The Missouri Health Strategic Architecture and Information Cooperative (MOHSAIC) is an initiative administered by the Missouri Department of Health (MDOH). The goal was to replace over sixty computer system programes. However, many challenges have arisen since the beginning of this project. The challenges including funding issues; recruiting the most qualified staff; coordinating systems; executing principles of data conversion and dealing with resistance to business re-engineering. As such, in surmounting these obstacles it required first obtaining appropriate funding through agencies that would have the integrity of financing the project. Next it was articulating internal external politics related to implementing a new health information system. Obviously, the existing sixty systems were obsolete, but functional to the organization because they became used to it (O’Carroll et.al, 2003).
Importantly, it was removing the philosophy whereby a series of systems were provided by different federal agencies subsequently funding their distinct categories. State funded information technology was designed as a stovepipe system. Information sharing became very difficult because there was no common identification number adapted to service the various systems. Clearly this hindered policy development at assessment at Missouri Department of Health. However, it was functional for those who used it. Missouri Health Strategic Architecture and Information Cooperative were going to disrupt this system. Hence, the apparent obstacles to change appeared. Indeed this was a great lesson learned from the project. How to deal with obstacles to change? (O’Carroll et.al, 2003).
Missouri Health Strategic Architecture and Information Cooperative (MHSAIC) soon realized that the Missouri Department of Health (MDOH) information system did not support service integration, which affected delivery of public health services. Interestingly, the systems that were used classified clients merely as program participants rather than individuals who have various health needs. How atrocious for a twenty-first century health care intervention! The lesson learnt here is that apparently departments of health have not grasped changing trends whereby public health education/promotion models focus has been shifted to the individual, family, community and globally financially. Programs cannot account for situations affecting individuals within a community. They are inadequate (Jackson et.al, 2006).
The implications then for developing other public health information systems are that a needs assessment prior to implementing the project ought to be conducted. This would help program executors to evaluate the level of resistance to change implied in gaining cooperation of departments of health officials, which are the internal and external political forces. These are agents foremost in the resistance process. Also, the extent to which these systems are outdated will be evaluated to design strategies prior to beginning the program (Jackson et.al, 2006).
Importantly, programs which did not have federal funding were poorly executed. Therefore, replacing or maintaining them was costly. Standard hardware discrepancies surfaced as challenges compounding an already dysfunctional system. A needs assessment would bring all these issues to the surface and Missouri Health Strategic Architecture and Information Cooperative would have valuable data to provide funding agencies that may be skeptical in financing any other of these projects administered by the Cooperative. Securing adequate funding before embarking on any other project is worthwhile when considering developing other public health information systems (Jackson et.al, 2006).
O’Carroll, P.W., Yasnoff, W.A., Ward, M.E., Ripp, L.H., & Martin, E.L. (Eds.) (2003). Public health informatics and information systems. New York: Springer
Jackson, S. Perkins, F. Khandor, E. Cordwell, L. Hamann, S., & Buasai, S. (2006). Integrated health promotion strategies: a contribution to tackling current and future health challenges. Health Promotion International. 21(1), 75-83.