The COVID-19 pandemic made real the need for local health information exchanges and regional health improvement collaboratives. According to Lisa Bari, Chief Executive Officer at Civitas Networks for Health, a multi-stakeholder approach to health data is the sound approach for states and communities to move forward with data exchange.

At a recent Connecting for Better Health coalition meeting, Bari presented several examples nationwide of how these efforts helped during the pandemic, such as creating access to vaccinations in underserved communities and giving providers real-time information about test results.

Some specific examples include:

• Indianapolis-based Indiana Health Information Exchange, in collaboration with the Indiana State Department of Health, is providing public, real-time updates of COVID-19 testing results.
• Vermont Information Technology Leaders, located in Burlington, created daily reports for the Vermont Department of Health to assist with the identification of COVID-19 cases and hospitalized patients.
• The Health Collaborative in Cincinnati, Ohio was instrumental in ensuring that the Ohio Department of Health has access to an evolving dashboard of geographic maps that pinpoints the location of outbreaks, hospitalizations, ICU admissions, and more.
• Cleveland-based Better Health Partnership supports six Federally Qualified Health Centers (FQHCs) with project management, data analysis, strategy design, and execution. In addition, it provides a website with COVID-19 testing and vaccination information for residents.
• Rochester, N.Y.-based Common Ground Health strives for the equitable, transparent, and efficient COVID-19 immunization of at least 70% of the population in the Finger Lakes Region.
• Seattle-based Washington Health Alliance collaborates with three local chambers of commerce and area CEOs who lead the region’s largest employers to vaccinate 70% of the population against COVID-19.

Launched in October 2021, as the result of an affiliation between the Strategic Health Information Exchange Collaborative (SHIEC) and the Network for Regional Healthcare Improvement (NRHI), Civitas Networks for Health represents local health innovators sharing and using data to improve outcomes. With more than 150 members across the country, Civitas is the largest network of its kind, working to educate the private sector and policymakers about health data exchange.

Civitas is promoting the creation of statewide Health Data Utilities (HDUs), or entities that “combine, enhance, and exchange electronic health data across different care and services settings,” said Bari. She explained that Civitas believes the best solutions are collaborative and “come from data-informed, multi-stakeholder input.”

“HDUs emphasize multi-stakeholder organizational, use case, and data governance with an emphasis on public health. Most will be designated non-profit organizations or independent state agencies. In all cases, state and stakeholder governance, oversight, and accountability are paramount,” Bari said.

In a state as large and diverse as California, Bari said, an HDU would operate similarly to California’s PG&E utility. However, it would not be one organization but rather would serve the public health system at all levels, including, for example, rural physicians, urban health centers, and social services agencies.

Bari said HDUs must “build on what’s there” rather than starting from scratch because they need existing technical and relationship infrastructure. Elements necessary for an HDU include:

• State policy levers (including incentives and mandates) broad stakeholder participation, connectivity, exchange, and community-level engagement;
• Mature use cases in place for Medicaid and public health;
• Multi-stakeholder, transparent corporate, and data/network governance, and
• High standards for data privacy and security going beyond the baseline of state and federal laws.

Civitas has an upcoming conference in San Antonio, August 21-24. For more information, see www.civitasforhealth.org.