1. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Developing a Community Health Information System NAPHSIS Conference – 2006 San Diego, CA June 7, 2006 Thomas F. Reynolds, MS St. Luke’s Episcopal Health Charities And University of Texas School of Public Health

2. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 We live in an information age that is transforming the ways in which we engage in actions to improve health. -- Institute of Medicine (2003)

3. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 1.Introduction to the St. Luke’s Episcopal Health Charities’ Community Health Information System (CHIS) 2.Presentation of Available Data 3. Changing Focus, Collaboration 4. Challenges (Problems?) Overview and Presentation Goals

4. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 CHIS Region 57 Counties in Southeast Texas Approximately 40% of the state’s population Greatly driven by Harris County needs Almost 4 million population Third largest county in population in the US Population greater than 24 states Sub-county health data are a must

5. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 CHIS Goals Provide community health data to diverse audiences at small area levels. Provide numerical, geographical and statistical information about a community’s population and health. Present data to assist in assessing both community needs and community resources or assets.

6. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 GEOGRAPHIC INFORMATION SYSTEMS (GIS)  A powerful computer-based data collection, analysis and mapping technology  Handle large quantities of data within a geographic context – emphasis “graphic”  Can provide points of reference for people seeking data and information  Allows targeting of resources to increase efficiency and effectiveness

7. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Current Available Data and Presentation

8. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Sources of Data for the CHIS (Population and Assets)  Vital Statistics (Birth and Mortality)  Department of State Health Services  Demographic Data  US Bureau of the Census  State Data Center  Commercial  Community Resources and Assets  St. Luke’s Episcopal Health Charities  Texas Gulf Coast United Way Database  Health Agencies and Committees  Department of Family and Protective Services

9. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Sources of Data for the CHIS (Spatial) City and County, especially Planning Divisions Other local area agencies – Councils of Government State Agencies Federal Government Commercial Sites

10. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Data to Information Data – individual, tabular, point, polygon Geocode – incidents, assets, point data Aggregate data to meaningful areas Apply “generally accepted” methods for data analysis – ex., small area estimates Create Reports Display on Web

11. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 CHIS POPULATION DATA Demographic and Population Health Indicators Age Distribution Race and Ethnicity Income and Poverty Educational Attainment Housing Characteristics Uninsured Estimates

12. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 CHIS Vital Statistics Data Birth Data Birth Weight Mother’s Race/Ethnicity Mother’s Age Mother’s Educational Attainment Trimester of Prenatal Care Mortality Data Infant Deaths Child Deaths Age of Death Cause of Death

13. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 CHIS Assets Data SLEHC Activity Data Texas Gulf Coast United Way Agencies Education and Schools Data Health Service Providers, Clinics Project Safety Net

14. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Portal - www.slehc.org

15. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Selections

16. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Map/Query Start Page

17. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Census Tracts

18. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 ZIP Code

19. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Super Neighborhood

20. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 State Representative District Overlay

21. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Process - View

22. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Process – Zoom and Explore

23. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Process - Selection

24. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Process - Report

25. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Collaboration and New Data, New Focus The Future Is

26. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Preparing for the Future Seeking Collaborative Relationships Developing Capacity for Expansion Preparing for Data Standards Standards for transferring data Standards for storing and maintaining data

27. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Collaboration Academic and Research Institutions Statewide community public health assessment Agreements to share data and teach methods Local Health Departments State Agencies More types of data Data use agreements

28. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Expanding Capacity More Relevant Data – Better Assessments Morbidity data: inpatient and outpatient Health services availability and use Survey and trend data Dissemination and Presentation Web-based GIS technology Advanced data query Secure research-level data

29. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Data Standards Public Health Information Network (PHIN) Better Quality, Increased Timeliness Data Integration from Multiple Sites Maintaining and Storing Data Metadata – data about data Increasing need for security

30. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Challenges

31. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Challenges for a CHIS Financial Resources Range of Skills Needed Statistical and data management GIS Programming Data Quality and Relevance Data Security Maintaining Confidentiality

32. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Security and Confidentiality Necessary, must be set as policies Primary Reason Given for not Sharing Data Data Use Agreements View Committees for the Protection of Human Subjects (CPHS) and Institutional Review Boards (IRB) in a friendly manner Standards and Skills Levels of Data, Levels of Access

33. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Problems? Lack of Good or Useable Data Unable to locate – not able to geocode Poor data set construction Mistrust or Fear When Sharing Data Lack of Initiative for Data “Owner” to Assist in Providing the Data “Not my job” (can be understood) Bureaucratic history – “We’ve never shared this data before” Poor or Costly IRB Procedures

34. Improving Security, Systems, and Statistics San Diego, CA June 4 th – 8 th, 2006 Thank You