Accessing and using Accessing and using statistical information from statistical information from
Ohio’s VS system Ohio’s VS system
OPHA Vital Statistics ConferenceOPHA Vital Statistics ConferenceOctober 12, 2011October 12, 2011
John PaulsonJohn Paulson
Center for Public Health Statistics Center for Public Health Statistics & Informatics& Informatics
Ohio Department of HealthOhio Department of Health
Ohio Vital StatisticsOhio Vital Statistics
• Rich source of information Rich source of information on on vital events.vital events.
• Provides important statistical Provides important statistical measures measures used in public health.used in public health.
Ohio Vital Statistics: BirthsOhio Vital Statistics: Births
• Newborn medical and demographic Newborn medical and demographic informationinformation
• Mom’s demographicsMom’s demographics
• Prenatal care, delivery, and after Prenatal care, delivery, and after delivery informationdelivery information
• Pregnancy Risk factors Pregnancy Risk factors
• Selected characteristics of the Selected characteristics of the FatherFather
Ohio Vital Statistics: Selected Birth Ohio Vital Statistics: Selected Birth DataData• Birth dateBirth date• Birth locationBirth location• Prenatal care infoPrenatal care info• Type of birthType of birth• Race, ethnicityRace, ethnicity• EducationEducation• Abnormal Abnormal
conditions of the conditions of the newbornnewborn
• Hospital Reg. Hospital Reg. NumberNumber
• Place of birthPlace of birth
Medical Risk Medical Risk factorsfactors
Method of deliveryMethod of delivery Mom’s age, race, Mom’s age, race,
ethnicityethnicity Gestation Gestation GenderGender Birth weightBirth weight Father’s age, race, Father’s age, race,
ethnicityethnicity Mom’s marital Mom’s marital
statusstatus44
415,000 vital events per 415,000 vital events per yearyear
Births
2011 Ohio occurrence births and 2011 Ohio occurrence births and deaths available for analysis as of deaths available for analysis as of 10/08/201110/08/2011
Data are getting to us rapidly
Deaths lag a bit behind births
2008-11 Ohio occurrence births by month 2008-11 Ohio occurrence births by month of birth (2008-9 final, 2010-11 as of of birth (2008-9 final, 2010-11 as of 10/08/2011)10/08/2011)
Annual birthing cycle
Decline in Ohio births
2010 and 2011 Ohio occurrence births 2010 and 2011 Ohio occurrence births
Approximately 2,000 fewer births Jan-Aug in 2011
BirthsBirths per 1,000 women, by age per 1,000 women, by ageOhio, 1990-2009Ohio, 1990-2009
<15
Nearly 50% decline!
Putting birth events in a population perspective
Diabetes association with NICU Diabetes association with NICU admission and heavy birth weight, admission and heavy birth weight, Ohio, 2009 Ohio, 2009
Percent
Singleton births
Cross-tabulation of one variable against another
Ohio births occurring in weeks 36-38, Ohio births occurring in weeks 36-38, and same without indication for and same without indication for induced deliveryinduced delivery
All 36-38 week deliveries
Data provided to Ohio Perinatal Quality Collaborative
Prenatal care timing component data:Prenatal care timing component data:Missing data in first prenatal visit and menses, 2010 Missing data in first prenatal visit and menses, 2010 and 2011and 2011
Effort to minimize missing data values
House Bill 197 Hospital Compare websiteHouse Bill 197 Hospital Compare website
• Three indicators are calculated from birth Three indicators are calculated from birth certificate filecertificate file– Antenatal steroidsAntenatal steroids– CS among low risk womenCS among low risk women– Appropriate level of care of very low birth weight Appropriate level of care of very low birth weight
babiesbabies
• Presented on the public Hospital Compare Presented on the public Hospital Compare website. website.
• Started data collection from hospitals in October, Started data collection from hospitals in October, 2009 for the items that are not BC derived2009 for the items that are not BC derived
• First display of data went public Jan 1, 2010First display of data went public Jan 1, 2010
IPHIS Hospital ID: B090 Hospital: Sample hospital
Hospital Volume Statistics
Number of births in IPHIS to date: 4409 Percent of Ohio births in IPHIS: 3.2 Hospital's rank among hospitals: 5
Missing Value Statistics Indicator No. missing Percent missing OH-wide missing % Rank
1st Pren. visit dt 1760 39.9 6.3% 1.0 Number visits 1483 33.6 11.3% 4.0 Mom height/weight 461 10.5 8.2% 20.0 WIC status 49 1.1 1.1% 15.5 Prev. pregnancies 113 2.6 1.0% 7.0 Summary statistics
Total missing values in this hospital: 5566 Total missing percentage in this hospital: 14.00 Missing values per birth in this hospital: 1.26 Rank: 1=most missing 122=least missing: 5
Ohio Vital Statistics: DeathsOhio Vital Statistics: Deaths
• Decedent demographic informationDecedent demographic information
• Decedent medical information Decedent medical information
• Decedent birth location informationDecedent birth location information
• Decedent armed forces informationDecedent armed forces information
• Decedent burial informationDecedent burial information
Ohio Vital Statistics: Selected Death Ohio Vital Statistics: Selected Death DataData• Death dateDeath date
• Birth dateBirth date
• Injury type and Injury type and datedate
• Race, Hispanic Race, Hispanic ethnicityethnicity
• Age, genderAge, gender
• Place of deathPlace of death
• Marital statusMarital status
• EducationEducation
• Place of residencePlace of residence
• Place of Place of occurrenceoccurrence
• Cause of deathCause of death
• Place of birthPlace of birth
• Branch of service Branch of service
• Disposition typeDisposition type
• Certifier, typeCertifier, type
• Injury placeInjury place
• Hospital of deathHospital of death
• Filing date Filing date
Sleep related deaths by location of Sleep related deaths by location of infant at time of deathinfant at time of death
Child Fatality Review annual report, Ohio Department of Health
Place of residence for African American infant deaths Place of residence for African American infant deaths (dots)(dots)drawn over census tract poverty leveldrawn over census tract poverty levelHamilton County, Ohio, 2003-2006Hamilton County, Ohio, 2003-2006
Data warehouse overview
Problem Statement:Problem Statement:
• Data are not accessibleData are not accessible
• Data are not timelyData are not timely
• Business Intelligence is not available to Business Intelligence is not available to support public health policy decisionssupport public health policy decisions
• Key performance indicators (KPI’s) are not Key performance indicators (KPI’s) are not available to drive operational efficienciesavailable to drive operational efficiencies
• Data and analytic tools are not transparent Data and analytic tools are not transparent and do not support a self service modeland do not support a self service model
The Present Landscape: The Present Landscape:
Average Age of Data available:● Public: 5 1/2 years old● Secure: 7 years old
• Represents less than 5% of ODH data• Too labor intensive to update data even annually • Scalability concerns• End-of-life technology
Vision of the OPHIWVision of the OPHIW::• Maximize timeliness, efficiency, scalability, Maximize timeliness, efficiency, scalability,
functionality and user friendlinessfunctionality and user friendliness
• Provide a “one-stop shop” where ODH data Provide a “one-stop shop” where ODH data is accessible in a consistent manneris accessible in a consistent manner– Both Secure and Public viewsBoth Secure and Public views– Near real time access to preliminary data using Near real time access to preliminary data using
a federated model. a federated model.
• More timely data for better decision supportMore timely data for better decision support
• Include shared analytic and GIS toolsInclude shared analytic and GIS tools
Business CaseBusiness Case::
ODH PerspectiveODH Perspective• Manual data processing Manual data processing
reducedreduced• Enterprise scalabilityEnterprise scalability• Elimination of Elimination of
duplication of effortduplication of effort• Health transformation/ Health transformation/
State agency State agency partnershipspartnerships
• HIE readinessHIE readiness
LHD PerspectiveLHD Perspective• Data accessibilityData accessibility• Data timelinessData timeliness• Prepopulate grant forms, Prepopulate grant forms,
AFR’s, SART review, etc.AFR’s, SART review, etc.• ““Mashups” of ODH, LHD, Mashups” of ODH, LHD,
and other data and and other data and contentcontent
• Integrated community Integrated community profilingprofiling
• Shared statistical & GIS Shared statistical & GIS analytic platformanalytic platform
Consumable data = transparency and innovation
What kinds of data can we liberate?
Vital Statistics Examples:•Birth events•Death certificate data•Infant mortality•Mass casualty planning
Surveillance & Registry
Surveillance & Registry
Provider Quality &
Performance
Provider Quality &
Performance
Inspection & Enforcemen
t
Inspection & Enforcemen
t
Vital Statistics
Vital Statistics
Screening & health
services
Screening & health
services
PreparednessPreparedness
ODHData Being Liberated?
10/11/2011
Open Health Data Initiative core activities: liberate data and catalyze innovation1.Publish brand new HHS data for public access – while rigorously protecting privacy and confidentiality
2.Make existing HHS data much more accessible -- “machine-readable,” accessible via application programming interfaces (APIs), free, much easier to find
3.Energetically publicize our data to innovators -- who can use it as raw material to develop applications and services that help improve health and health care
Are we on the right track?
The goal: a self-propelled, open “ecosystem of innovation” The goal: a self-propelled, open “ecosystem of innovation” using data to improve healthusing data to improve health
• Help consumers take control of their health and health care
• Help employers promote health and wellness
• Help care providers deliver better care
• Help journalists promote health information
• Help local leaders make better-informed decisions
• Support all of the above through “data intermediary” services
• And much more
A Rapidly Growing Array of Innovative Products and Services That:
Health-Related Data from
FUELS