Indiana Network for Population Health aims to address the social determinants of health

The Indiana Network for Population Health (INPH) has been launched by the Regenstrief Institute and collaborators, including the State of Indiana, Indiana University and the Indiana Health Information Exchange, to provide the secure exchange of comprehensive data -- especially information on social determinants of health such as housing stability and access to nutritious food -- to researchers, policy makers, healthcare providers and others on the front lines fighting opioid and other addictions.

The Indiana Network for Population Health can broadly enhance health surveillance in the community, tracking diseases we know well like Hepatitis C and diabetes as well as new diseases such as COVID-19. It's already providing situational awareness to physicians and public health officials about addictions and, in the future, we hope it will connect patients to community-based services to help them address their social determinants of health."

Brian Dixon, Ph.D., MHA, director of public health informatics at Regenstrief Institute and Richard M. Fairbanks School of Public Health at IUPUI

The stakes are high. Research over the past quarter century has shown that social determinants of health, such as tobacco use, alcohol consumption, exercise, access to nutritional food, stable housing, reliability of transportation and many other non-medical factors, are more significant contributors to longevity and quality of life than either healthcare or genetic makeup or the two combined. Yet these data are rarely accessible to physicians through their electronic medical record systems.

Dr. Dixon's presentation, "Integrating Social Determinants into an HIE Network," introducing the Indiana Network for Population Health to an international audience, is now available via HIMSS20 Digital. The annual HIMSS conference, the original venue for the presentation, was expected to attract more than 40,000 attendees but was cancelled due to the COVID-19 pandemic.

"It's not that physicians have totally ignored social determinants of health, but impactful information -- such as the fact that the patient had to take time off from a low-paying job and ride two buses to get to the doctor's office -- isn't typically collected in electronic medical records," said Dr. Dixon. "A clinician may have noted in unstructured free text in the medical record that an individual is a heavy smoker or homeless, for example, but free text information, with its lack of uniformity, can be difficult to extract correctly. Will a computer extracting data from the patient's file capture the phrase "has no safe home" or simply ignore the first two words and see "safe home" and not make this information accessible to community programs like the YMCA or homeless shelter organizations who might help the patient find a better place to live?

"Integrating social determinants of health into a health information exchange network from the patient's medical file is a big challenge. It seems to make more sense to retrieve data from the CDC, various state departments, census, Social Security, the food stamp program, etc. since all these entities routinely collect this data," said Dr. Dixon. "This is our vision for the Indiana Network for Population Health.

The Indiana Network for Population Health is an extension of the Indiana Network for Patient Care, which currently holds approximately 12 billion pieces of clinical data. Both the Indiana Network for Population Heath and the Indiana Network for Patient Care were developed by Regenstrief and are managed by the Indiana Health Information Exchange.