Health information for communities is limited. However, recent advances in accessing health care data provide novel methods to identify where disparities may exist. Through the Colorado Health Observation Regional Data Service (CHORDS), in partnership with Denver Metro public health agencies, electronic health record data are accessed using a novel technology to help pinpoint where to target public health dollars and initiatives.
CHORDS began at the Colorado Clinical Translation Sciences Institute (CCTSI) at the University of Colorado’s Anschutz Medical Campus in 2011. The following year, CHORDS was funded to support tobacco, obesity, and cardiovascular disease surveillance in Denver. The virtual project, now housed at Denver Public Health and the University’s Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), includes detailed registries for body mass index (BMI) and tobacco use.
Eleven health care providers contribute data from electronic health records (EHRs) through PopMedNet, an innovative software application that allows CHORDS to generate aggregated datasets without creating a massive, centralized data hub. CHORDS partners include:
- Children's Hospital Colorado
- Clinica Campesina
- Clinica Tepeyac
- Colorado Alliance for Health Equity and Practice
- Denver Health and Hospital Authority
- High Plains Health Center
- Kaiser Permanente of Colorado
- Metro Community Providers Network
- Salud Family Helath Center
As a distributed data network, CHORDS allows healthcare providers to keep their data behind their firewall. Queries from CHORDS are sent to sites to request only the data of interest. Queries are sent to all data partners simultaneously; partners must review each query and the results generated before returning those results to a central hub. No unauthorized data may be extracted. Providers have full control over who may submit a query, what data are available and whether data is sent.
By using EHR data for public health surveillance, CHORDS provides a level of accuracy, statistical power, and geographic detail unavailable through typical public health surveys where sub-county analyses are limited. Rachel Zucker, Data Collaborative Manager, explains, “CHORDS translates clinical data into health information to monitor public health trends and measures the efficacy of public health interventions and policies, which informs messages around population health needs and opportunities.”
The Denver area is already benefitting from the availability of CHORDS data. Geographically customized reports -- including maps of tobacco use, childhood obesity, and depression -- were shared with city council members in the 11 city council districts. The reports sparked targeted discussions between city council members and area public health leaders. Zucker notes, “The most evident impact of CHORDS is the increased engagement of community partners, policy makers, healthcare providers, and public health stakeholders. By identifying a community’s greatest health challenges, local health information from CHORDS has started and guided conversations with community stakeholders.”
Soon, CHORDS will expand to include new public health agencies and data providers. CHORDS is also implementing a research agenda designed to facilitate population- and patient-based research by increasing access to large, aggregated datasets. Zucker believes that CHORDS’ future is bright, “As EHR use increases across clinical settings, additional data will be available from communities and other service providers; CHORDS will have many opportunities to contribute to public health and research knowledge.”