interviews with key stakeholders across 6 public health agencies. This study leveraged 2 conceptual frameworks for the development of the interview guide and initial codebook and the organization of the findings of thematic analysis.
Setting:
Interviews were conducted virtually with informants from public health agencies at varying stages of eCR implementation.
Participants:
Investigators aimed to enroll 3 participants from each participating public health agency, including an eCR lead, a technical lead, and a leadership informant.
Main Outcome Measures:
Patterns associated with barriers and facilitators across the eCR implementation stage.
Results:
Twenty-eight themes were identified throughout interviews with 16 informants representing 6 public health agencies at varying stages of implementation. While there was variation across these levels, 3 distinct patterns were identified, including themes that were described (1) solely as a barrier or facilitator for eCR implementation regardless of implementation stages, (2) as a barrier for those in the early stages but evolved into a facilitator for those in later stages, and (3) as facilitators that were unique to the late-stage implementation.
Conclusion:
This study elucidated critical national, organizational, and person-centric best practices for public health agencies. These included the importance of engagement with the national eCR team, integrated development teams, cross-pollination, and developing solutions with the broader public health mission in mind. While the implementation of eCR was the focus of this study, the findings are generalizable to the broader data modernization efforts within public health agencies.
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