Policy and Position Statements


eHealth Policy Statement

Exchange and use of appropriate and timely information is at the heart of public health. Raw data transformed by analysis becomes information, which through appropriate application is transformed into knowledge. Timely application of knowledge gained through this process is essential in making informed decisions and taking appropriate action to improve the health of communities. State and territorial public health agencies supply data, information, and knowledge to a variety of constituencies such as citizens, local or tribal health departments, and federal bodies.

Public health informatics is the systematic application of information through computer science and technology to public health practice, research, and learning. Guided by informatics policies and principles, state and territorial health agencies rely on information systems to facilitate good decision making by providing the right information to the right people at the right time. Public health informatics is the science of the effective use of data, information, and knowledge to improve the health of individuals and the community. Information systems create a bridge linking public health, clinical care, individuals, and communities that fosters overall improved health system performance. Public health leaders ensure that the collection, analysis, and dissemination of information drive quality and efficiency in public health systems across geographical levels, which will ultimately lead to improved individual and population health.


The nationwide public health information infrastructure is composed of linked local, state, territorial, and federal public health information systems.

ASTHO supports:

  • State and territorial public health agency development of information systems that support public health agencies' objectives and are aligned with the agencies' informatics strategy.
  • A collaborative governance process that includes stakeholder input from all levels of government and nongovernmental partners.
  • A leadership role for state and territorial public health in the development of state and territorial information systems.
  • Funding that is sustainable and realistic over the long term for state and territorial public health information systems, which is coordinated across and within federal agencies.
  • Consistent informatics leadership across changes in federal administrations.
  • Coordination of federal health agency guidance and support of these systems to maximize resource investments.


Information systems should be designed according to national standards, recognizing that state and territorial health agencies will customize systems to meet their unique needs. Standards-based information systems deliver quick and accurate exchanges of comparable data and information that supports interoperability. Standards may be technical or definitional and clinical-based or population health-based. They may be developed through national bodies or the coordinated efforts of federal, state, and local entities. The integration of data from multiple programs improves the understanding of the populations that public health agencies serve.

ASTHO supports:

  • State and territorial public health agency involvement in health information technology policy processes at the national level and in standards development organizations.
  • Developing information systems that support bidirectional communication with clinical care and closer integration of public health with the healthcare system.
  • Universal geographic and population coverage by interoperable information systems equipped to respond in multijurisdictional emergencies and to support public health objectives.
  • Development of agreements to share, analyze, and disseminate information across jurisdictional boundaries.


State and territorial health agencies need additional assistance to manage, analyze, and leverage the information that they currently have.

ASTHO supports:

  • Development of a sustained pipeline of skilled public health informatics professionals for state and territorial public health.
  • Further development of decision support tools that promote public health action at the federal, state, and local levels.


Defining protocols and establishing relationships for information sharing are critical to preparation for emergency situations, addressing outbreaks that cross political boundaries, and working with clinical care to support public health objectives. State and territorial health agencies support preparedness activities by collaborating closely with partners at all levels to develop common communications methods, protocols, and defined coordination roles.

ASTHO supports:

  • The collaboration of federal, state, territorial, and local public health leaders and other responders to assure communication of emergency and time-sensitive information across agencies and jurisdictions.
  • Use of appropriate technology that sustains collaboration.


ASTHO supports an enterprise approach toward the development of information systems, rather than reinforcing programmatic silos. Public health information system requirements should arise from a thorough, collaborative business process analysis based on a common vocabulary and definitions. The broad use of such requirements-and the understanding of public health practices gained through their development-will support improved quality of services, performance, and interoperability among systems as well as increase the visibility and viability of the public health market among vendors. Efficiency and effectiveness are enhanced when systems support both routine and emergency functions, particularly when the human interface (for example, the graphical user interface) remains similar across different applications and data and systems are reused to the greatest extent possible. The transformations to systems and data transport needed for meaningful use of electronic health records and healthcare reform warrant personnel with new competencies and an agency-wide vision.


Use of data must balance a public health agency's need to know, in order to inform public health actions, with the rights of individuals to have their personal information protected. Since public health relies on the secondary use of personal clinical health information, related policies should include appropriate provisions for the protection of public health access.

Approval History:

e-Health Policy Committee Review and Approval: July 2014
Board of Directors' Review and Approval: December 2014
Ratified by the ASTHO Assembly of Members: December 2014
Policy Expires: December 2017

ASTHO policies are broad statements of enduring principles related to particular policy areas that are used to guide ASTHO's actions and external communications.

Related ASTHO Documents:

Position Statements:
Biosurveillance Position Statement
Accessing School Health Information Position Statement
Meaningful Use Position Statement