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Background: Urban tree canopies help to address issues of climate change related to all dimensions of health. Certain areas of the city of Indianapolis are more prone to the negative effects that lack of tree coverage can cause. This assessment explored the short term and potential long-term impacts of the efforts to increase the tree canopy coverage in vulnerable areas of Indianapolis. This effort was a collaboration of faculty members from the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis Department of Public Works, Keep Indianapolis Beautiful, and the Indianapolis Office of Sustainability. Methods: Our team used the standard seven-step Health Impact Assessment (HIA) process to make the recommendations provided. Using direct observation of the neighborhood, secondary data collection, literature review, and a key stakeholder interview, we examined key dimensions of health including environmental, physical, and personal health outcomes resulting from increased tree canopy coverage within census tract 3505 of Marion County, Indiana. Results: Increasing the percentage of tree canopy coverage in census tract 3505 – Crown Hill has significant positive health impacts with minimal negative outcomes. Such impacts may be, but are not subject to, lower temperatures, reduced cases of respiratory and cardiac infections/illnesses, promoting animal life, increasing neighborhood property values and filtering pollutants that resultfrom human production activity. Conclusions: Further implementation of the Thrive Indianapolis project has broad positive implications for the community members living in this area. While few negative implications were found, we make recommendations to mitigate these effects while attempting to supplement the current project plan with a focus on the effects to human health.

ObjectiveDevelop and evaluate the effect of a Fast Healthcare Interoperability Resources (FHIR) app, Health Dart, integrating information from Indiana’s community health information exchange (HIE), the Indiana Network for Patient Care (INPC), directly with Cerner, an electronic health record (EHR)Materials and MethodsHealth Dart was implemented in 14 Indiana University Health emergency departments (ED) using a stepped-wedge study design. We analyzed rates of INPC use in 286,175 ED encounters between October 1, 2019 and December 31, 2020. Logistic regression was used to model the probability of INPC use given the implementation context, such as user interface (UI) enhancements and the COVID-19 pandemic.ResultsINPC use increased by 131% across all encounters (from 3.6% to 8.3%; pHealth Dart implementation. INPC use increased by144% (from 3.6% to 8.8%; pDiscussionDirect integration of HIE information into an EHR substantially increased frequency of HIE use, but the effect was weakened by the UI enhancements and pandemic.ConclusionHIE information integrated into EHRs in the form of dashboards can potentially make information retrieval more efficient and effective for clinicians.