Post on 28-Feb-2019
Advancing Excellence in Health Care
Agency for Healthcare Research and Quality
Advancing Excellence in Health Care • www.ahrq.gov
Visit our website at www.monahrq.ahrq.gov
For information or to join our mailing list, email monahrq@ahrq.gov
REPORTING HEALTHCARE QUALITY DATA
Carol Sniegoski Agency for Healthcare Research and Quality
December 4, 2012
®
Advancing Excellence in Health Care
Healthcare quality
The degree to which health services
for individuals and populations
increase the likelihood of desired
health outcomes
and are consistent with current
professional knowledge.
– IOM, 1990
Quality care is
safe,
effective,
patient centered,
timely,
efficient,
and equitable.
– IOM, 2001
ahrq.gov/qual/nurseshdbk/docs/MitchellP_DPSQ.pdf
Healthcare quality information describes how well the healthcare delivery system is working.
Advancing Excellence in Health Care
Healthcare quality questions
Are these providers following clinical practice guidelines?
Do they achieve good outcomes, compared to others?
How experienced are they at this procedure?
Do they respect patient safety?
Do they use resources appropriately?
Do they provide good value?
Do they create a good patient experience?
Examples …
Advancing Excellence in Health Care
Uses of quality information
Patients and consumers
Providers
Plans
Decision makers
Institutions that need to publicly report
4
Choosing providers or plans
Quality improvement
Pay for performance
Transparency and public reporting
Who might want to use it?
For what purposes?
Advancing Excellence in Health Care
What healthcare quality information looks like
From monahrq.ahrq.gov/demo/index.html
Numerator, denominator, observed, expected, risk adjusted, confidence
intervals, stratification by provider, patient demographics, area …
Advancing Excellence in Health Care
What is MONAHRQ?
MONAHRQ is a free desktop software application from AHRQ.
Helps organizations generate their own local website that reports healthcare quality.
6
Helps convert data into useful information.
Advancing Excellence in Health Care
Goals of MONAHRQ
Selected as finalist in the Fall 2010/Winter 2011 HHSinnovates competition
hhs.gov/open/initiatives/hhsinnovates/gallery.html
Helps make local healthcare reporting
more effective by disseminating best
practices.
Help make local healthcare reporting
easier (time, resources, technical
knowledge).
7
Advancing Excellence in Health Care
MONAHRQ timeline
JUN 2010 MONAHRQ 1.0
AUG 2012 MONAHRQ 4.0
* Projected
JUL 2011 MONAHRQ 2.0
JUN 2012 MONAHRQ 3.0
MAR 2013 MONAHRQ 4.1 *
Advancing Excellence in Health Care
Download MONAHRQ software
from monahrq.ahrq.gov
How MONAHRQ works
MONAHRQ
9
Advancing Excellence in Health Care
MONAHRQ
Download MONAHRQ from
monahrq.ahrq.gov
How MONAHRQ works
* AHRQ Quality Indicators, CMS Hospital Compare measures,
HCAHPS survey measures
10
* Inpatient discharge data
Load your local
data*
Load quality
measure results*
Advancing Excellence in Health Care
MONAHRQ
Download MONAHRQ from
monahrq.ahrq.gov
MONAHRQ runs on
your desktop
How MONAHRQ works
Select customization
options
11
* AHRQ Quality Indicators, CMS Hospital Compare measures,
HCAHPS survey measures
Load your local
data*
* Inpatient discharge data
Load quality
measure results*
Advancing Excellence in Health Care
MONAHRQ
Output a healthcare
reporting website
You host the site:
Public, private, your choice
Download MONAHRQ from
monahrq.ahrq.gov
MONAHRQ runs on
your desktop
How MONAHRQ works
Select customization
options
12
* AHRQ Quality Indicators, CMS Hospital Compare measures,
HCAHPS survey measures
Load your local
data*
* Inpatient discharge data
Load quality
measure results*
Advancing Excellence in Health Care
Key MONAHRQ facts
MONAHRQ is not a reporting website.
MONAHRQ is a locally-used website builder tool.
Local organizations control all steps in the process:
data load, website creation, website hosting.
AHRQ supplies: software, benchmarks, web
templates for navigation and display, reference files
and functions for mapping, grouping, cost
estimation, etc.
MONAHRQ can use local data and/or Federal
datasets.
Advancing Excellence in Health Care
Sources of quality information for MONAHRQ (for now)
Based on data submitted by 4500
hospitals
CMS displays information on a
website and provides
downloadable tables
Includes benchmarks from CMS
14
AHRQ provides measure
specifications and software
Calculated by local organizations
from local data
AHRQ supplies benchmarks
CMS Hospital Compare
AHRQ Quality Indicators
Mortality and readmissions
Process of care
Surgical safety
Use of medical imaging
Patient experience (HCAHPS
patient survey)
Provider-level and area-level
Mortality
Volume
Patient safety
Avoidable hospitalizations
Advancing Excellence in Health Care
What MONAHRQ reports (for now)
15 MONAHRQ currently reports four types of information 15
Advancing Excellence in Health Care
MONAHRQ currently reports four types of information 16
Hospital rates and utilization (discharges, mean LOS, mean charges or
estimated costs)
County rates and utilization (discharges, discharge rates, mean charges or
estimated costs, maps)
Load local discharge data into MONAHRQ
Load local discharge data into MONAHRQ
What MONAHRQ reports (for now)
Advancing Excellence in Health Care
MONAHRQ currently reports four types of information 17
Hospital rates and utilization (discharges, mean LOS, mean charges or
estimated costs)
County rates and utilization (discharges, discharge rates, mean charges or
estimated costs, maps)
County-level quality measures
(area-level AHRQ Quality Indicators)
Hospital quality measures (provider-level AHRQ Quality Indicators, CMS
Hospital Compare, HCAHPS)
Load local discharge data into MONAHRQ
Load local discharge data into MONAHRQ
Load quality measure results into MONAHRQ
Load quality measure results into MONAHRQ
What MONAHRQ reports (for now)
Advancing Excellence in Health Care
MONAHRQ tour: Hospital Quality Ratings
County-level quality measures
(area-level AHRQ Quality Indicators)
Hospital quality measures (provider-level AHRQ Quality Indicators,
HCAHPS, Hospital Compare)
Hospital rates and utilization (discharges, mean LOS, mean charges or
estimated costs)
County rates and utilization (discharges, discharge rates, mean charges
or estimated costs, maps)
18
Advancing Excellence in Health Care
Hospital Quality Ratings: Search page
Choose hospitals
and a health topic
Select hospitals by
name, zip code, or
region
Select quality
measures by health
topic
19 19
Advancing Excellence in Health Care
Hospital Quality Ratings: Search page
Choose hospitals
and a health topic
Select “Patient
experiences”
20 20
Advancing Excellence in Health Care
Hospital Quality Ratings: Classification table
* Available from HealthData.gov
Compare hospital
quality ratings
21
Advancing Excellence in Health Care
Hospital Quality Ratings: Classification table
* Available from HealthData.gov
Friendly
measure names
Sortable
columns
Help popups
Drilldown to
details
Choose local or
nationwide
benchmarks
3-level
classification
with key
Compare hospital
quality ratings
Friendly icons
22
Advancing Excellence in Health Care
Hospital Quality Ratings: Bar charts
Ordered bar charts
– Synthetic data –
Bars ordered from
best to worst
Labeled with
numeric rates and
scale
Local and national
benchmarks in
contrast color
Arrow indicates
“Better” vs.“Worse”
23
Can optionally show
confidence intervals
Advancing Excellence in Health Care
Hospital Quality Ratings: Detailed statistics tables
Drill down to underlying
measure statistics
– Synthetic data – 24
Advancing Excellence in Health Care
MONAHRQ tour: Maps of Avoidable Stays
County-level quality measures
(area-level AHRQ Quality Indicators)
Hospital quality measures (provider-level AHRQ Quality Indicators,
HCAHPS, Hospital Compare)
Hospital rates and utilization (discharges, mean LOS, mean charges or
estimated costs)
County rates and utilization (discharges, discharge rates, mean charges
or estimated costs, maps)
25
Advancing Excellence in Health Care
Choose a measure
Maps of Avoidable Stays: Search page
Individual measures
organized by health
topic
26
Advancing Excellence in Health Care
Maps of Avoidable Stays: County maps
Compare rate ranges by
county
Rates are based on
patient residence, not
hospital location
Measures of avoidable
hospital stays reflect
quality of community
care, not hospital care
– Synthetic data – 27
Advancing Excellence in Health Care
Maps of Avoidable Stays: Potential cost savings
Drill down to underlying
statistics
Includes estimated cost
savings from reducing
rates
– Synthetic data – 28
Advancing Excellence in Health Care
See more at the MONAHRQ demo site
monahrq.ahrq.gov/demo/index.html
29
Maps
Statistical tables Bar charts
Classification table
Advancing Excellence in Health Care
Visit a MONAHRQ public report monahrq.ahrq.gov/msites.shtml
Commonwealth of Kentucky Office of Health Policy
Utah Department of Health
Maine Health Data Organization
Hawaii Health Information Corporation
Nevada Division of Health Care Financing and Policy
Arkansas Department of Health
30
Advancing Excellence in Health Care
Future: What could/should MONAHRQ do?
Future
– More types of measures and data
– Physician, plan, other Compare …
– Time trends
– Summary pages for a provider or area
– Measure composites
– Reporting at alternate geographic levels
– Cost information
– More benchmarking options
– More stratification options
– More options for website customization
– Improve ease of use
– Continue to incorporate best practices in reporting
– more …
31
Now
– AHRQ Quality
Indicators and
Hospital Compare
measures
– Hospitals
– Counties
– Modest customization
Advancing Excellence in Health Care
Email us:
Join our mailing list:
monahrq.ahrq.gov
monahrq@ahrq.gov
Input Your Data. Output Your Website.
Questions, comments, suggestions?
carol.sniegoski@ahrq.hhs.gov, pamela.owens@ahrq.hhs.gov, mamatha.pancholi@ahrq.hhs.gov
Visit our demo site: monahrq.ahrq.gov/demo/index.html
For more information:
Visit public MONAHRQ sites: monahrq.ahrq.gov/msites.shtml