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How HIE EHR Data Can Measure Disease Trends, Support Public Health

Regenstrief researchers leveraged EHR data from a regional HIE to measure pediatric asthma trends across the state.

Health information exchange (HIE) data can effectively measure epidemiological trends for pediatric asthma, according to a study published in the Journal of Asthma that points to the potential public health benefits of EHR data sharing.

Using data from the Indiana Network for Patient Care (INPC), a regional HIE, researchers from Regenstrief Institute and Indiana University School of Medicine analyzed EHR data for patients ages two to 18 from 2010 to 2019.

INPC is the nation’s largest inter-organizational clinical data repository, housing more than 14 billion pieces of patient data from 95 percent of the state.

“We wanted to see if the data collected by our health information exchange, could provide a timely and complete picture of pediatric asthma trends in an entire state,” Colin Rogerson, MD, study first author and Regenstrief Institute research scientist, said in a press release.

While the number of hospital admissions for children with asthma decreased over the study period, pediatric asthma death rates increased. White children with asthma had a significantly higher hospital admission rate compared to other racial groups. However, there was no difference in mortality rate among White, Black, and Asian children with asthma.

“Analyzing health information exchange data clearly revealed hospitalization and death trends associated with pediatric asthma without the often multi-year delay and other confounding issues, such as the increasingly common avoidance of answering of phone calls from unknown numbers, associated with gathering information the traditional way via telephone surveys,” noted Rogerson.

“This new method of using clinical data from a health information exchange to monitor disease trends, including outcomes, can enable more rapid response from public health and the clinicians to whom they provide guidance,” added Rogerson, who also serves as an assistant professor of pediatrics IU School of Medicine.

For instance, the study authors found increased lung injuries related to vaping in children and teens with asthma in 2019.

Applying near real-time surveillance through HIE and segmenting EHR data by factors such as age, geographic location, or co-morbidities could potentially help public health officials identity populations of concern and target outreach efforts for disease trends, Rogerson explained.

The methodology of this new study could be used for many conditions other than asthma, including pediatric epilepsy and trauma, Rogerson said. He also suggested that the methodology could highlight the emergence of potential new illnesses.

Now that Rogerson and his colleagues have demonstrated the use of HIE data to signal disease trends, they are exploring whether future studies could use HIE data to track treatment trends.

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