Indiana is home to the nation’s largest inter-organizational clinical data repository. The public and private sector data presented here — on emergency department visits, inpatient admissions and laboratory testing — aims to provide the most complete picture of the COVID-19 pandemic in our state.
We are presenting this dashboard to help augment the official data from the State of Indiana. The goal is to help our public health professionals, health systems, and other partners as they work to address this emergency.
The information above helps to identify regions that may be experiencing changes in key COVID-19 metrics. Using a series of 7-day moving averages, green, yellow, and red colors identify decreasing, inconclusive, or increasing trends, respectively. A second map provides per capita positive rates (per 100,000 people), placing all regions (county or ISDH district) into 4 equal groups by quartiles, ranging from low to high per capita positive rates. Bar charts to the right of each map below show daily counts for each metric. Trend indicators are designed to highlight regions for further review, and are not intended to predict future trends. We are working daily to augment these data, so the numbers above may change as additional data become available.
Trending logic. The trend indicator uses 3-element vector composed of the differences (represented as increase, decrease, or no change) between four consecutive 7-day averages. Each unique vector is mapped to one of three labels: Green – decreasing trend, Red – increasing trend, Yellow – inconclusive trend.
Data Delay. Receipt of clinical data can be delayed up to three days after the clinical event. Because of this delay, initial counts may be lower than actual counts, which may bias the trend indicator toward green. To avoid this bias, the trend indicator color will not reflect the most recent three days.
Early warning indicator. If a notable increase in daily counts is observed in the most recent three days, a red dot is displayed. A “notable increase” is defined as any individual count in the most recent three days that exceeds the average of the 7 days preceding the three days.
Small number rule. When all daily counts over the entire observational period are 3 or less, the trend is labelled green. This is in addition to the above trending logic.
Per Capita Positive Rates. The per capita rate is computed by dividing the number of positive cases in a region (state, county, district) by the total population for that region, then multiplying by 100,000.
Trend Color definitions
Red – Indicates a pattern of increasing daily counts
Yellow – Indicates an inconclusive pattern, neither clearly increasing or decreasing.
Green – Indicates a pattern of decreasing daily counts or low daily counts.
Information above includes COVID-19 specific tests that were resulted beginning March 1, 2020. Up to July 25, 2020, these testing numbers represented exclusively the private and public laboratory results that we received and we could match to individuals in the INPC data resource. As noted, these results did not include some lab tests that haven’t been incorporated into the INPC.
As of July 25, 2020, we have augmented our numbers with additional testing data obtained from the Indiana State Department of Health. As we work to fully integrate and match these new data into the INPC, we have added a new row of testing information to the dashboard to clarify the differences between these data.
The first row of testing data, indicated by “Indiana,” represents testing information we are aware of that includes people who live in Indiana. The second row of testing data, indicated by “INPC,” represents what we have been displaying since March, and includes that subset that is already incorporated into the INPC data resource.
Until we completely incorporate all of the new data into the INPC, the testing map, and graphs continue to reflect only those data that are presently in the INPC data resource.
Dates for these tests indicate when results are received, not when testing was performed. Even with the enhancements indicated above, these results may still not yet include some lab tests performed and available across the State. We continue working daily to augment these data, so the numbers above may change as additional data become available.
As always, the official test result figures for the State of Indiana are available on the State’s COVID dashboard, which can be found here.
Comorbidity rates are calculated based on the proportion of patients who are (a) COVID-19 test positive and (b) COVID-19 test positive patients who were hospitalized. Comorbidities are based on ICD-10 codes reported within 365 days from either a patient’s lab result, hospitalization, or ED visit. We are working daily to augment these data, so the numbers above may change as additional data become available. Relevant codes include:
Information above includes emergency department visits for patients with COVID-19 positive test that were resulted over the 14-days prior to and anytime since the admission. These numbers represent patient admissions data available via our combined healthcare data within the INPC. Data availability may lag real-time activity. These numbers may not include hospitalizations for some patients who have tested positive for COVID-19 but for whom we cannot yet link to hospital admission data. We are working daily to augment these data, so the numbers above may change as additional data become available.
Information above includes the first inpatient hospital admission for each patient with a COVID-19 positive test or COVID-19 diagnosis code that we receive during the 21-days prior to or following the admission. These numbers represent patient admissions data available via our combined healthcare data within the INPC. Data availability may lag real-time activity. These numbers may not include hospitalizations for some patients who have tested positive for COVID-19 but who we cannot yet link to hospital admission data. We are working daily to augment these data, so the numbers above may change as additional data become available.
The Regenstrief Institute and its partners value patient privacy and have made every effort to prevent this COVID dashboard from identifying any individuals. In the event you feel this dashboard identifies an individual, please contact firstname.lastname@example.org and the Regenstrief Institute will immediately address the issue.
The Indiana Health Information Exchange (IHIE) was founded in 2004, but its roots date back more than 30 years. IHIE manages the Indiana Network for Patient Care (INPC), the largest interorganizational clinical data repository in the country with a participant base of more than 100 hospitals, 50,000 providers, 18,000 practices, health networks, laboratories, and insurance providers. They represent combined data on more than 18 million patients in the form of 10 billion clinical observations, 1.1 billion encounter records, and more than 290 million mineable text reports. In addition to these clinic aspects, the INPC receives data on drugs that have been prescribed to patients within its various institutions. Approximately two-thirds of Indiana’s population is represented in the INPC.
This resource is nearly unparalleled for clinical research and includes additional data elements such as admissions, discharges, lab reports, pathology, radiology and cardiology.
Caveats (in data specific to the dashboard, this is not an exhaustive INPC caveat list)
The Indiana State Department of Health (ISDH) maintains the State Health Laboratories for the support of State Public Health, Environmental and Food Protection programs. The State Health Laboratories provide specific, high quality, and necessary laboratory tests, test data, and test interpretations to federal, state, and local health, environmental, and food protection programs. The data from these tests is required for effective and efficient detection and response to public health, environmental and food protection emergencies and for surveillance and detection of communicable diseases, environmental hazards and their health effects, and food contaminations and their health effects.
Established in 1998, the Michiana Health Information Network (MHIN) is one of the oldest and most mature health information exchanges (HIE) and healthcare information technology organizations in the U.S. With more than 20 years of longitudinal records for over 4.7M individuals, MHIN receives data contributions from more than 576 data sources across northern Indiana and southern Michigan, with over 20,304 connected providers submitting more than 3.9M inbound transactions per month. On January 1, 2020, MHIN consolidated into the Indiana Health Information Exchange (IHIE) to become Indiana’s state-wide HIE.
The following people made substantial contributions to our COVID-19 dashboard:
Public Health Informatics Experts:
Thanks to all who have contributed to date. Other contributors will be added as our work continues.