ASU in the Community - Bridging the Health Information Gap

Bridging the Health Information Gap

This feature is the second in a series highlighting the recipients of the 2008 President’s Medal for Social Embeddedness.

Health care providers face many obstacles in trying to assess, address and improve health care in Arizona. One major hindrance, especially to researchers, has been an historical lack of comprehensive, community-wide information on patients and disease.

“There’s not another state that has information on individuals across settings, like we do. It really is a community asset.” - Adda Alexander, executive vice president of the Arizona Hospital and Healthcare Association

Because individual Arizona health care organizations maintain their own patient data, there has been no way for the myriad of organizations to share data with one another comprehensively and securely. Hospitals that want to follow the health outcomes of their patients have no way to track those patients across other hospitals, clinics or doctors. Similarly, researchers interested in tracking health care trends and patterns in a particular setting are unable to do so efficiently, as health care data is often institution-specific rather than community-specific.

Arizona HealthQuery (AZHQ), however, aims to change the patchy landscape of health care information in Arizona. Created by William Johnson, director of the Center for Health Information and Research (CHiR) at Arizona State University, AZHQ consolidates health information from dozens of health care organizations in Arizona to form a community health data system.

“[AZHQ] informs public health people, health care providers, and the community in general, about trends and patterns in health care that can’t be identified by any one institution,” Johnson says.

By way of explanation, Johnson cites the program’s study on the prevalence and spread of MRSA (Methicillin-Resistant Staphylococcus aureus), a serious staph infection that is resistant to antibiotics. “We’ve just mapped out by zip code the rate of incidents of MRSA cases, which provides a lot of signals about how it might be spreading,” Johnson says. “The only reason we can do that is because we’re not dealing with one hospital or another – we can follow persons across data systems. The hospitals can’t do that.”

Ranging from single practitioners to whole health care systems such as Medicaid (with an enrollment of over one million just in Arizona), AZHQ’s 35 data partners certainly see the potential of such a database.

“Too often we’re looking at a single episode of care and not tracking people across time,” says Adda Alexander, executive vice president of the Arizona Hospital and Healthcare Association (AHHA), one of the program’s partners. “A hospital will understand what’s going on in their particular organization, but we never know how health care impacts the consumer overall – whether they end up in another emergency room for the same thing,”

In the ten years since its inception, AZHQ has consolidated data on nine million people living in Arizona, 200 million health care encounters, and represents around 60 entities ranging from health care delivery institutions, such as hospitals, to health insurers, and even employers.

“This project is unique in the United States,” Johnson says. “There are projects that are similar, but they don’t have the scope of data we do.”

One of six national demonstration projects for Medicare, AZHQ stands out from other similar projects because of the range of its data. “Some [projects] have larger data sets,” Johnson says, “but they don’t have the distribution. California has a very large database, for example, but it’s almost entirely private health insurance records.”
Alexander agrees. “There’s not another state that has information on individuals across settings, like we do,” she says. “It really is a community asset.”

Because of the range and comprehensive nature of AZHQ’s information, its data covers a large percentage of Arizona, with some datasets covering the entire state. Moreover, the range of data partners, offers much flexibility in terms of what kind of health care research can be conducted.

Among other initiatives, AZHQ has utilized its data to analyze health disparities in Hispanic and non-Hispanic children, conduct community health needs assessments, track asthma patterns in Arizona, study the evolution of Valley fever, and determine how well hospitals are serving the needy in their communities.

In addition to these community-wide reports, AZHQ also conducts private, specific analyses for individual data partners. “We do that without charge,” Johnson says, “as a sort of a partial pay back for their participation.”

Participation is crucial for the existence of the database and success of the project. In order to retain partner participation, AZHQ has gone to great lengths to ensure both the confidentiality and physical security of its data. Information that could be used to identify an individual patient is never released. AZHQ complies with HIPAA regulations and is regularly audited to ensure continuing compliance.

With the permission of these partners, the data compiled can also be used for research projects conducted by ASU. Sai Moturu, a computer science doctoral student working with AZHQ, has utilized some of this data to create a predictive model that will identify high-risk patients who, once pinpointed, can be placed in various health-promotion programs.

“We are using this community data to build these models,” Moturu says, “and these models can then be used to predict for the community. The results we got and the approach we proposed are better than what is currently available.”

While the community benefits of such projects may not seem immediately apparent to the general public, AZHQ and its many partners are confident in the program’s future impact on health care in Arizona.

“We saw the potential of how this type of data could really help change the delivery of health care in a positive way,” Alexander says. “The uniqueness of how the data is collected, and the expertise of analysis, is of great importance to us as we look at how to improve health care in the state. “

Arizona HealthQuery
http://chir.asu.edu/publications/documents/publication_21.pdf

Center for Health Information and Research
http://chir.asu.edu/index.php

Arizona Hospital and Healthcare Association
http://www.azhha.org/

President’s Medal for Social Embeddedness http://www.asu.edu/hr/programs/erp/social_embeddedness.html