use of a national standard dataset to accelerate development & reporting may 28 th, 2013 1
TRANSCRIPT
Use of a National Standard Dataset to
Accelerate Development & Reporting
May 28th, 2013
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Faculty/Presenter Disclosure
• Faculty: – Patricia Chung, Vancouver Coastal Health– Isabel Tsui, Canadian Institute for Health Information
• Relationships with commercial interests:– Nothing to declare.
Key Takeaway Points1. NACRS is a rich standardized dataset which
provides you with operational information to improve efficiency as well as national benchmark information that can be used for a variety of purposes
2. Use of a national standard dataset, NACRS, to standardize ED information had profound positive effects at Vancouver Coastal Health.
3. Many jurisdictions and hospitals with data warehouses can reap immense benefits from the adoption of NACRS and other CIHI data standards.
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Objectives• Describe the use of CIHI’s National Ambulatory
Care Reporting System (NACRS) dataset as the foundation of data warehouse development at Vancouver Coastal Health.
• Highlight far reaching positive effects and outcomes
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Standardization Benefits
One Version of the Truth
Comparability
Decrease Confusion
Harmonize Disparate Info Systems
Improve Efficiency
Reduce Risk Share Best Practices
Increase Productivity
Improve Communication
Mutual understanding
Improved Quality
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Vancouver Coastal Health
• 13 Acute Hospitals• 15 CHC• ~ 500 direct/contracted
services• Staff ~ 20,000• Volunteers ~ 5,000• Budget ~$3 Billion• Many disparate IT systems
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Data Warehouse Project
StandardizeData
OtherFacility’s
Information
VCHInformation
Secure Data WarehouseAutomated Reports
Cubes
Ad hoc reports
DAD
ED
OR
PARIS
ADTC
Other DatasetPixalere
Clinical Support
Finance
BSC/ Dashboard
Patient C
ontinuum Ministry/CIHI Submission
Po
rtal
s
NACRS Standards
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What is NACRS?• NACRS – CIHI’s National Ambulatory Care Reporting
System – supports data collection and reporting on Emergency Department (ED) and ambulatory care (day surgery and ambulatory clinics).
• CIHI (Canadian Institute for Health Information) is an independent not-for-profit organization providing essential data and analysis on Canada’s health system and the health of Canadians.
• CIHI provides information for pan-Canadian analyses from databases supported by national standards.
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NACRS in B.C.• In September 2010, the BC Ministry of Health
mandated NACRS reporting for 15 high-volume ED sites by April 2012 including 4 sites in VCH.
• NACRS ED Level 2 reporting was mandated: submission of wait times data elements plus 2 “pick-list” data elements• ED Discharge Diagnosis (CED-DxS)• Presenting Complaint List
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Warehouse & NACRS
CIHI NACRS
ED Mandated
in B.C.
Quick &
Easy
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VCH: BC NACRS Mandate
• VCH’s standardized ED data in warehouse
• No Vendor - Reduced Costs & Saved Time
• Minor modifications required
• Submitted Level 1 data 9 months after mandate opposed to 20 months
• More time to work with CIHI to improve COT descriptors & discharge diagnosis to be ready for Level 2 in May 2012.
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Results
• Low Stress
• Implementation with few errors
• Submit data on more than 4 mandated sites
• Ability to spend funds more innovatively to help end users
• Project on time and under budget
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VCH – BC NACRS Implementation
Implementation Milestone BC Project Target Dates VCH Achieved Dates
Sign Service Agreement with Vendor
May 31, 2011 N/A
Complete Technical Implementation Schedule
Jun 30, 2011 Oct 15, 2010
Complete NACRS Abstracting Software Installation
Sep 2, 2011 N/A
Complete Required Interfaces Nov 11, 2011 Dec 2010
Complete Internal System Testing Dec 16, 2011 Feb 2011
Confirm Vendor Testing Mar 16, 2012 N/A
Complete Facility Testing Apr 20, 2012 May 2011
Submit Data to NACRS May 3, 2012 June 2011
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Benefits of NACRS Data • Compliance = Badge of Quality
• Regional reporting sites faster and more efficient.
• Locally, information to improve ED operations:
• Improve patient flow
• Pay for Performance Reporting – Improve Revenue
• Physician Shadow Billing
• National Benchmarking to measure & improve performance
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NACRS ED Coverage 2013-14*
Canada: estimated 64% participation
YT100%
BC65%
AB100% SK
46%
MB45%
ON100%
QC†
NS77%
PE27%
*Includes current and planned NACRS implementations
†CIHI and Québec Ministry of Health and Social Services initiativeto include ED data from all Québec facilities in NACRS on hold
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eNACRS – National Reports
CIHI - ED Wait Times at a Glance(Dashboard)
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CIHI - ED Wait Times at a Glance(Quick View)
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CIHI - ED Wait Times Targets (Dashboard)
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CIHI - ED Wait Times Comparison (Dashboard)
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CIHI - Ambulatory Activity (Quick View)
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Summary/Conclusions• Standardizing ED information in data warehouse
to NACRS standard definitions had profound effects at VCH.
• NACRS is a rich standardized dataset which provides immediate and immense benefits.
• Many other jurisdictions and hospitals have data warehouses. If already not using NACRS and/or other CIHI data standards, we recommend you investigate them and update your systems accordingly.
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Thank You!!
Patricia Chung
Director of Data Management & Reporting, Decision Support
Vancouver Coastal Health
604 714 3771 x 2322
Isabel Tsui
Manager, CAD Database Development and Expansion
Canadian Institute for Health Information
416.549.5527
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