brianna gass, mph november 17, 2014 local needs, local data
TRANSCRIPT
Brianna Gass, MPHNovember 17, 2014
Local Needs, Local Data
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Understand local data integration efforts Highlight potential application of integrated and mapped data Identify ways integrated data can assist in targeting health
improvement activities
Objectives
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2010 Census dataCounty Nation
Total population 161,000 313,874,000
% Population over age 65 16.0 13.7
% Population below poverty level 18.1 14.9
% Bachelors degree or higher 21.0 28.5
% Hispanic or Latino 42.0 16.9
% Self report health status as fair or poor* 20.7 17.0
About the County
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Key informant interviews Data catalog Dashboards and Key user sessions Community case studies Focus groups with stakeholders Network analysis
Methods
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Key informant interviewsFacilitators of integration: Visionary organizational leadership Committed community members Necessity created by shrinking resources Experience with benefits of integrated dataBarriers to data integration: Regulatory complexity Technical challenges of integrating data on different platforms Lack of consistent variable definitions, analytic methods
Results
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Key informant interviews
Desire for data and service integration: Utilization data
– Behavioral health– Substance abuse treatment– Medicare & Medicaid
Health care quality indicators Disease prevalence
Results
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Key informant interviews
Use of integrated data Describe service utilization patterns Measure success of social programs Plan for integration of services for individuals Create efficiencies, maximize resources
Results
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Data Catalog Medicare beneficiaries
– Age (including beneficiaries under 65)– Admissions/30-day readmissions– Payment per beneficiary for inpatient stays, ED visits, observation stays, SNF
admissions Population variables
– Poverty status– Education– Age– Households with no vehicle– Housing Choice Vouchers
FQHC locations Medicaid Expenditures
Results
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Key user sessions and Dashboards Tableau dashboards displayed interactive maps and graphs
– Medicare utilization data – Demographic data– Elements based on key informant interviews
Key user chosen for access to and familiarity with local data sources, demonstrated leadership with integration efforts
Key user additions or modifications to the dashboards – • Percent of Civilian Non-institutionalized Populations With No Health Insurance
Coverage,– • ZIP Code level live births to mothers <=18 (Teenage pregnancy rates),– • various county health rankings,– • metrics around community needs assessment and surveying efforts, and– • Senior housing locations and program outcomes.
Results
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Focus groups
Community characteristics: High poverty; poor health outcomes Many organizations provide social services Limited resources drive desire to create efficiencies Existing and active community collaboratives Leaders are well connected and used to working together
Results
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Data elements desired by participants
Results- Network Analysis
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County priorities Access to poverty and income data Micro-target census tracts identified as areas of need
– Target services under circumstances of limited resources Engage residents in process to identify local needs Leverage existing collaboratives to break down silos and share
information Integrate data from diverse sources to inform program
interventionsMany participants expressed desire for raw data
Discussion
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Limitations Platform license structure created limitations Stakeholder competing agendas Reluctance to share Lack of community resources
– Limited resources available to invest in integration– Few stakeholders have skills necessary, key user cannot act alone
Above factors limited key users’ ability to incorporate dashboard into workflow and take full advantage of functionality
Discussion
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Recommendations Align funding cycles for initiatives that target similar
populations Identify common measures for health improvement Improve local agency access to federal data sources Develop maps that show utilization, demographics,
prevalence of conditions, and social determinants of health at the census tract level
Discussion
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Acknowledgements This material was prepared under contract with the Centers
for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.Sequence #: 11SOW-QINNCC-00033-11/10
For more information: Jane Brock, MD, MPH – [email protected] Brianna Gass, MPH – [email protected]
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