HIE inPractice Blog Series: Using Health Information Exchanges to Identify Vulnerable Populations (Part 2)

by: Sharon Davis, CPHIMS, PMP, Senior Project Manager

In our previous blog post, we defined a vulnerable population (VP) and introduced concepts of gathering clinical data from these populations.  In this blog, we will discuss the basics for collecting data and identifying locations where data can be gathered on vulnerable populations.

As you begin a data gathering activity and you have identified the specific VP group you are gathering the clinical data on, it is important to have a firm vision of ‘who’ is using the data and ‘what’ specific questions the data will answer.  Furthermore, it is also important to recognize if this data is to support internal or external metrics, such as Accountable Care Organizations, creating personas for users of this data, defining user motivations and identifying goals for the data would be helpful.

Other than a clinical visit, surveys are the most common method of gathering data; they should be conducted quickly, discretely, and should be easily understood. When creating survey questions, you must determine if you are looking for quantitative (distinctive counts, usually numeric) or qualitative (more elaborative, usually text) responses.

With survey development, determine whether users will fill out the surveys themselves or if someone else will complete it on their behalf.  The look and feel of the survey is critical. For example, the style of the questions can vary – consider single or multiple choice, or free text.  Also, determine what the survey experience will be – whether it will be a paper based, mobile, or a web-based experience.  The survey questions will need to be engaging, respectful and easy to understand.  Also it is important to note that some ethnicities may require questions in languages other than English, with translation to English being done behind the scenes.

Upon the survey being administered, be sure to explain to the survey participant what data is being collected and why, as well as reassuring participants that no privacy or security laws will be violated.

As you design the questions and associated response formats, standardization of data received becomes critical.  If a data standard is not already determined by the EHR you are using, identify a commonly used standard for your responses such as HL7.  Standardization determines how far your data will seamlessly travel and transverse through the HIE environment.  This helps greatly with interoperability if the data is standardized.

Data hygiene is among other IT based aspects of data care – specifically, how clean and current the data is will be critical to its usability. If you don’t already have a Data Management manager or team, now is a great time to establish one.  Data Management ensures that data remains clean, safe, and of high quality.

Finally, you will need to determine which sources will be used to gather the data.  Below is a list of sites to consider when sourcing data – these sites were selected because they are where target VPs go to either seek health care, visit on a regular basis to conduct business, or for personal reasons:

  • Healthcare system
    • Acute care
    • At home visits
  • Healthcare community fairs
  • Outside of Healthcare system
    • Outreach strategy (fast, efficient, discreet)
    • Church/religious outreach
    • Back room nurses
    • Barber/beauty salons
    • Government offices
      • DMV
    • Drug stores (e.g.: CVS, Walgreens)
    • Grocery stores (e.g.: Tom Thumb, Kroger)
  • Government sources
    • Registries

The final post in this three part series we will explore the geographic elements to this identification process as well as review next steps once the data is gathered.




About Mari Greenberger, MPPA

Director of Informatics at HIMSS North America
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