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Electronic Health Records May Hold Key to Better Health Planning Within a County

October 25, 2013

IUPUI researchers received a $200,000 grant to study the feasibility of using electronic health records to measure health outcomes of Marion County residents by neighborhood or even by census block for public health planning.

Brian E. DixonThe two-year study will also determine the validity of integrating those records with community health indicators such as parks, grocery stores selling fresh produce, and access to healthcare facilities, said the study’s principal investigator Brian Dixon, an assistant professor of Health Informatics in the IU School of Informatics and Computing at IUPUI. Dixon is also a research scientist at the Regenstrief Institute and the Roudebush VA Medical Center. The research team also includes other IUPUI researchers from the IU School of Medicine and Polis Center as well as epidemiologists from the Marion County Public Health Department.

The project is one of 11 that received research awards, totaling $2.7 million, facilitated by the National Network of Public Health Institutes, with guidance from the National Coordinating Center for Public Health Services and Systems Research housed at the University of Kentucky’s College of Public Health. Support for this study was provided by a grant from the Robert Wood Johnson Foundation.

“Current information on the health of people living in Marion County available to public health officials is based on samples representing county-wide statistics,” Dixon said. “But the increasing availability and use of electronic health records may permit public health officials to peer within the county at smaller and smaller groups of residents.” If that’s possible, public health officials could more readily determine which areas of the county are most in need of particular public health programs.

“When there is a limited budget for, say preventing diabetes, the county health department has to decide how to spend its resources,” said Dixon. “One option is to evenly divide the money across all communities within the county, some of which probably don’t have as much need as others. A second option is to identify specific areas within the county that might need intervention the most.”

“The growing use of electronic health records offers the potential to follow the second choice,” Dixon said. “Researchers will look at aggregate data for finite geographical regions within the county to measure the health of a particular neighborhood or set of neighborhoods and use that information to identify where particular public health programs or interventions are most needed.”

Researchers will analyze the electronic records of smaller and smaller groups of county residents, including by zip code (average population of 8,000), neighborhood (average population of 3,000 to 4,500) and census block (average population of 1,500), the smallest population grouping to be examined.

The first test will be to come up with health measurements at a sub-county level for information like how many people in a particular area receive flu shots. Then Dixon and other researchers will be able to take that data and link it to socio-economic factors, enabling them to tease out what determinants make one area healthier than another.

In the current era of health reform, public health transformation, and diminishing resources, practitioners and policy-makers need sound data on the most efficient and impactful approaches for improving community health, according to the National Network of Public Health Institutes. Research findings resulting from the electronic health records study and the other projects will provide relevant information to public health practitioners and policy-makers, contributing evidence that is urgently needed to improve quality, efficiency, and equity in public health practice with an ultimate goal of improving population health nationwide.

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