thinking about health information differently population ......and healthcare delivery through...

Thinking About Health Information Differently

Population Health Collaboration

Practical Approaches

www.dfwhcfoundation.org

Mission

To serve as a catalyst for continual improvement in community health and healthcare delivery through education, research, communication,

collaboration and coordination.

Vision Act as a trusted community resource to expand knowledge and develop

new insight for the continuous improvement of health and healthcare.

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Relationship and History

Non-profit foundation affiliated with Dallas-Fort Worth Hospital Council

Information & Quality Services Center in existence for 14 years

Services contracts in place with Business Associate Agreements

80 facilities participate

Data submitted to the Texas Healthcare Information Collaborative

http://www.google.com/url?sa=i&rct=j&q=History+&source=images&cd=&cad=rja&docid=Rp1hZGePglrDLM&tbnid=cl1s9_-YD07vfM:&ved=0CAUQjRw&url=http://www.stjohns.edu/academics/undergraduate/liberalarts/departments/history&ei=WQY-UbvEIuSy2gXjuIGYDA&bvm=bv.43287494,d.aWc&psig=AFQjCNEuK9dd3GA7Q6mIt6H9iOd35FMsUQ&ust=1363105743956007


Information and Quality Services Collaborative

Community Health Collaborative

Research Collaborative Workforce Development

Center

Board of Trustees

North Texas Regional

Extension Center

Texas Quality Initiative

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Foundation Structure


Foundation Committee Structure

DFWHC Foundation Board of Trustees

North Texas Health Information and

Quality Collaborative

Community Health

Collaborative

Workforce Advisory

Committee

Research Collaborative

North Texas Regional Extension Center Advisory Board

Texas Quality Initiative Advisory Board


Committee Sub-Structure for Data Management/Use

North Texas Information and Quality Services

Patient Safety and Quality Committee

IS Technical Advisory

Committee

Product Development/Data

Users Group

Research Committee

Nominating Committee


DATA INTEGRITY

is KEY

Prepared by Ed Schmitt

As of September 28, 2010

Data Source:

Cognos Cubes

Analytic Type (e.g., Quality, PUDF):

Timeframe of tested data:

Known items per previous quarter

release:ProviderID Name Issue Status

Date Comments Status

9/28/2010 Pass Complete






















Zip Codes

Inpatient Label Checks - All Diag and Proc Code

Positons

Previous Period Change Review

Trauma - Class Values

MRSA - Class Values

Counts for inpatient claims for each hospid are

within upper and lower bounds, notes for

exceptions

Payor

Compare MSDRG counts of tallpatientdata to

counts in DI_PUDF_MSDRG for 2010Q2 - PUDF

Source

Cognos Counts - PUDF to Source and PUDF to

Previous Quarters

Cube Invalids/Orphans/Default Keys

Diagnosis Counts - All Quarters and No Variance -

PUDF to Source

Procedure Counts - All Quarters and No Variance -

PUDF to Source

Delivery Types/Classes

Admit Type

Admit Source

Age Categories

Mortality Pop

Charge Ranking

Discharge Status

Validation & Reconciliation & Fitness

INFORMATION & QUALITY SERVICES CENTERQUALITY ASSURANCE REPORT

DISQLWAREHOUSE/'DI PUDF MSDRG'

Audit

Charge Totals for inpatient claims for each hospid

are within upper and lower bounds, notes for

exceptions

Compare discharge counts of tallpatientdata to

counts in DI_PUDF_MSDRG for 2010Q2 - Cognos

Data Source Validation

Compare discharge counts previous quarter All

Periods in DI_PUDF_MSDRG to tallpatient data -

Cognos Data Source Validation

'DI PUDF v1_2', 'DI PUDF MRSA 2008Q4 to Present', 'DI PUDF v1_2 PHY_DRG',

'DI PUDF V2 Trauma'

Reconciliation, Validation, Fitness

2010Q2 and Previous Periods

http://www.google.com/url?sa=i&rct=j&q=Integrity&source=images&cd=&cad=rja&docid=M2sRDB9I8b7NkM&tbnid=PPA5kaTlt7gXPM:&ved=0CAUQjRw&url=http://www.drsukhi.com/why-integrity-matters-most&ei=Egw-UZHHNcjq2QXR34GwAw&bvm=bv.43287494,d.aWc&psig=AFQjCNHRBaMEjlxwnUM21pIUaZ-eBvMlQw&ust=1363107202127926


Contributing Facilities and Patients


Who Are the Data Submitters?

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• 80 Facilities

– 65 Acute

– 7 Rehab/Psych

– 8 AmbSurg

17 counties


How much data is captured in the DFWHC Data

Warehouse?

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* Note 2010 Data--Excludes Rehab and Behavioral Health


General Description of Information Submitted

• Claims from all participating hospitals

• HIPAA compliant blinding

• All payers - including self-pay patients

• All patient encounters except

– outpatient lab

– hospital-based outpatient clinic


• Run on THCIC State Data

– About 1 year lag to most current quarter

• Run on DFWHC Region Wide data

– About 2.5 months lag to end of most current month

http://www.google.com/url?sa=i&rct=j&q=Timeliness&source=images&cd=&cad=rja&docid=TufN3G-wqR5ElM&tbnid=y1IansmkCLMR2M:&ved=0CAUQjRw&url=http://247transcription.ca/&ei=PgU-Uf2FF5LE2QWfsIGYDg&bvm=bv.43287494,d.aWc&psig=AFQjCNFb0tzvpvRNym7aRvz5kU_QGTPm-g&ust=1363105459075399


• North Texas Data from 2003 to Present

• Texas State Data 2004 to Present

• Case level detail

• Diagnosis codes 1-25

• Procedure codes 1-25

• All Charge Data (Total Charge only in Texas State Data)

• Physician ID and Name (Not included in Texas State Data)

Inpatient Claims Information


• North Texas Data from 2006 to Present – 44 volunteer hospitals 2006 -2009

– All Facilities beginning Q4 2009

• Case level detail

• Diagnosis codes 1-25

• Procedure codes 1-25

• All Charge Data

Outpatient Claims Information


Physician ID and Name

ER Encounters with NYU

Algorithm

Observation, GI and Cardiology

Encounters

Outpatient

Claims

Information

Unique to

DFWHC

Foundation

http://www.google.com/url?sa=i&rct=j&q=Unique&source=images&cd=&cad=rja&docid=zwjILIc6ywlKFM&tbnid=U9pfELgqbLXZVM:&ved=0CAUQjRw&url=http://saveourpostoffice.com/category/economics&ei=NAI-UeTtCKbQ2wW4pYG4Cg&bvm=bv.43287494,d.aWc&psig=AFQjCNGzx2p6bGPpOLpgUGLQvAj7mGtqZg&ust=1363104660695490


Regional Enterprise Master Patient Index

(REMPI)

• Probabilistic electronic tool that matches patient

encounters across hospitals and systems when

applied to the Information and Quality Services

Center Data Set

• Identification and analysis of patient activity

regardless of encounter location or payer

• Readmissions

• ER utilization

• Imaging utilization


• Regional STS Certified Clinical Data Registry

• > 90% of North Texas CABG and AVR Encounters

• REMPI Matching to Claims Warehouse Information

Texas

Quality

Initiative

http://www.google.com/url?sa=i&rct=j&q=Heart&source=images&cd=&cad=rja&docid=GHwbRJY5upUulM&tbnid=6pTcGeXmVuKEiM:&ved=0CAUQjRw&url=http://360healthcare.com/category/articles/naturopathic-medicine-articles/&ei=DQo-UZXJC6LE2gW-_oDYBA&bvm=bv.43287494,d.aWc&psig=AFQjCNF93698bgEaI8WWxdD-CREWl56e-g&ust=1363106687718144


Business Intelligence

Quality Metrics – Hospital Engagement Network and AHRQ Measures

Improvement of Cardiovascular Services

Readmission Analyses

ER “Frequent Flyer” Reports

Market segment assessments – by service line, physician and geography

Community Health Needs Assessments and Regional Community Health Improvement Reporting

1115 Waiver Metric/Outcome Support

ACO Alignment Information

Regional Health Information Exchange Support

Grants/Research

http://www.google.com/url?sa=i&rct=j&q=Business+Intelligence&source=images&cd=&cad=rja&docid=L_QwxdIzxCEIIM&tbnid=hFTU10Ae1sLHXM:&ved=0CAUQjRw&url=http://www.mosel.ro/main/Business_Intelligence&ei=HQQ-UYHKHrD22QXpnoCYCA&bvm=bv.43287494,d.aWc&psig=AFQjCNERk-UhXPH-KJeRMiavtueLbBu3gg&ust=1363105085465905


Taking Data to the Next

Level

Population Health, Research,

Physician Analytics


Community and Population Health Management

• Diabetes

• Congestive Heart Failure Readmissions

• Patient Migration

• Emergency Room Analysis

• Form 990 Analyses

• 1115 Waiver Metrics

• Rural Uses


www.healthyntexas.org

http://www.healthyntexas.org/


Contacts Kristin Jenkins

[email protected]

or 817-319-3587

Dallas-Fort Worth Hospital Council

Education and Research Foundation

mailto:[email protected]

thinking about health information differently population ......and healthcare delivery through...

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