Using Electronic Health Record Data to Improve Community Health

By Bree Allen, MPH, Shine Fellow, Office of Health Information Technology, Minnesota Department of Health

Minnesota’s local health departments and hospitals have a common need to develop actionable, outcomes-oriented, and collaborative community health assessments. Many Minnesota hospitals, being newer to this reporting requirement, have reached out to their local health departments for support in developing these assessments and integrating social determinants of health.

Data housed within hospitals’ and health systems’ electronic health record (EHR) systems have the potential to provide timely and complete data for subpopulations, geographic areas, and health conditions that are typically underrepresented in traditional assessment methods. For example, a rural Minnesota local public health department worked with a local provider to use EHR data to validate regional survey data related to smoking rates by zip code to assist public health in targeting outreach to a specific community. Another Minnesota collaborative is piloting the use of EHR data to enhance public health surveillance around the root causes of obesity, identifying and mapping individuals with high health needs.

With EHR adoption nearly universal in Minnesota clinics (98%) and hospitals (100%), there is a significant increase of the amount and type of data at varying levels of sophistication available for use. Providers and local public health can work together to acquire, manage, and use these EHR data beyond clinical use to create knowledge about issues in the community to encourage action. It’s critical that early innovators from data sharing collaborations like those in Minnesota and throughout the All In: Data for Community Health network share practical lessons so that we can forge a path forward together.

In this spirit of collaborative learning, we would like to share a new resource we have developed that may be of interest to the All In network— a toolkit, Connecting Communities with Data: A practical guide for using electronic health record data to support community health, that shares the stories and experiences of three pioneering collaborations (see Figure 1) between local public health and health care that are using EHR and public health data to improve health in their communities. Two collaborations are metro-based and the other is rural. Included in this toolkit are their lessons learned and tools to encourage the movement of data to knowledge, and furthermore, knowledge to practice to improve community health. Specific documents include population and measure definitions, a core indicator set, and example data use agreement.

The highlighted pioneering collaborations provide valuable lessons learned and key elements for action, which can be broken into a framework of four main components (see figure 2). For example, Stearns County recommends finding a ‘champion’ within a provider or health system to establish a relationship. They consulted with their emergency preparedness contact to suggest connections within a hospital or larger health system. For Stearns County, this contact in the health system’s Community and Government Relations team is someone who is passionate about supporting an integrated regional care system, including local public health.

The toolkit is a culmination of work to develop a framework and practical guide so any community can tap into the potential of using clinical data to support community health in a way that complements their existing data sources. By working together to understand how these data can describe population health, local public health can develop strategies that can “move the needle” toward real outcomes, while local hospitals/clinics can understand how to apply meaningful strategies to support community health.

This type of work is relatively new, so ideas and documents shared in this document are subject to change. The Minnesota Department of Health welcomes your thoughts on how to update this practical guide to keep it useful and practical for Minnesota collaborations. If you have questions or comments about this document, please contact

About the Author

Bree Allen, MPH, is a SHINE Program Fellow based at the Minnesota Health Department’s Office of Health Information Technology and e-Health. As a fellow, she has supported the sharing and use of information between public health and health care to improve community health, specifically around the sharing and use of electronic health record data to support community health assessments. She received her MPH from the University of Minnesota School of Public Health in public health administration and policy.