Table 2. Themes and corresponding categories regarding public health information systems (IS) and technology.

Selected theme	Selected category	Specific areas & example quote
Factors affecting information system quality		Descriptions of factors, circumstances, or conditions that affect specific quality characteristics or overall quality of the data within the IS
	Information system quality - reporting / output capability	“…it’s not a report writing system in the sense that I would think it is where it generates aggregate output…when we run a report we’re basically creating another data file.” - Epidemiologist, urban LHD “We do have the opportunity to run some reports. But, to be honest with you, it's so difficult to run a report that no one does it.” – Communicable Disease, suburban LHD
	Information system quality - interoperability	“Our health department providers that use [the IIS], they're like, "Really? We have to input everything into [the IIS] and then at the end of the month we have to do it again into [Vaccine management system]?" And it would be a lot easier, yeah, if they talked to each other…” – Immunization coordinator, urban LHD
Barriers to data acquisition from others		The system level context, organizational level factors, or situations that affect the need or ability of staff to get information from other organizations or sources
	Jurisdictionally defined work	“The access we have now for neighboring counties is just that we can put a name in and we can see it's in there, but we can't necessarily see the disease or see what's going on there.” – Nurse, urban LHD “You just don't have the ability to see everything that's going on, because some things are blocked.” - Communicable Disease, suburban LHD
	Mobile populations	“Confidentiality. They don't wanna be known wherever they're going. So if they feel like they can't have the confidentiality there in [city in neighboring state], then they'll come here and be tested.” – Public health nurse, rural LHD
	Data ownership	“We need our data back, and we need it back immediately…[The SHA is] looking at it simply as data… What that means to us is much more important.” – Registrar, urban LHD
Barriers to effective data sharing (to others)		Experienced and reported difficulties, challenges or factors/situations that need to be overcome/addressed in order to provide data to others
	Reporting back	“So it seems like our staff in the unit have to pull information from [IS], put it on a separate piece of paper, and then send it to the state. So I’m not sure why we have to add that extra step when I feel like, in an ideal world, we would be able to use [the IS] to report on the information that they need since there already is a way for us to collect it.’ – Epidemiologist, urban LHD
Consequences of Data Sharing Barriers and ISQ Problems		All consequences or outcomes associated with the inability to efficiently secure desired information from other sources and of having poor data quality
	Duplication of work/re-work / inefficient work	“If you got a parent that’s not a good steward of records, they could possibly have that same child immunized about 3 or 4 times by the certain age and they don’t necessarily need all those vaccines.” – Immunization staff, rural LHD
	Workarounds	“We were having to write everything in the comment field for zoonosis.” – Public health nurse, urban LHD
	Shadow IS	“We're duplicating our reporting. We do one for in house to help us keep track, and then we use the state system.” – Communicable disease, suburban LHD