Colorado Health Observation Regional Data Service (CHORDS)

Colorado Health Observation Regional Data Service (CHORDS) is a collaborative regional pilot project that uses electronic health record (EHR) data to monitor public health trends, as well as to measure the efficacy of public health interventions.

How CHORDS Works?

CHORDS collects, analyzes and presents data from participating partner EHRs into one, easy-to-use registry per topic area. CHORDS securely exchanges data by removing personally identifiable information.

Each registry collects and presents health information specific to its topic area. For example, to monitor tobacco use, CHORDS collects demographic characteristics and geographic information on the patient and their visit, in addition to whether or not the patient uses or is exposed to tobacco. This information is extracted and used to populate the tobacco registry. No identifying information about the patient is presented in the registry's reports.

Each participating health care provider chooses which registry they want to participate in and contribute data to. For instance, a children's hospital would not provide data on adult indicators.

Learn more about CHORDS from a CDC Webinar and the Colorado Culture of Data Conference.

How Does CHORDS Improve Public Health?

Obesity, tobacco use, mental health conditions, cardiovascular disease, and other chronic conditions contribute to increased illness, healthcare costs, and preventable, premature deaths. CHORDS provides an efficient, easy-to-use way to track population trends (across healthcare providers) and show the outcomes of policies and clinical- and community-based interventions.

With CHORDS, public health officials can:

  • Monitor health indicators (e.g., community Body Mass Index [BMI], community diagnosis and control of cholesterol and/or hypertension) across populations.
  • Identify demographic characteristics and geographic areas at higher risk of poor health behaviors and outcomes.
  • Support policy, clinical and community health-based initiatives to prevent or intervene around specific behaviors or diseases by tracking clinical measures over time.

How CHORDS is Funded?

CHORDS is supported by several federal and state grants/contracts and non-profit foundations. Its founding members include Colorado-based healthcare providers, local and state health departments, and the University of Colorado Denver.

CHORDS Areas of Focus

CHORDS currently provides information and data to monitor the following health topics.

Registry Topic Areas Example Health Questions that CHORDS Can Track Example of Relevant Data Fields
Cardiovascular Disease
  • What percent of adults/adolescents have been diagnosed with hypertension?
  • What percent of adults/adolescents are screened for high blood pressure? (Future)
  • What percent of adults/adolescents are screened for high cholesterol? (Future)
  • What percent of adults/adolescents have been diagnosed with high cholesterol? (Future)
  • Diagnosis of hypertension
  • Blood pressure levels (Future)
  • Cholesterol test results (Future)
  • Diagnosis of high cholesterol (Future)
  • What percent of adults/adolescents have been diagnosed with type 1 or type 2 diabetes (combined)?
  • What percent of adults/adolescents have been diagnosed with pre-diabetes? (Future)
  • What percent of adults/adolescents have been diagnosed with type 1 diabetes? (Future)
  • What percent of adults/adolescents have been diagnosed with type 2 diabetes? (Future)
  • What percent of adults/adolescents have had a blood glucose test? (Future)
  • Diagnosis of diabetes (type 1 or 2)
  • Diagnosis of pre-diabetes (Future)
  • Blood glucose test results (Future)
 Mental Health
  •  What percent of adults/adolescents have been diagnosed with depression?
  • What percent of adults/adolescents have been screened for depression? (Future)
  • Diagnosis of depression
  • Depression screening test results (Future)
  • What percent of adults/adolescents are underweight/healthy weight/overweight/obese?
  • Height
  • Weight
  • Body Mass Index (calculated)
 Substance Abuse
  • What percent of adults/adolescents have been diagnosed with opioid use disorder?
  • What percent of adult/adolescents have been diagnosed with cannabis poisoning an adverse effects? (Future)
  • Diagnosis of opioid use disorder
  • Diagnosis of cannabis poisoning and adverse effects (Future)
 Tobacco Use and Exposure (Future)
  •  What percent of adults/adolescents smoke? (Future)
  • Tobacco screening results (Future)
  • Current/Infrequent smoker designation (Future)


CHORDS Partners

The following healthcare providers currently contribute data to CHORDS.

The following technology partners support the CHORDS effort:

How is data shared in CHORDS?

Data sharing in the CHORDS health data network is powered byPopMedNet™, a software application that creates and enables simple, efficient use of distributed data networks. The system provides secure query tools. Data partners exercise full control over which data are available for querying, what queries are approved and executed, whether results are returned to requestors, and who is permitted to submit queries. The Department of Population Medicine at the Harvard Pilgrim Health Care Institute (HPHCI) led development of the system in collaboration with Lincoln Peak Partners (LPP). The CHORDS instance of PopMedNet is hosted and supported by the University of Colorado Cancer Center’s Research Informatics Shared Resource with blended funding from National Institutes of Health (Colorado Clinical and Translational Sciences Institute) and a variety of grants from Colorado governmental (Colorado Department of Public Health and Environment) and foundation (Kaiser Permanente Community Benefit and The Colorado Health Foundation) funders.

How can my organization participate in CHORDS?

CHORDS welcomes participation by other healthcare providers. If your organization is interested in contributing health data for public health surveillance, contact the project manager or project director to find out more about how your organization can get involved.

Who else is doing this type of project?

Using electronic health record (EHR) data for health monitoring is a relatively new concept. Many groups have used this approach for health research. Various Health Care Systems Research Network projects, SAFTInet Project, pSCANNER and several NIH-sponsored SHRINE projects use EHR data for clinical trials and pharmaceutical outcomes research.

Several national initiatives have successfully developed networks and are monitoring health issues including FDA-funded Mini Sentinel, the CDC-funded Vaccine Safety Datalink and PCORI-funded PCORnet. Efforts to adapt these national models have been implemented locally through New York City’s Primary Care Information Project and the MDHNet in Massachusetts.

Can anyone query CHORDS for information?

Currently, CHORDS queries are only executed for public health monitoring purposes. Public health officials who retrieve the data use it purely in an aggregated form for public health information. For more information, contact the project manager.

Denver Public Health Declaration of Readiness to Receive Specialized Registry Data

July 19, 2016

Denver Public Health is currently organizing a specialized registry for population health monitoring from eligible hospitals and providers, in Denver County, seeking Meaningful Use Stage 2 (MU2) incentive payments. In addition to the electronic data submission for syndromic surveillance, one public health objective is contributing to specialized registries for eligible Denver hospitals and providers under MU2. This notice deals only with specialized registry data submission to the Colorado Health Observation Regional Data Service (CHORDS).

Denver Public Health is proactively reaching out to Denver hospitals and providers to participate in electronic health record data submission to a distributed data network maintained at each health facility in coordination with a federated query tool (For more information, read Frequently Asked Questions about CHORDS). Denver Public Health will facilitate testing and validating data warehousing and transmission specifications and provide acknowledgments to Denver hospitals and providers that achieve ongoing specialized registry participation. Instructions on how hospitals and providers participate will be sent once intent has been registered.

For hospitals or providers in Adams, Arapahoe, Boulder, Broomfield, Douglas or Jefferson counties wishing to participate in specialized registry efforts, please visit your local health department website for more information. Hospitals or providers outside those counties are not currently required to submit specialized registry data but may make inquiry at Denver Public Health. For more information or to request and exemption letter, please contact Greg Budney at or (303) 602-5758