How a health information exchange makes a verifiable difference in care
The Indiana Network for Patient Care does more than just serve as data collector – it analyzes it to enable better population health.
Can health information exchanges make a credible difference in improving public health and advancing the quality of care for populations? Definitely yes, says a study of one of the nation’s longest functioning state exchanges.
With massive amounts of data accumulated over two decades, the Indiana Network for Patient Care (INPC) is able to support disease reporting, the automation of electronic laboratory reporting to public health agencies and rapid outbreak responses, just to name a few information-related capabilities.
INPC was created by the Regenstrief Institute, a healthcare research organization that has researched ways to modernize and improve healthcare. INPC is operated by the Indiana Health Information Exchange, which has served in the state for nearly three decades.
Bankrolled with data from the state exchange, INPC has reached a level of maturity that has enabled it to transform itself from a clinical and claims data repository supporting individual patient care into a powerful, statewide – and even regional – engine for advancing public health and population well-being, according to recently published research.
The analysis, published in BMC Medical Informatics and Decision Making, shows the potential for health information exchanges with access to wider ranges of patient data to make measurable improvements in patient care, indicating vast potential for data-sharing initiatives that could emerge as a result of growing interoperability requirements.
Additionally, the findings are important as healthcare organizations seek to use data to meet top healthcare priorities, including the Quintuple Aim, which include better patient experiences, improved population health and reduced costs.
Taking advantage of data
INPC grew from small beginnings in the 1990s, and, by the end of 2023, it incorporated records for more than 20 million patients, more than 16 billion clinical data elements, and contributions from 123 hospitals, 19,000 practices and 54,500 providers spanning Indiana and regions in four surrounding states. Patient data from multiple Institutions are matched and linked in INPC’s database.
The INPC dataset consists of a longitudinal view of a large proportion of healthcare that is provided in Indiana. It includes clinical and encounter information. INPC’s clinical data includes diagnoses, results, laboratory reports, medications, orders, procedures and textual reports associated with a given encounter. In all, it contains 1.1 billion encounter records and 290 million text reports.
The published analysis, conducted by Regenstrief Institute and Indiana University research scientists, found INPC is making strides because it is built on a foundation of core health information exchange “building blocks.” Foundational elements include patient identity management, provider directories, standardized terminology services and longitudinal record linkage, it said. Those capabilities have enabled the development of complex, higher-level functions that are important in both clinical and public health domains.
Wide capabilities
According to a synopsis of the report, “The INPC plays a pivotal role in improving the timeliness and completeness of notifiable disease reporting. By automating electronic laboratory reporting to public health agencies, the INPC notifies officials of new infections, triggers investigation and contact tracing and supports rapid outbreak responses.”
In addition, the exchange also has enabled population-level clinical alerts, such as automated notifications for multi-drug-resistant organisms, which help protect hospital patients and the broader community.
INPC operates the Public Health Emergency Surveillance System (PHESS), which “exemplify the power of collaboration and reusable, data-driven infrastructure in public health,” says Shaun Grannis, MD, vice president for data and analytics at Regenstrief. “By connecting hospitals statewide and enabling real-time, rapid-response surveillance, PHESS has become vital to Indiana’s ability to detect, respond to and study emerging health threats.”
In another example cited by the researchers, INPC innovators developed Health Dart, a Fast Healthcare Interoperability Resources (FHIR)-based app capable of integrating HIE data directly into a provider’s EHR. Used in 16 IU Health emergency departments across the state, Health Dart streamlines data retrieval for seven common clinical complaints, reducing the average number of clicks for clinicians from 50 to just six and slashing search times from three minutes to 10 seconds, “resulting in improved data use and faster, better-informed care decisions.”
INPC also supports a range of disease registries, improving surveillance, research and funding opportunities. For example, “by linking with state cancer and sickle cell registries, INPC helps uncover previously unidentified patients, supporting targeted interventions and resource allocation. Specialized registries for stroke, traumatic brain injury, diabetes and sexually transmitted infections help researchers and policymakers monitor treatment, outcomes and disparities across populations.”
INPC has been instrumental in the Patient Centered Data Home (PCDH) initiative, a grassroots solution that enables HIEs across the U.S. to securely share admission, discharge and transfer data.
INPC serves as the foundation for multi-domain data commons, which are pools of health and social data that facilitate advanced research and policy. The Indiana Addiction Data Commons, for instance, combines health, demographic, criminal justice and environmental data to inform state strategies for battling substance use disorders.
Learnings for HIEs
The research piece notes the role that health information exchanges currently play and how INPC exemplifies a growth path for advancing public health.
“Health Information Exchanges are essential components for national health data exchange and must continue to evolve to remain relevant and sustainable,” it concludes. “HIEs must continue to build upon existing capabilities, expand the focus to population health, and ensure value in the services provided to the stakeholders. To take full advantage of their potential, HIEs must continue to innovate and evolve.”
Fred Bazzoli is the Editor in Chief of Health Data Management.