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Program Collaboration and Service Integration (PCSI) at NCHHSTP

PCSI Success Stories

Strengthening Collaboration and Service Integration
in San Francisco

Developing Integrated IT Solutions for SFDPH

As part of the San Francisco Department of Public Health’s (SFDPH) Program Collaboration and Services Integration (PCSI) initiative, the health department formed a Data Systems Work Group to help improve the sharing of health information. One of the primary goals of the work group was to develop recommendations to enhance the local jurisdiction’s data systems by identifying and implementing a fully integrated system for a syndemic database. The work group and the PCSI Steering Committee reviewed several data integration options (see Table 1), realizing that the process would need interim steps toward reaching the overall goal.

Steps Toward Integration

SFDPH first requested technical assistance from CDC on the current informatics environment in which the data systems were running. They used an informatics data gathering process to assess and report the strengths and weaknesses within their data system and that of other infectious disease systems. Working with CDC, they conducted 14 focus groups with staff from different sections within the Public Health Division (PHD). Information was collected on each section’s priorities, challenges, and concerns. The CDC Informatics staff also interviewed IT staff and leadership.


Through these steps, PHD identified numerous strengths within the division, such as:

  • Thought leadership;
  • “Best in class” epidemiologists and researchers;
  • Extensive commitment to public health; and
  • Local knowledge and creative problem solving.

The focus groups also provided information to help tailor recommendations for the Division. Some of these recommendations were to

  • Hold additional collaborative meetings to conduct further analysis into the section’s processes and workflows.
  • Have town-hall style meetings and brown-bag sessions with staff in each section.
  • Talk to stakeholders to find ways to engage key individuals in each section to promote cross-collaboration.
  • Measure progress to plan a phased implementation with concrete milestones, deliverables, and performance indicators.
  • Contact other public health departments and identify successful integration projects.
  • Identify champions from each section to lead transformation efforts.
  • Solicit ideas and suggestions from staff on how to achieve integration.
  • Ensure the IT Support Team is involved as an equal partner.
  • Develop memorandums of agreement to define what is needed to meet the expectations of the sponsor, stakeholders, and users.
  • Implement “tiger teams,” i.e., a group of experts assigned to investigate and/or solve technical or systemic problems.

Successes and Lessons Learned

This process was a successful collaborative project, which truly showed the benefit of input coming from all levels of the Division to design this future data system. PHD staff gained an appreciation for the breadth of work being done at SFDPH as well as the challenges for data integration. PHD is in the process of implementing the recommendations. Through the PCSI process, SFDPH has a unique opportunity to demonstrate how integration and collaboration can improve public health and its health department. SFDPH is attempting to become the next generation model of public health services where integration is the cornerstone for delivering essential public health services.

Figure 1. Data Integration Options
Option 1. Each registry sends analyst surveillance data (extent of baseline assessment).  
Option 2. Expand level of analysis of the baseline assessment (expand the questions, incorporate more variables). 
Option 3. Surveillance data repository–Each section sends all surveillance/epidemiology data elements into a repository and an analyst will create analysis (data mining). 
Option 4. Syndemic database—Fully integrated system.

For more information, please contact:
Israel Nieves
PCSI Coordinator Director, Policy Unit HIV Prevention Section San Francisco Department of Public Health

Printable PDF version of PCSI Success Story

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