February 22, 2021

Statewide health information exchange leveraged to support COVID-19 tracking and response

Regenstrief, IHIE and partners created visualization applications to display key data for public health departments

Data has been a crucial part of the COVID-19 response. Regenstrief Institute and its partners leveraged the extensive information and data-sharing capabilities available in Indiana to create visual tools to inform public health leaders, media and citizens about the spread of the virus. The approach serves as a model for other states and nations to address the current situation and future public health crises.

A peer-reviewed paper published in the Journal of the American Medical Informatics Association describes the process of creating interactive visual dashboards for COVID-19 and the positive impact they had in Indiana. Regenstrief and many partners leveraged data available in the Indiana Network for Patient Care (INPC), managed by Indiana Health Information Exchange (IHIE), to create applications that displayed clinical and public health information from across the state. Informational categories include positive COVID-19 tests, hospitalizations, ICU admissions, emergency department visits and deaths.

At the start of the pandemic, IHIE worked with Regenstrief to enhance the capabilities of the INPC’s 14 billion pieces of patient data to identify COVID-19 reports and route them to public health authorities. From there, Regenstrief led a collaboration among multiple organizations to design and implement dashboards for COVID-19 information. The dashboards cover data related to person, place and time, all of which are important in public health surveillance.

The first dashboard, launched March 23, 2020, was created to guide public health decisions and is only accessible to authenticated users in state and local public health departments to protect privacy. The team then developed a public dashboard with less granular data to be used by health systems and other stakeholders, including the public and media.

As the pandemic progressed, the capabilities of the dashboards were enhanced to include positivity rates, estimated recovery metrics, and length of stay, among others. The new features are important public health metrics and enhance support for decision making. The dashboard team also created a second public page to identify recent trends in data, color coding them to make them easily interpretable.

The private dashboard identified several local outbreaks, including one at a meat packing plant. It also allowed health officials to initiate responses to trends and growing clusters, such as targeted testing and business closures.

This project took standard static dashboards, which have long been a tool for public health surveillance, and turned them into an interactive, dynamic visualization that provides more in-depth information in less time. Rather than sort through numbers, public health officials can navigate the dashboard to gather the desired information.

The dashboards were made possible by the biomedical expertise at Regenstrief, cross-sector partnerships and the statewide health information exchange. Partners informing the design and use of the dashboards include Indiana Department of Health, Indiana Management Performance Hub, the Indiana Governor’s Office, Marion County Public Health Department and Indiana Family and Social Services Administration.

The authors of the paper encourage other states to build cross-sector collaboration as well as invest in health information infrastructure.

Leveraging Data Visualization and a Statewide Health Information Exchange to Support COVID-19 Surveillance and Response: Application of Public Health Informatics” was published in the Journal of the American Medical Informatics Association. This work was supported by a grant from the Indiana Department of Health to the Regenstrief Institute to support COVID-19 pandemic response.

Authors are Brian Dixon, PhD, MPA, Regenstrief Institute and Indiana University Richard M. Fairbanks School of Public Health at IUPUI; Shaun Grannis, M.D., M.S., Umberto Tachinardi, M.D., MSc, and Peter Embí, M.D., M.S., all of Regenstrief and Indiana University School of Medicine; Andrea A. Broyles, MPH, Ashley Wiensch, MPH, Jennifer L. Williams MPH, all from Regenstrief Institute; and Waldo Mikels-Carrasco, M.A., Indiana Health Information Exchange.

IHIE is a non-profit, software development organization which operates the INPC — the nation’s largest inter-organizational clinical data repository housing 14 billion pieces of patient data from 95% of Indiana.