At this week’s AcademyHealth Concordium 2015 meeting in Washington, D.C., the focus is on how to think differently about patient-reported outcomes and social determinants of health. At a Sept. 21 session, attendees heard about a Robert Wood Johnson Foundation-sponsored program called Data Across Sectors for Health (DASH) that will highlight the challenges and opportunities in connecting information systems and sharing data across sectors ranging from public health to government to social service agencies.
I have written about two such efforts. Last year I described the Parkland Center for Clinical Innovation effort to build the infrastructure to connect clinical and community-based organizations by creating the Dallas Information Exchange Portal. PCCI is working with food delivery, housing and HIV support networks, as well as human services agencies and one providing chronic care support using a community health worker model. In June I wrote about the Community Connected (C2) Network being set up in Southern Oregon to share data among human services agencies and medical providers. One goal is to enhance referrals and increase engagement by creating opportunities for “warm handoffs” and coordinated care between provider organizations.
To build on this type of work, DASH will fund eight to 10 pilot projects starting next year and form a learning community among pilot communities. “The idea is to test an assumption most of us have: wouldn’t it be better if we had data that was concentrated in our community and that let us better understand what was happening, but also represented social determinants of health?” said Peter Eckart with the Illinois Public Health Institute, which is co-leading the DASH national coordinating office with the Michigan Public Health Institute. “It is an idea we all have, but it hasn’t been tested yet. We are fostering a learning collaboration intended to spin off lessons for an emerging field.”
Clare Tanner, a program director with the Michigan Public Health Institute, talked about some of the early research DASH has done on the current landscape of partnerships across multiple sectors.
They are putting together a database of 85 communities seeking to share data across sectors. Of the initial proposals they received, most involved entities related to public health and health systems. The most common goal is identify needs and health disparities. They are starting with needs assessment and strategic planning, but they report wanting to move onto root cause analysis, monitor progress, and hold providers accountable, she said. Very few are actually linking individual level data to improve care yet, she added. Some are using GIS software to analyze geographical trends.
During the Concordium session in Washington, the DASH team asked attendees to brainstorm a list of the most significant barriers to this work of connecting data from different sectors. Here is a brief list of what the audience came up with:
• Privacy concerns
• Governance
• Incompatibility of systems
• Insufficient understanding of other sectors
• Relationships and trust
• Difficulty of linking data
• Holistic perspective missing
• Funding
Can you think of some others?
In DASH’s environmental scan, people spoke about IT barriers as well as the challenges involved in managing relationships and cross-sector collaborations, as well as making value cases across sectors, Tanner added.
Issues with data quality become even greater once the data is crossing different sectors and if the users don't even understand what the data meant in its original settings, said Hilary Heishman, program officer with the Robert Wood Johnson Foundation. “Many said they have work to do to clean up data in their own sector before they can build systems to make data meaningful to one another.”
We’ll keep our eye on what the DASH community works on over the next year.
