In Utah, chronic disease conditions are tracked through the Bureau of Health Promotion (BHP). This consists of pulling data from self-reported surveys such as BRFSS, and other aggregated data sources. It is unknown how well this data represents the true burden that chronic disease places on the population.
The BHP also reports on the Clinical Quality Measures (CQM). Available data used to measure performance related to CQMs does not paint an accurate picture.
The adoption of EHR systems by many healthcare systems may permit the acquisition of more accurate and complete data. Therefore a partnership between the Division of Disease Control and Prevention (DCP) Informatics Program and the BHP was created to identify additional data sources that can be electronically collected to improve the validity of the CQM performance.
METHODS:
BHP identified key partners, set goals, objectives, developed plans, identified strategies and resources needed to accomplish the goals and objectives. It was important that the goals and objectives aligned with those of the other bureaus and divisions within the UDOH to allow for the use of shared resources, infrastructure, and to accomplish common goals and objectives efficiently. The development team for this project consisted of a subject matter expert (SME), an informatician, and an epidemiologist.
RESULTS:
BHP established partnerships with Utah’s cHIE, a mid-sized health system, and a small health system to obtain linkable, de-identified patient level clinical data for hypertension and diabetes.
Linkable de-identified clinical data is collected directly from the EHR system and sent securely to the UDOH via a secure electronic interface.
Initially the data is being used to provide a more complete and accurate measure for reporting on CQMs and other health outcome measures. However, in the future the data will be used for working closely with health systems to improve the health outcomes of patient population.
CONCLUSIONS:
In public health, there is a need to break down the silos that exist related to data collection and data sharing and develop a process of working together with health systems to access electronic health data. Public Health needs more collaboration across disciplines and to approach health systems with a united purpose. Public health can be a key partner with health systems in using clinical data to identify best practices to improve chronic disease health outcomes for identified populations. Utilizing pilot-funds to build a sustainable infrastructure without the need of ongoing grant funding, presents a real opportunity for public health.