the management and flow of data in drug treatment agencies
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The Management and Flow of Data in Drug Treatment Agencies. Jennifer P. Wisdom, PhD MPH James H. Ford II, PhD Using Performance and Outcomes Measures to Improve Treatment March 21, 2008. Improving the quality of care requires… Identifying problem areas Creative interventions - PowerPoint PPT PresentationTRANSCRIPT
The Management and Flow of Data in Drug Treatment Agencies
Jennifer P. Wisdom, PhD MPHJames H. Ford II, PhD
Using Performance and Outcomes Measures to Improve Treatment
March 21, 2008
Improving the quality of care requires… Identifying problem areas Creative interventions See if the intervention worked
In other words, you have to capture and track essential measures of performance and quality … which requires staff (or someone*) to collect, analyze, and learn from data
Drug treatment agencies have extensive reporting requirements … but few agencies have access to well-developed information systems.
Agencies spend enormous resources collecting data … but very little data is used for clinical decision-making or program planning
For most agencies, it’s just “paperwork.”
Research Plan
Step 1: How to drug treatment agencies learn to use data?
Step 1, revised: What do drug treatment agencies need to improve their capacity to collect data?
Step 1, take 3: What on earth are drug treatment agencies doing with data?
How do drug treatment agencies learn to use data? In context of NIATx, we defined success in “using
data” as: Successful use of data in process improvement
decisions Data collection appropriate to identified goal and
interpret it correctly Data reported are internally consistent and reliable Agency staff have expertise to resolve data
inconsistencies and to explain results to others
How do drug treatment agencies learn to use data? Factors associated with success in improving
timeliness and retention Agency leadership values data Resources committed to infrastructure Training on data issues Sharing of change results Success making data-driven decisions
How do drug treatment agencies learn to use data? Barriers to implementing process-focused
data systems
Time and moneySystem complexityExpertiseResistance*
What do drug treatment agencies need to improve their capacity to collect data?
Met with stakeholders to inquire about what is needed Agency staff = 10 Researchers/evaluators = 6 Funding agency staff = 1 An additional funding agency staff provided
perspectives.
What do drug treatment agencies need to improve their capacity to collect data? Attendees were asked to consider three main
questions: How can policy makers and funding agencies
promote data education and support? How can agencies that value data help other
agency leaders promote and value data and tie data to financial outcomes?
How can educational bodies, licensing boards, and agency continuing education programs foster the value of data?
What do drug treatment agencies need to improve their capacity to collect data?
The discussion revealed areas of conflict: Even though treatment agencies, researchers, and
funders agree on the importance of data-reporting and accountability, it can be difficult for addiction treatment agencies to obtain and analyze data to meet those goals.
Infrastructure (including technology and training) is needed, but support of agency infrastructure may not fall within the funder’s / state’s strategic objectives.
Educational bodies teach to licensing requirements, which are difficulty to modify.
And what data do we really need to collect anyway?
What are drug treatment agencies doing with data? Robert Wood Johnson Foundation funded
examination of the flow and management of data in drug treatment agencies
8 drug treatment agencies in 4 states Staff interviews (n=55) Flow charts of how information moves Review of forms
What are drug treatment agencies doing with data? All agencies had at least two levels of care Sampled broadly for varied characteristics
(urban/rural, large/small) Examined 3 processes
Intake Transfer within agency Discharge (or transfer outside of agency)
What we’ve learned…
What influences agency sophistication The state data tracking system
Including sophistication of data system Emphasis of state on tracking/using data Whether state gives data access to agency
Executive leader recognition of the importance of data Influences resource allocation
Grant participation
Factors that influence what data are collected and how
Always done it this way State reporting requirements Financial contracts/referral sources Level of Care Informal Agency Protocols
Few agencies had written protocols that Describe the flow of paperwork,
Govern the use of information or
Outline procedures for error checking to ensure data accuracy
Flow of information in the agency
Disparity in the amount and type of information collected at intake vs. any other time (discharge or transfer)
How information is shared across the agency depends on the level of sophistication (Electronic distribution vs. written documentation vs. verbal communication)
The Issue of Paper…
Despite technology, paper is king! Even with electronic systems, staff like paper.
It appears many forms are completed, filed, and never looked at again.
One agency was attempting to move to a paperless system; staff were challenged to let go of the paper…
Implications
There are opportunities to increase efficiency in how drug treatment agencies manage information. Processes for information collection
Reduce amount of data Simplify processes
Processes for using information Increase use of data Increase focus on outcomes
But there is a See Saw Battle
+ -Agencies can benefit from training to help them learn how to use data (e.g., NIATx).
Training is often hard to obtain due to time, finances, availability or technological barriers
When they learn how to use data, they improve their infrastructures to the level of sophistication desired.
No significant funding to drive these infrastructure changes such support may not fall within the funder’s / state’s strategic objectives.
Data reporting & accountability is important
Difficult to obtain and analyze data to meet goals
And then there is…
Next Steps
We need research that Identifies how the role of data sophistication and the
ability to use data impacts an agencies ability to improve and impact outcomes
Verifies organizational “factors” influencing data use and offers advice for improvement
Determines what type of organizational feedback is most useful to help drug treatment agencies use process and outcome measures to enhance quality of care, and
Allows drug treatment agencies to assess their own organizational data readiness
Finagle Law of Health Information
The information you have
is not the information you want,
The information you want
is not the information you need,
The information you need
is usually not available,
And the Information you can get
costs more than you want to pay.
Contact:Jennifer Wisdom, PhD [email protected]
Appreciation to:
Robert Wood Johnson Foundation
Elaine Cassidy PhD Victor Capoccia, PhD
Deirdre Mackey, BA Meg Wise, PhD Dennis McCarty, PhD
Extra slides if there’s time…
How can policy makers & funding agencies promote
data education and support?
Universal agreement that drug treatment agencies generally are not well-skilled at collecting or interpreting data, and that it would be beneficial for them to increase their ability to do so.
Barriers to system development hamper progress: unsophisticated state and agency data systems lack of computer skills of drug treatment staff general lack of understanding by all parties about common
goals and metrics Stakeholders suggested policy makers use both
incentives (such as providing higher reimbursement rates for demonstrated performance) and
penalties (such as making funding contingent on data collection).
How can agencies that value data help other agency leaders promote and value data and tie data to financial outcomes?
Agencies can assist each other by: promoting the benefits of data collection (e.g.,
increasing the likelihood of funding) sharing evidence of how using data to make
decisions has improved their financial bottom line
sharing strategies for increasing infrastructure capability and staff expertise.
How can educational bodies, licensing boards, and agency continuing education programs foster the value
of data?
Stakeholders suggested increasing communication between drug treatment agencies and educational bodies and licensing boards to partner in increasing quality and quantity of training.
Training should specifically focus on information will be directly applicable to graduates’ duties in drug treatment agencies.