Leveraging data visualization and a statewide health information exchange to support COVID-19 surveillance and response: Application of public health informatics

Abstract

Objective: We sought to support public health surveillance and response to coronavirus disease 2019 (COVID-19) through rapid development and implementation of novel visualization applications for data amalgamated across sectors.

Materials and methods: We developed and implemented population-level dashboards that collate information on individuals tested for and infected with COVID-19, in partnership with state and local public health agencies as well as health systems. The dashboards are deployed on top of a statewide health information exchange. One dashboard enables authorized users working in public health agencies to surveil populations in detail, and a public version provides higher-level situational awareness to inform ongoing pandemic response efforts in communities.

Results: Both dashboards have proved useful informatics resources. For example, the private dashboard enabled detection of a local community outbreak associated with a meat packing plant. The public dashboard provides recent trend analysis to track disease spread and community-level hospitalizations. Combined, the tools were utilized 133 637 times by 74 317 distinct users between June 21 and August 22, 2020. The tools are frequently cited by journalists and featured on social media.

Discussion: Capitalizing on a statewide health information exchange, in partnership with health system and public health leaders, Regenstrief biomedical informatics experts rapidly developed and deployed informatics tools to support surveillance and response to COVID-19.

Conclusions: The application of public health informatics methods and tools in Indiana holds promise for other states and nations. Yet, development of infrastructure and partnerships will require effort and investment after the current pandemic in preparation for the next public health emergency.

Keywords: coronavirus; health information exchange; health information interoperability; pandemics; public health informatics.

Figure 1.

Screenshot of the original Regenstrief COVID-19 Dashboard. This version debuted with simple bar charts to allow users to see daily counts of new COVID-19 cases and hospitalizations along with the demographics of infected individuals.

Figure 2.

Screenshot of the enhanced Regenstrief COVID-19 Dashboard. This version features enhanced functionality for users to filter the contents of the dashboard. It further debuted headline numbers that provide a snapshot of the cumulative impact of COVID-19 in the state as well as enhanced visualization of hospitalization data.

Figure 3.

Screenshot of the public Regenstrief COVID-19 Dashboard. This public version illustrates enhanced visualizations added to the laboratory testing (surveillance) section of the tracker for demographics as well as calculation of test positivity.

Figure 4.

A series of 3 panels representing how the Regenstrief COVID-19 Dashboard was used to examine a localized coronavirus disease 2019 (COVID-19) outbreak in Cass County, Indiana. (A) The component of the dashboard that monitors COVID-19 laboratory tests and their results. (B) A rollover chart that displays weekly testing figures, including the number of individuals tested, the number of individuals testing positive, and the calculated test positivity. (C) The component of the dashboard that visualizes hospitalization data for individuals with COVID-19. Admissions and discharges are included in the graph as well as critical care utilization.

Figure 5.

Trends section of the Regenstrief COVID-19 Dashboard. The figure depicts statewide trends in COVID-19 (coronavirus disease 2019) test results as well as geographical variation at the county level.