When the Michigan Health Information Authority (MiHIA) sought a way to boost the visibility of population health quality among its constituents, the group took its cue from the business world: it decided to build a performance measurement dashboard.

A dashboard takes in performance information of various kinds and presents the underlying trends in graphical format. Users can scan charts and diagrams depicting key performance indicators in much the same way a driver views a car's instrumentation. The technology has typically been the province of corporate executives who need a quick, at-a-glance overview of sales, ongoing projects and other activities.

In MiHIA's case the objective is to get local government leaders, providers and the public to rally around community health improvements. Traditionally, public health officials were the individuals most concerned with community health data. But MiHIA seeks an expanded audience.

"The whole goal here is to try to get the rest of the community engaged around managing the population's health," said Timothy Pletcher, director of applied research at Central Michigan University and the university's CMUResearch Corporation. CMU-RC serves as the fiduciary agent for MiHIA.

"What we are really trying to do is community performance management around health and wellness," Pletcher said.

The MiHIA, which plans to roll out its dashboard over the next few months, fits a growing pattern of dashboard deployments.

Calls for greater accountability and transparency in government has sparked dashboard adoption in the federal sector, as well as state and local agencies. That trend now appears to be spilling over into public health organizations, which look to take advantage of advances in health information exchanges to collect the data.

"Public health dashboards are a natural progression from quality measures reporting that are required to meet ARRA's meaningful use objectives," said Lynne Dunbrack, program director at IDC Health Insights.

"HIEs can play a key role in aggregating this data across the community or region to be presented in dashboards to help public health officials and other healthcare stakeholders pinpoint areas for opportunity for improvement," she said.

The expanding dashboard

States and counties are not alone in their interest in dashboards. The Department of Health & Human Services has a number of dashboard initiatives underway as part of its Open Government plan.

In one example, the Centers for Medicare and Medicaid Services earlier this year released a beta version of a dashboard that provides a graphical window into data from its Inpatient Prospective Payment System, which issues payments for hospitals for inpatient stays under Medicare Part A.

The dashboard provides an animated "bubble chart" to illustrate inpatient volume, average inpatient payment per claim, and total inpatient payment amount by state. The bubbles change in size to indicate volume and move across the chart to help users visualize payment and claims trends.

The graphics accelerate comprehension for the average person, who would normally have difficulty identifying trends in data presented in tabular form"rows and columns of numbers.

"A lot of organizations are still trying to move out of a tabular, spreadsheet kind of view and into something this is more easily understandable," said Ari Tapper, sales director for the federal civilian organization at MicroStrategy, which developed the CMS dashboard in nine weeks using the firm's business intelligence software suite.

HHS dashes data

The Office of the National Coordinator, meanwhile, is building a performance dashboard to help the office monitor its programs and grantees, according to the Department of Health & Human Services' Open Government plan, published earlier this year.

Another HHS effort, the Food and Drug Administration's agency-wide FDA-TRACK performance management system, already has 40 Web-accessible dashboards online. With it, more than 100 FDA program offices collect performance data and report results through the dashboards. One of them, for example, tracks the number of reported adverse events for drug and biologic products reviewed by the Center for Drugs Evaluation and Research.

Dr. Joshua Sharfstein, the FDA's principal deputy commissioner, said the dashboard initiative makes data available to a number of the agency's constituencies, including consumer, business and patient groups. "I don't think they have ever seen this kind of data before," Sharfstein said.

The FDA-TRACK also makes participants think about what they are trying to accomplish and ways in which to measure progress. "It's a good tool for managers to use and helpful to us as leaders of agencies," he noted.

Individual hospitals and providers also deploy dashboards. The National Institutes of Health's Clinical Center, a clinical research hospital in Bethesda, Md., is using a MicroStrategy-developed tool. In Pennsylvania, Access Services uses a software-as-a-service dashboard from myDIALS to track key operational, financial, human resources and safety metrics. Access Services, a non-profit that receives state and federal funding, provides services to people with cognitive disabilities.

"If you put data in a way that people can easily understand it, suddenly you start to use it more to make decisions and ask the right questions and manage better," said Rob Reid, Access Services' chief executive officer. "I've seen incident management reports before, but when you put them in a graphical format you can easily see the issues the people who we serve are having. To me, that was an eye opener."

SIDEBAR 1:
Michigan's Pop Health Board

The Michigan dashboard hopes to open eyes as well. The MiHIA project will eventually involve local governments, schools and physicians. Pletcher said the dashboard will initially target county economic development agencies, specifically those agencies' quality of life committees.

Quality of life committees usually concern themselves with public safety issues, but don't wander too far into the health domain, he explained. The dashboard view for county officials, still in development, might track such health indicators as smoking, obesity, binge drinking and physical activity. The dashboard aims to identify opportunities for improving health, tracking trends over time.

Pletcher said the dashboard will serve as a "data-driven tool to help those quality of life committees measure progress in the health dimension."

In MiHIA's way of thinking, better quality of health makes a region more attractive and contributes to economic development. Pletcher said he hopes to have the dashboard ready in the fall.

The organization also seeks to track children's physical activity through a dashboard. That effort will evolve as an outgrowth of MiHIA's Kindergarden to Retirement Health (K2R Health) project. K2R Health aims to advance "consumerbased preventative healthcare" through the adoption of personal health records, according to MiHIA.

The MiHIA dashboard would tap personal health records to collect information, which would be reported in aggregate form. Here's the scenario the organization envisions: When a child registers for a physical activity, such as a fun run, that information is added to his or her PHR. The dashboard is given permission to read only the part of the PHR that tracks physical activity. The PHR infrastructure then feeds the data into the dashboard. Data could be aggregated for teams (5th graders at local elementary schools, for example) and reported via the dashboard.

A longer-term dashboard project will let providers see how their quality of care compares across the