Harnessing the Power of Shared Data Across Sectors

Jul 24, 2015, 9:47 AM, Posted by Hilary Heishman

Silos of data need to be opened up across sectors to reveal hidden connections with the potential to improve health outcomes. Here's how RWJF is investing in innovative solutions.

Lab personnel provides explanation to patient.

A year and a half ago, the Robert Wood Johnson Foundation wrote about the groundswell of interest in connecting health care systems with other organizations and their local communities to build a Culture of Health. Since then, the Data4Health listening tour and the launch of Data Across Sectors for Health (DASH), have given more evidence to the importance of data—or the flow of information—in creating and benefitting from these connections. With work the Foundation and others across the country are doing, the “connections checklist” is increasingly taking shape.

In communities large or small, data can become a bridge between one organization’s need and a very different organization’s solution. In Rochester, New York, the business community took a hard look at a most alarming expense they faced—soaring health care costs. In 2009, the Rochester Business Alliance entered into a strategic partnership with the Finger Lakes Health Systems Agency to build a healthier workforce and lower costs. Analyzing data about community health issues revealed a shared concern about high blood pressure. The Agency developed community-based interventions that the Business Alliance and local businesses could use to help their employees and the wider community understand the importance of controlling their blood pressure. Working together, this collaboration has improved the county’s blood-pressure control rate by over 7%.

Underlying this community connection is a data connection between health care and the business community that brings root-cause analysis and rapid-cycle evaluation together to really focus attention towards groups of people who are at highest risk of uncontrolled hypertension. The Agency created a registry of information from electronic health records (EHRs) to fully understand the situation and monitor any changes brought about by their activities. Careful stewardship of sensitive information, real results, and the tantalizing promise of further benefits are sustaining and expanding this partnership.

The promise of benefits from connecting health care data with other sectors is where the Colorado Health Observation Regional Data Service (CHORDS) seeks to build upon the success of this data-driven public health surveillance tool to realize new benefits. CHORDS aggregates clinical and demographic information from health care partners’ EHRs. Queries are used by public health and health care delivery sectors in the Denver metro area to make data-driven decisions about targeted interventions, as in Rochester. Multiple public health jurisdictions are working with each other and community partners to understand and use data, including targeting resources and evaluating intervention impact within their communities. Clinical data obtained through CHORDS have been integrated with social, economic and community data and displayed at smaller geographic levels (e.g., neighborhood). This helps policy makers consider the health impact of decisions made in sectors outside of those traditionally considered “health-related.” For example, layering census, eligibility, and EHR clinical information with health services location or public transportation helps identify high need neighborhoods with limited provider access or transportation options; enabling planners to make decisions about bus routing that are more responsive to community needs.

While checklists can look easy, we are learning that this stuff is hard. From different collaborations, to different use cases, to different health aims to different tools, challenges and opportunities change. However, by keeping our focus on the connections of data and information systems across sectors to improve community health, we have identified key areas, such as financial limitations, collaboration building, and data exchange that will be important to address in order to build the field. Limited financial resources will always present a challenge, but we have clearly heard that technical and analytical resources are also scarce. Data can be used to foster multi-sectoral collaborations to address community problems, and multi-sectoral collaborations can help manage the use of the expertise, share it, value and reimburse it, but building collaborations is an art. Silos of data need to be opened up to reveal the connections that will build our nation’s culture of health. The program mentioned at the beginning of this post, DASH, has released a Call For Proposals seeking innovative solutions to these challenges.

Communities all over the country are doing impressive things, and as we learn about them, our own toolkit will evolve and grow. Through DASH, RWJF would like to hear about your attempts, successful or not, to share data across sectors. Our shared purpose is to strengthen how different kinds of organizations work together and use data together to improve community health. Let us know and help us learn from other exciting examples that you know about.