Abstract
Electronic health information systems can re-shape the practice of public health including public health surveillance, bi-directional communication, disease and injury investigation and control, decision making, quality assurance, and policy development. While these opportunities are potentially transformative, and the federal program for the meaningful use of electronic health records has included important public health components, significant barriers remain. Unlike incentives in the clinical care system, scant funding is available to public health departments to develop the necessary information infrastructure and workforce capacity to capitalize on electronic health records, personal health records, or big data. Current electronic health record systems are primarily built to serve clinical systems and practice rather than structured for public health use. In addition, there are policy issues concerning how broadly the data can be used by public health officials. As these issues are resolved and workable public health solutions emerge, they should yield a more efficient and effective public health system.