Evaluating community health outcomes with electronic medical record data

Kaiser Permanente's (KP) Community Health Initiative (CHI) program facilitates and funds community-based interventions to increase health eating and active living (HEAL). CHI interventions are developed and implemented at the local community level, with a focus on underserved populations. A challenge of the KP CHI program is measuring the physiologic outcomes of HEAL interventions at the community-level. KP electronic medical record (EMR) data offer one potential way of tracking health outcomes in CHI communities. For this study, we used Census data to match eight CHI-participating communities in California and Colorado with demographically-similar communities within the same counties not participating in CHI. EMR data were used to track key health indictors (i.e., average body mass index (BMI) and chronic conditions) for CHI and comparison communities over three consecutive years. While short-term changes in physiologic indicators are not expected, we hypothesize that long-term reductions in BMI and chronic conditions in the CHI communities will be greater than those seen in the comparison communities. The usefulness of the EMR data is greatest when KP market penetration is high in the defined geographic areas and when KP members are representative of the population at large (including those who are uninsured) in terms of their HEAL behaviors and health outcomes. Linking EMR data with communities provides a low-cost, efficient method of establishing long-term surveillance of community health initiative outcomes.