Incorporating Health Data from Electronic Health Record Systems and Administrative Data Sets into...

Incorporating Health Data from Electronic Health Record Systems and Administrative

Data Sets into Public Health Systems for Administrative Uses – A Landscape Analysis

and Guidance Document

Detailed Profile Proposal for 2011/12Detailed Profile Proposal for 2011/12presented to thepresented to the

Quality, Research & Public Health (QRPH) Quality, Research & Public Health (QRPH) Planning CommitteePlanning Committee

Sarah QuaynorSarah QuaynorBob DavisBob Davis

Anna OrlovaAnna OrlovaNovember 11, 2011November 11, 2011

Quality, Research & Public Health (QRPH) Planning CommitteeQuality, Research & Public Health (QRPH) Planning Committee

The Problem

• No integration across EHR systems, public health registries, No integration across EHR systems, public health registries, quality measurements registries for quality measurements registries for health data exchanges health data exchanges for administrative usefor administrative use

• Relevant data:Relevant data: includes hospital discharge data, claims includes hospital discharge data, claims data, billing records sent to the state – data, billing records sent to the state – Needs definitionNeeds definition

• Administrative uses: evaluate patient safety, monitor the Administrative uses: evaluate patient safety, monitor the occurrence of disease, assess health resources, identify occurrence of disease, assess health resources, identify services, monitor environmental conditions.services, monitor environmental conditions.


The Problem

• Many public health programs working independently on topicMany public health programs working independently on topic– DiabetesDiabetes– Cancer RegistriesCancer Registries– AHRQ (Agency for Healthcare Research and Quality)AHRQ (Agency for Healthcare Research and Quality)– NAHDO (National Assoc. of Health Data Organizations)NAHDO (National Assoc. of Health Data Organizations)

• RISK - if this proposal is not undertaken this cycle RISK - if this proposal is not undertaken this cycle – Continued development of discrepant standardsContinued development of discrepant standards– Duplication of work effort with duplication of resourcesDuplication of work effort with duplication of resources– Fragmented implementation based on patient populationFragmented implementation based on patient population


Use Case

Patient visits Provider with symptoms indicating communicable Patient visits Provider with symptoms indicating communicable disease. disease.

Visit data recorded in patient’s Visit data recorded in patient’s medical record (paper or medical record (paper or electronic)electronic)

Visit data recorded in EHRVisit data recorded in EHR

Provider orders lab test. Test Provider orders lab test. Test order is recorded in medical order is recorded in medical record. record.

Order recorded in EHROrder recorded in EHR

Specimen is collected & sent to lab. Lab conducts test & Specimen is collected & sent to lab. Lab conducts test & records results in LIMSrecords results in LIMS

CURRENTCURRENT SOLUTIONSOLUTION


Use Case (contd.)

Health data for administrative and financial use added to medical Health data for administrative and financial use added to medical record - may need to be exchanged with PH agenciesrecord - may need to be exchanged with PH agencies

Lab sends result to Provider Lab sends result to Provider Received into EHRReceived into EHR

Provider reviews & confirms Provider reviews & confirms diagnosis. Identifies patient for diagnosis. Identifies patient for reporting to PH agencyreporting to PH agency

EHR pre-populates initial PH EHR pre-populates initial PH report form & sends notificationreport form & sends notification

Provider authorizes report Provider authorizes report submission to PH-SSsubmission to PH-SS

Directly from EHR, or via HIEDirectly from EHR, or via HIE

PH staff receive reportPH staff receive report PHSS sends acknowledgement PHSS sends acknowledgement to EHR/HIEto EHR/HIE

CURRENTCURRENT SOLUTIONSOLUTION


Proposed Standards & Systems

SYSTEMSSYSTEMS STANDARDSSTANDARDS

APCD’sAPCD’s ASC X12 Messaging StdsASC X12 Messaging Stds

EHR-SEHR-S NUBCNUBC

HIEHIE HL7 (vocab, CDA R2, v2.x)HL7 (vocab, CDA R2, v2.x)

LIMSLIMS IHE Sharing Value SetsIHE Sharing Value Sets

PH-SSPH-SS PHIN-VADSPHIN-VADS

Payer SystemsPayer Systems IHE PIX & PDQIHE PIX & PDQ

State Data Collection SystemsState Data Collection Systems HL7 PH Reporting Reqs HL7 PH Reporting Reqs

Systems for assembly of health Systems for assembly of health data for administrative usesdata for administrative uses

Other data stds for Other data stds for exchanges of health data exchanges of health data for admin usefor admin use


Process & Deliverables

1.1. Common definition of administrative use of health data Common definition of administrative use of health data

2.2. Relationship between EHR-S, State Data Collection Relationship between EHR-S, State Data Collection Systems, Public Health agency systems - Deliv. #1Systems, Public Health agency systems - Deliv. #1

3.3. Inventory of data elements currently collected in the Inventory of data elements currently collected in the Hospital Discharge Data Set Hospital Discharge Data Set

4.4. Inventory of state-specific data elements/program specific Inventory of state-specific data elements/program specific data elements and what is needed by public health data elements and what is needed by public health - Deliv. #2 & #3- Deliv. #2 & #3


Process and Deliverables (contd.)

5. Analysis and Recommendations for identifying and 5. Analysis and Recommendations for identifying and collecting health data for administrative use (Deliv. #4)collecting health data for administrative use (Deliv. #4)

• Strategic PlanStrategic Plan

• Recommendations for:Recommendations for:

– Data source - from EHR or other administrative data set Data source - from EHR or other administrative data set systemssystems

– Resolution of data gapsResolution of data gaps

– Generic content moduleGeneric content module

– Adding data to the Uniform Billing standards (ASC X12)Adding data to the Uniform Billing standards (ASC X12)

– Consistency in patient demographic fields (names, Consistency in patient demographic fields (names, addresses, DOB, SSN) - and use of MPIaddresses, DOB, SSN) - and use of MPI


Effort Estimates

QRPH Technical Committee SupportQRPH Technical Committee Support

EventEvent Time allotmentTime allotment SupportSupport

QRPH Conf QRPH Conf CallsCalls

WG report q2 WG report q2 weeksweeks

Provide feedback and Provide feedback and suggestionssuggestions

One week prior One week prior to F2Fto F2F

2 hours2 hours Review profile in Review profile in preparation for F2Fpreparation for F2F

QRPH F2F QRPH F2F 2- 90 minutes 2- 90 minutes sessionssessions


Public Public Comment Comment ReviewReview

2 – 90 minute 2 – 90 minute sessionssessions


Admin Data White Paper Work GroupAdmin Data White Paper Work Group

EventEvent Time allotmentTime allotment

WG Conf CallsWG Conf Calls 90 minutes q 3 weeks90 minutes q 3 weeks

Offline workOffline work 2 hours /week2 hours /week

QRPH F2FQRPH F2F Attend meetings below via Attend meetings below via conference callconference call

Admin Data White Paper Work Admin Data White Paper Work Group ParticipantsGroup Participants

PHDSC PHDSC (Profile Editor)(Profile Editor)

HL7 Diabetes Strategy ProjectHL7 Diabetes Strategy Project

NAHDO (National Association of NAHDO (National Association of Health Data Organizations) Health Data Organizations)

CDC / NCVS?CDC / NCVS?

NAACCR (North American NAACCR (North American Association of Central Cancer Association of Central Cancer Registries)Registries)

CDC-NPCR (National Program CDC-NPCR (National Program of Cancer Registriesof Cancer Registries

Registry WidgetsRegistry Widgets


QUESTIONS??QUESTIONS??

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