Co-Creating a Community Roadmap for Interoperability

Abstract

After decades of focusing on the health care system as the main driver of health and healthcare outcomes, there is an increasing recognition of the influences of social, economic, and environmental risk factors as predictors of health disparities at both individual and community levels. Given that local circumstances and settings have the most direct influence on people’s lives, the number of community-based and regional initiatives to promote health equity has been growing rapidly, encouraged by the Affordable Care Act’s emphasis on population health and community engagement and supported by federal, state, and local government initiatives as well as by philanthropic organizations. Most aspire to an eventual future state of interoperability so that data from a variety of sources can be synthesized to make real-time policy, practice, and resource decisions more efficiently and collaboratively. This chapter describes three phases of multi-sector approaches to improving community health, beginning with the pre-Internet public health initiatives Healthy Cities, Healthy Communities, and Healthy People and the Community Health Information Network (CHIN) movement; then highlights some key community-focused initiatives under the Heath Information Technology for Economic and Clinical Health (HITECH) Act in 2009, including the Beacon Community and Community Health Peer Learning programs; and then briefly reviews some of the other major current initiatives that seek to integrate economic and social risk factors into health care, such as Data Across Sectors for Health (DASH). The chapter’s emphasis will be on the shared challenges and successful approaches to multi-sector collaboration and health data interoperability at a community level.