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Best Practices for Data Modernization Across the United States Public Health System: Scoping Review

Background: The adoption of new technologies and data modernization approaches in public health aims to enhance the use of health data to inform decision-making and improve population health. However, public health departments struggle with legacy systems, siloed data, and privacy concerns, hampering new technology adoption and data sharing with stakeholders. This paper maps how to address these shortcomings by identifying data modernization challenges, initiatives, and progress. Objective: To characterize the evidence for data modernization associated gaps and best practices in public health. Methods: This scoping review was conducted using the five-stage framework developed by Arksey and O’Malley and was reported according to the PRISMA-ScR guidelines. A structured search was performed in databases PubMed, Scopus, CINAHL, PsycINFO, and was complemented by a further search in the Google Scholar search engine, covering publications from January 1, 2019, to April 30, 2024. Eligible studies were peer-reviewed, published in English, and focused on data modernization initiatives within U.S. public health and reported on best practices, challenges, and outcomes. Search terms combined concepts such as β€œData Modernization,” β€œInteroperability,” and β€œPublic Health” using Boolean operators. Two reviewers independently screened titles, abstracts, and full texts using Rayyan QCRI, with conflicts resolved through consultation with a third reviewer. Data was extracted into Microsoft Excel and thematically analyzed. Results: This review analyzed 22 studies focused on public health data modernization. Across the literature, common components included transitioning to cloud-based systems, consolidating fragmented data into unified platforms, applying governance frameworks, and implementing analytics tools to support decision-making. Primary data sources were electronic health records, insurance claims, and disease surveillance registries. Key challenges identified across studies involved data quality issues, lack of interoperability, and limited resources, particularly in underfunded settings. Notable benefits included more timely and accessible data, improved integration across systems, and enhanced analytical capabilities, which collectively support more responsive and effective public health interventions when guided by clear standards and policy alignment. Conclusions: Progress hinges on balancing local adaptability with national coordination, improving data governance practices, and enhancing collaboration across institutions. These steps are vital to ensure public health systems can deliver timely, accurate, and actionable information to support effective public health efforts.
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Digital Health Technology Infrastructure Challenges to Support Health Equity in the United States: Scoping Review

Background: Even though Digital Health Technology (DHT) is widely utilized in the United States (U.S.) at both hospital provider and individual levels, it is beset with several challenges that have contributed to inequities in the health service delivery. Previous studies have shown that health inequities observed may be amplified many by DHT requirements. Objective: The objectives of this scoping review are aimed at synthesizing information on DHT inequities by exploring evidence that describes DHT infrastructure needs focused on promoting health equity in the U.S. and identifying key challenges at both the individual/patient level and at the health service provider's level. Methods: We adapted Arksey and O'Malley's scoping review guidelines in our review. We searched PubMed, Web of Science, CINAHL, and PsycINFO were searched. We also conducted supplementary searches on Google Scholar. The inclusion criteria were peer-reviewed publications that broadly conceptualize or analyze DHT infrastructure from a health equity perspective and the challenges of DHT requirements between 2020 and 2024. Following a full-text screening using eligibility criteria such as studies were included if they examined DHT infrastructure in the U.S. from a health equity perspective, discussed health disparities resulting from DHT interventions, or investigated the variables influencing health inequities connected to DHT. Two researchers evaluated each citation’s individually at the title and abstract levels. Thematic approach and qualitative analysis determined this scoping review’s outcome. Results: Of the 628 research articles from the search, 27 were included in the analysis based on the inclusion criteria. In this review, we discussed factors such as elderly population, education, race, ethnicity, and socioeconomic status leading to health inequities in DHT. Patients and Service providers challenges that exist in health inequities related to DHT. The most common challenges for service providers were infrastructure and technical issues such as inadequate integration with existing workflows, user-unfriendly health information exchange (HIE) interfaces, and lack of skilled staff, while for individuals or patients, this included limited broadband internet access, cultural or linguistic appropriateness, and access to digital tools. Conclusions: The study identified that in the U.S., DHT is an essential part of the delivery of health services, yet it is saddled with key challenges leading to health inequities. Finding pragmatic solutions to these challenges can improve health equity in DHT.
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