Data available to everyone through the DOH Public Website:

- Perinatal Data and Statistics

- Community Health Assessment Clearinghouse

- Prevention Quality Indicators (PQI ) Tool

- MCHBG Application

Health data only available to those authorized to use the Health Information Network (HIN) and Health Provider Network (HPN)

Data available to Birthing Hospitals – SPDS Data

Data submitted by Hospitals, but not generally available -- QI data from SPDS

Data not currently available, either because the data are not accessible or because analysis not yet finalized

Statistics and Data MCHBG Application Community Health Assessment Clearinghouse

Prevention Quality Indicators

Live Births

Table 4a

- Live Birth Summary by Mother's Race/Ethnicity, New York State 2007

Table 4b

- Live Births by Financial Coverage and Mother's Race/Ethnicity, New York State 2007 (Births Recorded Outside NYC)

Table 4c

- Live Births by Financial Coverage and Mother's Race/Ethnicity, New York State 2007 (Births Recorded in NYC)

Table 5a

- Live Birth Summary by Mother's Age, New York State 2007

Category Total2 Number

Total Percent

Race1/Ethnicity

White Number

White Percent

Black Number

Black Percent

Other Number

Other Percent Hispanic3

Number

Hispanic Percent

All Births 252,662 100164,555 100 52,450 100 35,324 100 60,326 100

Sex

Male 129,027 51.1 84,170 51.2 26,580 50.7 18,107 51.3 30,555 50.6

Female 123,630 48.9 80,384 48.8 25,867 49.3 17,217 48.7 29,770 49.3

Not Stated

5 0 1 0 3 0 0 0 1 0

Mother’s Age

10 - 14 193 0.1 86 0.1 87 0.2 20 0.1 86 0.1

15 - 17 5,277 2.1 2,892 1.8 1,938 3.7 443 1.3 2,361 3.9

18 - 19 12,322 4.9 7,166 4.4 4,086 7.8 1,057 3 4,619 7.7

20 - 24 51,543 20.4 31,731 19.3 13,400 25.5 6,346 18 16,011 26.5

25 - 29 67,290 26.6 42,798 26 13,699 26.1 10,699 30.3 16,878 28

30 - 34 66,128 26.2 45,151 27.4 10,641 20.3 10,253 29 12,278 20.4

35 - 39 39,457 15.6 27,614 16.8 6,485 12.4 5,314 15 6,418 10.6

40 - 44 9,613 3.8 6,549 4 1,961 3.7 1,084 3.1 1,564 2.6

45 + 811 0.3 557 0.3 146 0.3 104 0.3 108 0.2

Not Stated

28 0 11 0 7 0 4 0 3 0

Maternal and Child Health Services Title V Block Grant Program  

Maternal and Child Health Services Title V Block Grant ProgramA copy of the latest Maternal and Child Health Services Title V Block Grant Program application (PDF, 2.9MB, 451pg.) is currently only available in Portable Document Format (PDF).Maternal and Child Health Title V Block Grant Program - 2009 Application / 2007 Annual Report (PDF, 2.9MB, 451pg.)

Vital Statistics data, including trend information

Program-specific data and information

Newborn Screening data

Survey Data, including:

PRAMS BRFSS SLAITS YRBS

National data, such as Current Population Survey &

Census.

Births per 1,000 Females Ages 15 - 17New York State by Region 1997 - 2006

0

10

20

30

40

New York State 23.2 21.8 22.4 18.7 16 15.7 14.9 14.2 13.7 13.3

New York City 31.9 29.1 30.7 24 21.3 20.3 19.3 18.7 17.8 17.2

Rest of State 17.6 17.1 17.3 15.1 12.6 12.6 12 11.3 10.9 10.8

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

County Health Indicator Profiles

Community Health Data Set

County Health Assessment Indicator

Reports

Data collection, analysis and interpretation of relevant data including:

Demographics of the population

Health status of the population related to the problem

Availability, accessibility and acceptability of needed resources

Also includes, under Maternal and Infant Health:

Spontaneous fetal deaths 20+ weeks Infant, neonatal and postneonatal mortality Low and very low birthweight Births by gestational age at delivery Early and late/no prenatal care Maternal mortality Newborn drug related discharges

Under Family Planning, includes:

Pregnancy rates by age (total, and by groups for teens)

Birth rates by age (total and by groups for teens)

Teen births Abortion rates Out of wedlock births

For all of these indicators, data available:

Rates by County and Region

Mapping of rates by County

Comparison graph of rates by County

PQI Website Finding the Site …

PQI Website

PQI Website Entry Page … Links

PQI Website Entry Page … Links (2)

PQI WebsitePQI Website Main Page … Drill-Down Main Page … Drill-Down (3)(3)

PQI WebsitePQI Website Main Page … CompareMain Page … Compare

Statistics and Data Page (www.nyhealth.gov/statistics)

SPARCS (www.nyhealth.gov/statistics/sparcs)

Vital Statistics (www.nyhealth.gov/vital_statistics/index.htm)

MCHBG Application (particularly Needs Assessment) (http://www.nyhealth.gov/community/infants_children/maternal_and_child_health_services/)

Websites / Resources cont.:

Community Health Assessment Clearinghouse(www.nyhealth.gov/statistics/chac)

Community Health Data Set (www.nyhealth.gov/statistics/chac/chds.htm)

County Health Assessment Indicator Reports (www.nyhealth.gov/statistics/chac/chai/index.htm)

County Health Indicator Profiles (www.nyhealth.gov/statistics/chip/index.htm)

Data Retrieval – SPARCS

Data Tables -- Zip code-based perinatal data

• The Core Module of the SPDS includes all items on the electronic birth certificate, such as:

Maternal and paternal demographic informationInformation on prenatal care receivedMaternal history and conditionsMethod of deliveryBaby’s information, such as gender,

birthweight, gestational age at delivery, Apgar Scores, feeding status at discharge, etc.

Data Available to Birthing Hospitals: Statewide Perinatal Data System (SPDS)

Statistical summary of key indicators 2 delivery method reports Risk factors/Complications/Outcomes Perinatal outcomes by birth weight Statistical summary by insurance type Healthy People 2010 comparisons

Month to date (MTD) and year to date (YTD) counts and

percentages for key indicators such as:

multiple births early/late prenatal care Medicaid and no insurance primary and repeat cesarean births low birth weight NICU admission breast-feeding

Delivery Method Statistics, Part A MTD, quarterly, and YTD counts and

percentages detailing delivery route and method

Delivery Method Statistics, Part B MTD and YTD counts and percentages of

dominant indications for cesarean and operative vaginal births, and anesthesia used for vaginal and C-section births

MTD and YTD counts and percentages for selectIndicators such as:

diabetes hypertension fetal genetic testing medicinal induction and augmentation of

labor births occurring prematurely births with serious congenital anomalies

Perinatal Outcomes by Birth Weight -- MTD and YTD counts and percentages of live births and infant deaths by birth weight category

Statistical Summary by Type of Insurance -- YTD counts and percentages for indicators, broken out by Medicaid (HMO/Other), private (HMO/Other) or other insurance

Healthy People 2010 -- Comparison of hospital or RPC performance to year 2010 goals for select indicators, such as maternal complications, adequacy of prenatal care, first birth c-section rate among low risk women, alcohol, cigarette, and illicit drug abstinence during pregnancy

“Quality Improvement” or “QI” items (summaries under development)

Content of prenatal care Maternal depression Exercise during pregnancy Oral health during pregnancy Pregnancy planned/or not Genetic testing Infertility treatments Indications for vacuum/forceps delivery Other items not officially part of the Birth Certificate

These data are not protected by law, and can be summarized and provided to interested parties.

Medicaid Client Identification Numbers (CINs) While this information is collected, it is not available to other than the Office of Health Insurance Programs

NYC Vital Statistics – NYC Vital Statistics data are collected as part of a separate vital statistics registration area, and are therefore only available with special permission from the NYCDOHMH Office of Vital Statistics or in summary form through DOH.

Fetal Death information: Fetal death certificates, and therefore information, are protected by special public health law (PHL Title 10. Section 35.3 Fetal death; confidential information.

(a) The information contained on a fetal death certificate shall be disclosed by the State Commissioner of Health only to the mother, her lawful representative, and to authorized personnel of the Department.

(b) The confidential information for medical and health use only furnished with a fetal death certificate shall not be copied and shall not be detached except as herein provided.

Analyses are proceeding on a number of topics, and data will be presented at the annual NYSPA meeting in June:

Very low birthweight analysis

C-section analysis

SPDS data and information on updates to system

NICU data and information on updates to system

QI indicators

Etc.

Examples include:

March of DimesNational Center for Health StatisticsAnnie E. Casey Foundation

State-specific information on perinatal health,

including:

Perinatal overview Births Preterm births Birthweight Prenatal care Infant mortality Singleton vs Multiple births Delivery method

Smoking/alcohol/drugs

Obesity

Infections

Health Insurance

Newborn screening

Folic acid

Population

MCH programs

Birth defects

Some trend information

Cross tabs – e.g., low birthweight by maternal

age

Data posted up through 2005 so far

See:

http://www.marchofdimes.com/peristats/

DOH sends Vital Statistics data to NCHS

NCHS posts data on their web site

Low birthweight and preterm births Total and by county and subgroups (race/ethnicity, mother’s

age) Method of delivery Risk factors Prenatal care Trends

Ability to define your own variables (data

warehouse)

2006 data posted – but data go back to 1990

See: http://www.cdc.gov/nchs/

Child-focused site

Kids Count Data Center – Choose state and even

city, for:

Low birthweight infants Infant mortality Teen births by age group

Go to: http://www.aecf.org

Child Health Information Integration

CHI2

States Efforts to Integrate Child Health

Information Systems

46%

8%

26%

20%Already Integrated Some or All CHIS

Planning to Integrate in Next Year

Planning to Integrate in Next Three Years

Data Source: Public Health Informatics Institute (unpublished

data)Response from 39 states

Most states are integrating data from additional early

childhood programs such as WIC, early intervention programs

and Medicaid.

Integrated information systems for two or three program areasT

he most common registry system that is integrated starts

with an Immunization Information System (IIS). IIS have a longer history of development and standardization,

and, as such, are further along in integration efforts. As of December 2006, 65% of all children <6 years of age in

the US are participating in IIS

Master person index (MPI)

Single biggest step a public health agency can take towards making its information bases more accessible to authorized providers and families.

There are various architectural designs available to organizations that

seek to integrate person-centric records into an integrated system.

Demonstrate that regardless of an agency's legacy systems it is possible to create a single record of information held by a public health agency and to deliver that record to a requestor on demand

The five core programs of early childhood for creating a consolidated

record, child health profile.

A concept developed and promoted by the Genetic Services Branch of HRSA\MCHB. These include: vital records, immunization, lead screening, newborn hearing and newborn dried bloodspot screening

Vision for Child Health Information Integration (CHI2)

Physician with Patient Immunizations Lead Newborn

screening WIC services Pharmacy

history Early

intervention program services

Pharmacy utilization

EmedNY HIE CDC HIE NICU Module

PH Researcher Conduct studies

to create generalizable knowledge

Patients/Families Assurance of

complete medical history

Maximize care Minimize

unnecessary or dangerous care

PH Program Manager Follow up kids

with conditions of public health interest (lead)

Quality monitoring

Monitor population health

PH Administrator Program

monitoring and administration

Reimbursement

Vital registrationElectronic birth and death registration

249,000 birth cohort (NYC: 118,600 NYS: 130,400)NYC separate vital registration jurisdiction

Statewide Perinatal Data System (SPDS) Registries

Immunization (NYS & NYC) – statute effective 1/08; NYS outside NYC to become universal

Lead (NYS & NYC) – all blood leads reportableCongenital malformations (NYS) – 10,000/year Environmental Public Health Tracking System

(EPHT) – track environmental exposures.

Statewide public health programs

Newborn Metabolic Screening ProgramNewborn hearing screening (aggregate reporting)Early Intervention (0-3 yrs) – 75,000/yearWIC (pregnant women and 0-5) –

Pregnant women 123,000 Infants 123,000Children 1-5 years 230,000

Statewide administrative data systems

SPARCS Hospital discharge incl. ED visitseMedNY Medicaid billing systemPCAP (Medicaid Prenatal Care Assistance Program)

dataManaged care encounter data (Medicaid and CHP)

Maximize the use of the existing information infrastructure

Develop a standard infrastructure that promotes everyday use, access and data sharing

Improve bidirectional communication

Employ standards to assure a seamless flow of information

Children, their families, and society pay the priceΔ

Preventable illness or even life-long disabilityΔ

Duplicate or incomplete immunizations, screenings, and follow-up

Δ Lack of timely, complete and accurate health information

Δ Information not shared among health providers, public

health, social services, and familiesΔ

Few or no linkages exist among information systems

Develop integrated data system that: Benefit private practice

Reduce medical errors (misdiagnosis, prescription interactions, fewer accidental deaths)

Improve quality of care (more timely and accurate patient information for diagnosis and treatment)

Reduce complexity of billing and claimingProvide feedback to cliniciansAssist in quality improvement and assurance

Develop integrated data system that Collect individual level data for major activities

such as Newborn Hearing Screening or School Based Health Centers

Provide seamless flow of information between jurisdictions

Link events of public health significance in child life (e.g. immunizations, lead tests, EI services, asthma events)

Integrate location data to assess environmental risks

CHI2 Scope Implications for DOH Planning

Development of an integrated environment within DOH that fosters the creation of application and infrastructure standards following federal and state guidelines

Formalized project management approach utilizing project sponsors, establishment of an advisory executive team, identification and involvement of stakeholders through the use of functional teams

Importance of good communication in an integrated environment for planning and efficiency

Bi-directional informational flow Leverage existing infrastructure, utilize existing

national standards and provide for the privacy and data security of participants as required.

Design should start small and grow – phased approach

Flexibility with integration of applications and the ability to change frequently utilizing middleware approach – mapping / translator software product

Scalable and extensible to other key NYS projects of interest: Regional Health Information Exchange (aka RHIOs), Electronic Health Record (EHR)

Federal Strategic Framework for Health Information Technology to assist improved clinical practice Interconnect clinicians Personalize care Support public health program and improve population

health

An infrastructure in New York State to share clinical information among stakeholders on a State/Regional Level. Patient Physician Hospitals Nursing homes Insurers Pharmacies Public health entities

Ensure that the systems used or built ( by providers ) are able to communicate easily with one another, using open architecture and Federal ‘HIT’ standards for interoperability among various stakeholders

Ensure data integrity, availability as well as confidentiality and Security as required by the State and HIPAA

Establish a process for monitoring quality and outcomes to allow individual institutions, as well as the State, to monitor their performance against state and national benchmarks

69

Physicians

Offices and Clinics

Hospitals, Nursing Homes, IDNs, etc

Pharmacies and PBMs

Diagnostic Centers

Patients’Secure Personal Health Records

Managed Care

NYS DOHUPHN

SHIN-NY**

SHIN-NY**

Medicaid

Public Health

CDC

*RHIOs = Policy**SHIN-NY = Technology

Home Health Care and Telemedicine

CDC Biosurveillance and Public Health Investigation Project

Immunization and Child Health

Other NYS DOH Databases

Local Health Depts.

NYC Health Dept.Multiple RHIOs*

CHITA projects