US 5-digit ZIP Code level

Health Data Atlas

An interactive visualization of US HIE network reach across all 5-digit ZIP codes

About This Tool

This map displays the coverage of Health Information Exchange (HIE) networks across the United States at the 5-digit ZIP code level. It shows how many unique and non-unique patient records are held by participating HIE networks in each ZIP code, and what percentage of the census population those records represent. This allows researchers, policy makers, and healthcare networks to analyze network penetration, patient fragmentation, and coverage gaps across the country.

Why Are There Black Areas on the Map?

The empty black regions on the map represent unpopulated lands that do not have residential ZIP codes. ZIP Code Tabulation Areas (ZCTAs) are generalized representations of postal routes, which are only created by the USPS where people reside and receive mail. Consequently, large expanses of public lands—such as military test ranges, national parks, national forests, and deserts in the western United States—have no assigned ZIP codes. These blank spots accurately reflect where the population is located, rather than indicating missing data.

Key Interactive Features & Controls

• Live Tooltip Hover: Hover over any ZIP code to see a detailed breakdown by HIE network — including unique lives, non-unique records, and MRN fragmentation (records per person), alongside the total number of networks covering that ZIP.
• HIE Headquarters Points Layer: Large star icons mark HIE main headquarters. Green stars (★) designate Civitas member networks, while red stars (★) mark non-members. Hovering over a star reveals a detailed profile card with vendor information, technical capabilities (FHIR API, eCR, PCDH, HiTrust), and audit completeness ratings.
• Color By Dropdowns: Use the Color By selector to color-code the map by HIE coverage, dynamic capabilities (PCDH, FHIR, HITRUST, Civitas), Census demographics (30+ fields), CMS Rurality, or the Number of Mapped Networks.
• Real-time Glassmorphic Dashboard: The floating dashboard in the upper-right corner aggregates unique lives, non-unique records, total covered ZIPs, record fragmentation, average network density, and estimated penetration. Toggle between Viewport Area (automatically re-calculated as you pan/zoom) and National selection.
• Interactive Filters & Toggles: Use the network checklist to check/uncheck networks. The map, legend, and dashboard instantly update in under 2ms. Toggle the Core Service Areas checkbox to highlight only ZIPs designated as core service regions.
• Client-Side Search: Use the search bar in the top-middle to fly the map directly to any ZIP code, city, or state.

Data Metrics & Calculations Explained

• Unique Lives: The deduplicated number of patients with records in the HIE. If a patient is seen across multiple clinics within the same HIE network, they are counted only once in the "Unique Lives" metric.
• Total Records (Non-Unique / MRNs): The total raw volume of records (clinical messages, submissions). If a patient has multiple Medical Record Numbers (MRNs) across different hospitals or clinics, each MRN is counted.
• Fragmentation (MRN per Person): Calculated as `Total Records / Unique Lives`. A higher fragmentation ratio indicates that patients in that ZIP code are seen across more separate healthcare systems or clinics, indicating fragmented medical history. A ratio of `1.0` means a perfect 1-to-1 ratio, while a ratio of `2.5` means patients have records fragmented across 2.5 facilities on average. Ratios less than `1.0` indicate missing record counts for some networks in that ZIP.
• Estimated Penetration Rate: Calculated as `Unique Lives / Census Population`. This represents the HIE's coverage rate. Because some HIEs receive records from regional facilities whose patients reside outside that ZIP, or because of historical records of deceased or relocated individuals, penetration rates can exceed 100%.

HIE Core Technical Capabilities

• PCDH (Patient Centered Data Home): A national initiative by Civitas that routes real-time Admission, Discharge, and Transfer (ADT) alerts between a patient's home HIE and the HIE covering the facility where they are receiving care outside their home region.
• FHIR API (Fast Healthcare Interoperability Resources): Modern web service API capability allowing HIEs to query and transmit structured patient documents (USCDI data classes) in real-time using JSON-based standards.
• HITRUST Certification: High-security framework certification indicating the HIE undergoes rigorous independent audits to protect sensitive Protected Health Information (PHI) and comply with HIPAA security controls.
• Civitas Member Networks: Participation in Civitas for Health, the national collaborative for Health Information Exchanges and regional health improvement initiatives.

Special Color Scales

• CMS Rurality Coloring: When selected, ZIP codes are colored cleanly by their official CMS category:
  • ● Rural (Green): Super Rural / Payment Bonus Eligible ZIP code.
  • ● Mixed (Yellow): Standard Rural Locality.
  • ● Urban (Red): Urban / Non-Rural Locality.
• HIE Coverage & Demographics: Uses a Green → Yellow → Red gradient representing the percentile or percentage scale. ZIP codes with no active HIE data are shown in muted indigo.

Data Privacy & Protection Rules

• Tiger/LaCIE Deduplication: Joint network records (such as Tiger Institute & Lewis and Clark Information Exchange) are fully deduplicated and consolidated at the pipeline level to ensure no double-counting occurs on tooltips or totals.
• Security & Privacy Gating: All data is aggregated at the ZIP code level to prevent any individual patient re-identification, satisfying HIPAA Safe Harbor requirements. Only verified HIE stakeholders are authorized to access detailed network breakdowns.

Data Sources & Credits

• HIE network patient counts: Aggregated directly from HIE participating network submissions
• ZIP code demographics: SimpleMaps US ZIP Codes database (uszips.csv), sourced from US Census ACS 5-year estimates
• ZIP code boundaries: US Census Bureau ZCTA 2020 500k cartographic boundary files

Submit bug reports, technical issues, data discrepancies, or general feedback about the Health Data Atlas. Our team will review your submission.