Connecticut invests billions of dollars annually in providing health and human services to state residents. But are those funds being allocated in such a way as to have the greatest possible effect on residents? health and well-being? That?s one of the major questions the University of Connecticut Health Center and its partners aim to answer through the work of the Connecticut Health Information Network, or CHIN.
CHIN is a suite of sophisticated applications and algorithms that brings together health data from several state agencies, including the Departments of Public Health, Developmental Services, and Children and Families. It is spearheaded by UConn Health?s Center for Public Health and Health Policy, UConn?s Departments of Computer Sciences and Engineering, and Boston-based medical informatics firm OpenClinica LLC. It?s conducted in collaboration with representatives from participating state agencies. The state legislature created CHIN in 2007 and continues to provide funding as the initiative progresses.
Robert H. Aseltine
CHIN focuses on collecting and analyzing data from state agencies to see what programs, services and treatments yield the best outcomes for people those agencies serve. According to Robert Aseltine, director of the Institute for Public Health Research at the Health Center and a professor in the Division of Behavioral Science and Community Health, ?The ultimate goal of CHIN is to foster better government by improving the allocation of resources and creating efficiencies in programs that address health and human service problems. Ultimately we?re trying to improve population health by making better use of data.?
Breaking down data ?silos?
State agencies that focus on health and social issues maintain data on the individuals they serve. Each agency, however, stores the data in its own system. With data existing in separate ?silos? and no common numeric identifier associated with an individual, it?s been extremely difficult to use cross-agency data to assemble a clear picture of how shared clients are faring. ?For example,? says Aseltine, ?families receiving financial benefits from the state typically have children who are attending school and receiving daycare services and publicly funded health care, yet there is virtually no coordination among these programs. Coordinating these benefits and services so that we maximize their effectiveness is in everyone?s interest, but it is not possible without the ability to share data across programs and agencies.?
CHIN has addressed this obstacle by developing special software that takes data from all the agencies and uses a ?probabilistic? approach to assemble relevant information about individual clients. The system, Aseltine says, ?makes it easy and straightforward to be able to integrate data across agencies.?
Improving public health
The data CHIN extracts has wide-ranging implications for public health. It can be analyzed to compare patient outcomes in order to identify best practices for managing patients with diabetes, for example, and reduce rates of hospitalization among people with chronic diseases. Recent data suggest that patients covered by Medicaid and Medicare have much higher rates of hospital readmission. ?Aseltine says CHIN?s data may be useful in linking those patients to other sources of health care in the community, so that they receive the care they need without costly hospital readmissions.
Dr. Bruce Gould
Both federal legislation and trends in health care reimbursement make data collection especially critical, says Dr. Bruce Gould, associate dean for primary health care at the UConn Health Center and medical director of both the Burgdorf Health Center and Hartford?s Department of Health and Human Services. ?If you look at where the health system is going with the implementation of the Affordable Care Act and with many of our health systems looking at accountable care organizations, it will be all about managing the care of populations of patients,? Gould says. ?One cannot ever hope to do that without robust population data.?
Data can also shed light on environmental and social factors that affect a person?s health and well-being. Does the person live in an area where there?s no access to primary care services? This could be rectified to ensure access to care. Is public safety lacking in the person?s neighborhood? Resources could be targeted to improve safety and reduce risk. If a patient being discharged from the hospital is going home to an unsafe environment, it?s important to know that, says Aseltine. ?If we?re about promoting health, we have to take the broader social and physical environment into consideration. The vast majority of people?s lives are lived outside a medical institution, and that environment, not hospitals and physicians? offices, is the primary determinant of overall health and well-being.?
From the public health perspective, Gould says, ?In order to optimize the health of the residents of a place like Hartford, you need data across populations that can be used to drill down to specific neighborhoods and census tracts to identify unmet needs.?
With the technology to integrate and analyze data now in place, CHIN participants are making plans to deploy the initiative later this year. They are meeting regularly to work on issues such as governance, policies on data access and management, approval mechanisms and more. ?Our goal is to develop a deployment plan and execute it,? Aseltine says. ?We want to get this thing up and running.?
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Source: http://today.uconn.edu/blog/2013/07/using-data-to-improve-the-health-and-lives-of-state-residents/
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