At a meeting last week of health care journalists, Centers for Medicare and Medicaid Services director Donald Berwick unveiled a new government site called the Health Indicators Warehouse (HIW) that provides public access to what he calls “a treasure trove of data.”
According to Covering Health, the blog of the Association of Health Care Journalists, HIW includes “information never released before in an easily accessible form, including patient safety data, preventive health care indicators, Medicare payment claims and hospital performance at the state and hospital referral region level. Information is searchable by topic, location, health outcomes among other factors.”
Once on HIW, you can search for information on a whopping 1,119 health indicators—including adolescent health issues, hospital readmission rates, obesity statistics, patient safety data and many, many more—broken down by topic, geography and by initiative.
The idea is that through parsing this mass of information, policy makers and community advocates will be able to identify key problem areas in health care and offer more tailored, local solutions. For example, lung cancer mortality data is available by state and also by county. Targeting smoking cessation efforts to those counties in Illinois, say, with the highest lung cancer mortality and highest smoking rates will be much more cost-effective than implementing a blanket state or national program. The same is true for hundreds of other health indicators that alert communities to problems in need of attention from substance abuse to stroke rates to falls in the elderly.
According to the HIW homepage, the initiative is a collaboration of “many Agencies and Offices within the Department of Health and Human Services. The HIW is maintained by the CDC’s National Center for Health Statistics.” Data, support and funding are provided by the following:
* Centers for Medicare & Medicaid Services
(Including the ability to search for community utilization and quality indicators broken down by the 306 Hospital Referral Regions as defined by the Dartmouth Atlas Group)
* Department of Health and Human Services
* Health Resources and Services Administration
According to the HIW site, new partners are expected to be announced soon and software developers are being encouraged to use the data to develop region-specific applications and services that can help improve community health.
One important set of data included in the HIW comes from the County Health Rankings project, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute that produces a collection of 50 reports—one per state—that provides data for more than 3,000 counties nationwide on mortality, morbidity, health behaviors, clinical care, social and economic factors and physical environment (whether there are parks, sidewalks, ample places to exercise, for example.) The idea, according to the site, is that “community leaders see that where we live, learn, work, and play influences how healthy we are and how long we live.” A look at New York’s page for example, ranks Putnam County #1 while Bronx County (just 40 or so miles to the south but a relatively impoverished borough of NYC) comes in dead last at #62. If someone wanted to, they could go further and see how these counties fare in individual indicators; in Putnam only 9% of residents are in fair or poor health; in the Bronx 26% of residents are in this category.
The 2011 results came out last month, but since the last-year’s first-ever release of the ranking reports, local communities have used the county-level data to institute programs they hope will raise low marks in key areas. For example, in Wyandotte County in southeastern Kansas, community leaders designed initiatives to confront several indicators that ranked far below the rest of the state like a high teen birth rate and STD rate, low measure of social support, and poor high school graduation rates.
The County Health Rankings project has a section called “Action Steps” that includes an interactive graphic that provides recommendations for how different segments of communities—government, education, business, etc.—can work through the cycle of making changes to improve local ratings in obesity, smoking or access to care, just to name a few. One key element is that the section includes guidance for communities in identifying funding sources that can be tapped to help tackle the troubling issues that are raised by the rankings.
It is clear that public access to detailed, rigorous health indicator and community health rankings data will be essential for moving forward with many of the initiatives in the Affordable Care Act. In fact, the concept of evidence-driven change is a cornerstone of the law—making sure that limited resources are targeted at cost-effective initiatives that improve health, improve access to care and reduce the waste and errors associated with poor-quality care. The HIW and other new sources of easily-accessible health data will play a vital role in this effort.