A health partnership in Indiana is urging hospitals and public health departments to use a free spatial data analytics tool to better assess and improve community health.
The nonprofit Indiana Partnership for Healthy Communities reviewed more than 100 hospitals' 2012-2013 federally mandated community health needs assessment reports and found in a preliminary paper that many are using county-level information, not specific enough for targeted health interventions in neighborhoods or even ZIP Codes, according to Karen Comer, director of health geoinformatics at the Polis Center.
"Unfortunately the majority of hospitals still just look at data at the county level for both their assessment needs as well as for implementation planning," Comer said. The Polis Center is a research unit at Indiana University-Purdue University Indianapolis and member of the partnership along with the Richard M. Fairbanks School of Public Health and the Indiana Clinical and Translational Sciences Institute.
Digging for Health Data
For a clearer picture of Indiana's public health, the Polis Center is digging for more data and participating in a research project to integrate the state's electronic health records data with population-level data for eventual publication in SAVI, its data and mapping system.
The Polis Center is teaming with the Regenstrief Institute and the Richard M. Fairbanks School of Public Health for the project, which is funded by the Robert Wood Johnson Foundation.
"We want to tap into that growing availability of electronic health data to create more timely and more geographically specific information," said Karen Comer, director of health geoinformatics at the Polis Center.
The Polis Center is figuring out how to extract and aggregate clinical health measures, like diabetes, by testing their use at population-level and overlaying them with social economic indicators.
"Once we've worked out all the kinks and feel like we've got solid health measures, then the combination with SAVI will allow us to think of social determinants of health," Comer said.
Within the next year, Comer said the center's goal is to prove the validity of these prototype health measures and then to publish them in SAVI.
"One hundred percent this research is intended to advance the information that's available for community health needs assessments," she said.
The goal is for hospitals to use specific community information to understand health disparities, and to collaborate with other hospitals and public health providers in response to the data. This will more effectively leverage partners' limited resources, Comer said.
For neighborhood-level information, central Indianans can access the nation's largest community information system, SAVI (social assets and vulnerabilities indicators), a GIS-enabled database of mapped and tabular data. Created by the Polis Center in 1994, SAVI is used by human service and community planners and relates health indicator data to historical data on social economic conditions (like housing, education and crime) that can impact a person's health.
The Polis Center is encouraging the use of its free resource, which it created for the United Way of Central Indiana, built on the notion of "place matters" and to "compare needs and assets," according to Sharon Kandris, director of community informatics and the SAVI project at the Polis Center.
Kandris explained that SAVI tools provide a way for hospitals and public health departments to chart, graph and map community demographics and social economic information, and then connect that with resources to meet service provision gaps — an often forgotten piece in the assessment puzzle, she said.
"One of the really nice things about SAVI is that it uses space to combine information about the needs or vulnerabilities of geographic communities," Comer said. "It really facilitates doing a gap analysis between what's needed and what's there to address the need."
The tool supports hospitals and public health departments as they undertake community health needs assessments, which the IRS mandates hospitals to complete every three years and for nationally accredited health departments every five years, and to implement their resulting improvement plans.
SAVI also facilitates establishing partnerships by revealing possible community organizations that can support health, which the report also found was an area of improvement for hospitals.
"Our goal is not only to provide an infrastructure for ready community information access, but also an infrastructure that facilitates cross-sector collaboration and community engagement," Comer said.
Although some hospitals are collaborating with public health departments, logistical challenges are keeping others from doing so, according to the report. "The ideal situation is that the hospitals would be partnering with their local health department in their service area because that's the expertise at public health departments — it's their job to understand public health data."
For instance, the partnership assisted Logansport Memorial Hospital and the Rush County Health Department with their community health needs assessments and is also advising a collaboration among the four large hospital systems in Indiana interested in the report's findings. The hospital systems are coming together regarding data collection and discussions with local health departments, and they are considering collaborating at the health improvement planning level too. "It's a huge step for them," Comer said.
Additionally SAVI will be rolling out new dashboards this year for accessing quick reports and resources to help users more usefully explore data, such as a template planning tool that acts as a step-by-step guide throughout assessment and plan implementation; the template can be molded for use in any kind of assessment, according to Kandris.
"There are lots of indicators and systems out there, but not tools that bring folks through the community health needs assessment process," Comer said.
SAVI will soon also include an online report card that tracks progress toward community goals regarding social determinants of health, like race and income, to explore the health effects of these disparities.
This year marks the beginning of the next round of assessments for hospitals, and Comer said she's already seeing changes as hospitals are collaborating more and are starting the assessment process early.
"But it's not a simple thing to figure out how to use their combined resources," Comer said.That's why the partnership is supporting the exchange of health information and its collaborative use to make decisions.