Hear about a powerful tool for visualizing COVID-19 data developed by the Regenstrief Institute and its partners in the newest episode of our special season focused on the COVID-19 pandemic.
Imagine something for a minute. Think about how impossible it would be to try and drive a car without a dashboard.
There’s so much we information that we depend on having automatically available to us at a glance. If you don’t know how fast you’re going, you might wind up with a ticket. If you can’t see your gas gauge, you’ll most likely find yourself on the side of the road waiting for a friend with a gas can.
What’s more, we need dashboards that can quickly alert us about parts of our vehicle’s operation and status that we might not even be thinking of while we’re driving. Think about the alerts that pop up on your dashboard – your check engine light, your tire pressure sensor, and several other lights that give you the notice you need to pull over, get help, and stay safe.
It’s no different in population health. To solve the problems presented by crises like pandemics on a population level, is next to impossible without the right data and the right systems to help notify us of additional hidden problems that lie beneath the surface.
In this episode, we’ll talk about the COVID-19 dashboard, a Regenstrief-led effort that helps everyone, from public health leaders to everyday citizens, understand the spread of the disease in Indiana, the strain it creates on health systems, and the populations most affected.
Welcome to The Problem, I’m your host, Phil Lofton.
In many ways, it seems like the book on COVID-19 is being rewritten nearly every other day. New findings are constant, as researchers find new pieces of information on transmission and care providers improve their understanding of care for patients with coronavirus.
Imagine trying to combat a pandemic without understanding where and how fast it’s spreading or what demographics are being most affected by the disease. In a lot of ways, it would be like you were driving a car with no dashboard, just a steering wheel and a windshield.
Creating a framework to accurately understand and communicate the spread of the disease was a critical step in Indiana’s efforts to fight COVID-19.
To be most informed, Indiana would need a tool that could accurately describe how fast the disease would spread, information on testing rates, and the numbers on hospitalizations of individuals with COVID-19, amongst other information. It would need to have this information displayed in a way that would be valuable to policymakers and understandable by the general public.
If that sounds extremely complicated, it is. And it wouldn’t be possible without an expert team working together.
Here’s Peter Embi, Regenstrief Institute’s president and CEO, talking about the steps that led to the creation of the dashboard.
We at the Regenstrief Institute work closely with our colleagues at the Indiana Health Information Exchange, our colleagues at the State now, and in response to this with the Management Performance Hub and all of our health system partners to be able to look across the data sets that we have because of the Indiana Network for Patient Care. And what we started to do was analyze the hospital information about COVID patients so that we can better inform our state representatives, Dr. Box, and others, about what it is that they need to understand in order to be able to better respond to the COVID crisis. So they asked us to take a look, and we’ve been doing an analysis for our state and for our health systems to look at: To what degree are people with COVID being hospitalized showing up to emergency rooms when they are hospitalized? Two, they end up in the intensive care unit. And how long do they stay there? And then, what can we start to learn about recovery with discharge numbers and the like? So that was really the initial motivation for doing this analysis. Through our public health informatics team and our colleagues across the state and IHIE and the and the health systems, we pulled this together.
Regenstrief created this dashboard in partnership with Indiana State Department of Health, Indiana Family Social Services Administration, Indiana Management Performance Hub, Indiana Health Information Exchange, Indiana University Richard M. Fairbanks School of Public Health at IUPUI and Indiana University School of Medicine. The teamworked hard to come up with the information to support a useful tool quickly once the pandemic hit Indiana.
Luckily, here in Indiana, we have the Indiana Network for Patient Care, the clinical data repository managed and operated by the Indiana Health Information Exchange. It’s an invaluable pool of patient data that helps researchers and policy makers.
In the course of gathering and interpreting the information of COVID-19 patients, the group behind the dashboard determined the most important metrics that could help inform a reopening. In the terms of our original metaphor, this would be like determining which metrics told you that you weren’t speeding or running low on gas.
Here’s Regenstrief’s vice president for data and analytics, Shaun Grannis, on some of the most important metrics that the team needed to watch.
So, we want to watch. We want to make sure that we’re watching at different parts of the healthcare system. So we are watching emergency department visits for patients who might have influenza like illness, respiratory illnesses, perhaps feel that aren’t tested yet. They show up at the ER complaining of respiratory illness. If we see a spike in those types of visits, that would lead us to have some concern if we see an increase in hospitalizations for COVID-19 in any region in the state. Of course, we would be concerned, and at its core, testing is key to this. And so obviously, if we see an increase in either the number of total tests or that test positive rate. We want to watch those items as well. So those are the types of metrics that we’re looking for. There’s something called the doubling rate. And that is how many days would it take for cases to double based on today’s rate. And we like to see that doubling rate get longer and longer and longer. That means the epidemic is spreading — is slowing down.
But there’s more to monitoring public health data than just watching until one particular metric hits a sweet spot, just like there’s more to your car’s dashboard than telling you your speed. As we collect data on a big enough scale to make public health decisions, we start to see trends in those data. And those trends help guide our decisions.
Here’s State Health Commissioner Kristina Box, from a press conference in late May:
As most of the state enters stage three of the “Back on Track” plan, we continue to focus heavily on the four guiding principles that the governor has said will determine when and how we reopen our state. One of those key elements is the number of people who are hospitalized for COVID-19. We have the latest data from Regenstrief that gives us a better picture of where we are in terms of hospitalization and recovery from COVID-19.
In the instance of COVID-19 data, we started to see populations in Indiana that were disproportionately affected by the virus. Just as we’ve seen on the national scale, here in Indiana, we’ve found that minority populations have been hit particularly hard by COVID-19.
While white Hoosiers are 85 percent of the state’s population, they’ve only make up 45 percent of coronavirus cases. On the other hand, while 10 percent of Hoosiers are black, 13 percent of all people diagnosed with COVID-19 in Indiana have been black.
The dashboard continues to grow and evolve in its capabilities, including a new feature that can help describe trends, but it’s only been possible due to unprecedented data sharing partnerships among the Regenstrief Institute, local health systems, state agencies and other nonprofits.
As Indiana continues the slow process of reopening, the dashboard will continue to help provide important information and guidance for every step we take toward a return to normal. By keeping a close eye on several specific metrics and watching for unexpected alerts, we can steer the process of reopening clear of any potholes and keep it on the right track.
Join us next time when we’ll talk about Mindfulness, the emotional toll of COVID-19 on providers and patients, and what researchers are pointing to for help managing the trauma of life under COVID.
We’ll see you then on The Problem.
If you’d like to see the Regenstrief dashboard in action, head to regenstrief.org, where you can see all of the features on display.