Transcript
Page 1: NYS Health Innovation Challenge Webinar

NYS Health Innovation ChallengeInformational Webinar

April 24, 2014

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On the call

• DOH, SPARCS – John Piddock

• DOH, QARR – Joanne Guo

• DOH, Cardiac Reporting System – Kim Cozzens

• DOH, Prevention Agenda - Trang Nguyen

• ITS, Health Data NY – George Javitz

• Health 2.0 – Graeme Ossey

• Health 2.0 – Jen David

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Agenda

• Challenge Description• Challenge Data Assets• Health Data NY and API’s• Challenge Details• Evaluation Criteria• Timeline• Q & A

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The Challenge

• Create tech-driven solutions that enable consumers, employers, public health experts, communities and purchasers to explore quality, charges and costs data for medical procedures provided by NYS inpatient hospital facilities.

• Goals• Increase usage and usability of open health data• Reduce costs of health care through value based health care decisions• Turn open data into actionable information that will empower consumers

and others to make informed purchasing decisions

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Challenge Data Assets

• Statewide Planning and Research Cooperative System (SPARCS)

• Quality Assurance Reporting Requirements (QARR)

• Cardiac Reporting System

• Prevention Agenda 2013 – 2017 Tracking Indicators

• Hospital locations, services, and beds will be posted on Health Data NY soon.

• Additional data from Health Data NY, Open NY, and other open data sites.

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Statewide Planning and Research Cooperative System

(SPARCS)

John Piddock

Bureau of Health Informatics

Office of Quality and Patient Safety

New York State Department of Health

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What Is SPARCS?• Statewide Planning and Research Cooperative System (SPARCS)

• Cooperation between the health care industry and government

• In existence for over 35 years• Established through statute in 1979

• Enabling legislation and regulations for SPARCS are located under Section 2816 of the Public Health Law (PHL); and Section 400.18 of Title 10 (Health) of the Official Compilation of Codes, Rules, and Regulations of the State of New York (NYCRR)

• All payer calendar year-based discharge/visit dataset

• Claim-level detail on patient characteristics, diagnoses, treatments, services, and charges for hospital discharges, ambulatory surgery, emergency department, and hospital-based outpatient service visits (or EODC) in New York State

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Many Uses of SPARCS Data• Financial, Rate Setting (e.g., APR-DRG SIW)

• Developing and Evaluating Policy

• Epidemiology

• Health Planning/Resource Allocation

• Quality of Care Assessment

• Research

• Surveillance

• Utilization Review

• Geo-coding

• Linkages with other data sets, registries, etc.

• AHRQ Healthcare Cost and Utilization Project (HCUP)

• Potentially Preventable Readmissions (PPR)

• Potentially Preventable Complications (PPC)

• Patient Safety Indicators (PSI)

• Inpatient Quality Indicators (IQI)

• Prevention Quality Indicators (PQI/PDI)

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SPARCS Data Collection

• Submissions are by Article 28 facilities or their vendors• Inpatient Services

• Hospitals

• Outpatient Visits • Emergency Departments

• Ambulatory Surgery Centers

• Free-Standing Diagnostic & Treatment Center (D&TC)

• Hospital-Based

• Hospital-Based Outpatient (Expanded Outpatient Data Collection)

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SPARCS File Types1. Identifying/Deniable: Contains data elements that—if disclosed without any

restrictions on use or re-disclosure—would constitute an unwarranted invasion of personal privacy

• External applicants for identifying data must be approved by a Data Protection Review Board (DPRB)

2. Limited: Contains some indirect patient identifiers, such as the month and year of date fields and some geographic identifiers of the patient

3. De-Identified: As a public use file, it contains basic record-level detail; all public health information (PHI) has been removed. This has been posted on Health Data NY (https://health.data.ny.gov) starting with calendar year 2009.

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SPARCS Data on Health Data NY (Tabular Format)

Charges and/or Costs Included

Yes No

DischargeLevel

YesHospital Inpatient Discharges(SPARCS De-Identified): 2009, 2010, 2011, 2012

No(Aggregate)

Hospital Inpatient Cost Transparency: Beginning 2009

Hospital Inpatient Discharges by Facility (SPARCS): Beginning 2009

Hospital Inpatient Discharges by Patient County of Residence (SPARCS): Beginning 2009

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SPARCS Charge and Cost Data on Health Data NY

• Hospital Inpatient Discharges (SPARCS De-Identified)• These datasets (2009-2012) contains discharge level detail on patient characteristics,

diagnoses, treatments, services, and charges. This data contains basic record level detail regarding the discharge; however, the data does not contain protected health information (PHI) under HIPAA. Costs are available on 2009-2011.

• Hospital Inpatient Cost Transparency: Beginning 2009• The dataset contains information on the volume of discharges, All Payer Refined Diagnosis

Related Group (APR-DRG), severity of illness level (SOI), medical or surgical classification, median charge, median cost, average charge and average cost per discharge.

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Prevention Quality Indicators (PQIs) - Adult• The Agency for Healthcare Research and Quality (AHRQ) Prevention

Quality Indicators (PQIs) are a set of population based measures that can be used with inpatient discharge data to identify conditions where: 1) the need for hospitalization was potentially preventable with appropriate outpatient care, or 2) conditions that could be less severe if treated early and appropriately.

• All PQIs apply only to adult populations (over the age of 18 years).

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Prevention Quality Indicators - Adult• PQIs can be used as a starting point for evaluating the overall quality of

primary and preventive care in a geographic area (i.e. Zip Code, County). • PQIs are sometimes characterized as "avoidable hospitalizations," but this

does not mean that the hospitalizations were unnecessary or inappropriate at the time they occurred. It means that if proper outpatient care had been given the hospitalization might not have occurred.

• PQIs can provide initial information about potential problems in a community that may require further, more in-depth analysis from SPARCS data.

• This analysis can assist in identifying areas where if good outpatient care is provided it could potentially prevent the need for hospitalization, or for which early intervention can prevent complications or more severe disease.

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Prevention Quality Indicators – Adult • PQI 01: Diabetes Short-Term Complications

• PQI 03: Diabetes Long-Term Complications

• PQI 14: Uncontrolled Diabetes

• PQI 16: Lower-extremity Amputation among Patients with Diabetes

• Composite S01: Diabetes

• PQI 07: Hypertension

• PQI 08: Heart Failure

• PQI 13: Angina Without Procedure

• Composite S02: Circulatory

• PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults

• PQI 15: Asthma in Younger Adults

• Composite S03: Respiratory

• PQI 10: Dehydration

• PQI 11: Bacterial Pneumonia

• PQI 12: Urinary Tract Infection (UTI)

• Composite PQI 91: Acute

• Composite PQI 90: Overall

• Composite PQI 92: Chronic (S01, S02, & S03)

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PQIs on Health Data NY• Data files of PQIs, at the Patient County and Zip Code level on Health Data NY.

• Data Elements include : Year, County or Zip, PQI Number and Name, Observed and Expected Rates per 100,000 people

• Observed (crude) and Expected (adjusted for age group, gender and race/ethnicity) rates are presented in two distinct datasets (one by Patient County, one by Patient Zip Code) to allow comparison with the statewide average, thereby identifying geographical variation.

• Metadata is also posted for the files.

• Lower PQI rates represent better results.

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Thank You!

SPARCS OperationsBureau of Health InformaticsOffice of Quality and Patient SafetyNYS Department of HealthCorning Tower, Rm. 878Albany, NY 12237

Phone: (518) 474-3189E-mail: [email protected]

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Quality Assurance Reporting Requirements (QARR)

Joanne Guo

Office of Quality and Patient Safety

Bureau of Health Services Evaluation

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Background-What is QARR Standardized national measurement set for the ambulatory health care delivery

system

Measures are developed to reflect the quality of care being given in a certain population, condition, or event

Generally based on recommendations from national organizations or experts in designated areas

Required for Commercial HMO, Commercial PPO, Child Health Plus and Medicaid

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What is included in the dataset?Domain Example Measures

Provider Network Board Certification, Satisfaction with Doctors and Specialists

Child & Adolescent Health Childhood Immunization, Lead Testing, Well Care Visits Dental Visits, Care for Colds and Sore Throats, Medication for Asthma, Preventive Care and Counseling for Risk Behaviors

Women’s Health Mammography, Cervical Cancer Screening, Chlamydia Testing, Prenatal and Postpartum Care

Adult Health Preventive Care, Tobacco Cessation, Flu Shots, Management of Asthma, COPD, Diabetes, Cardiovascular disease and Medications

Behavioral Health Antidepressant Medication Management and Follow Up Care After Hospitalization for Mental Illness

Satisfaction with Care Getting Care Needed, Getting Care Quickly, Customer Satisfaction, Care Coordination and Rating of Health Plan

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How are the data used?

Annual Publications – Statewide Executive Summary of Managed Care, Health Plan Comparison, Regional Consumer Guides, Health Plan Service Use, Health Care Disparities

Financial Rewards – Quality Incentive for Medicaid plans based on performance in quality, satisfaction and preventable hospitalization rates

Quality Improvement Activities – performance matrix and action plans, plan-specific reports, improvement projects and focus studies

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The Challenge• Allow comparability across all organizations (e.g. health plans, or

health insurance products)• Provide the public with information about how effective and

satisfying the care and service delivered is across organizations• Encourage accountability and quality improvement in health care

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Limitations

• Only validated information is included in the data• Not all measures are collected every year, some measures are

rotated to control collection burden• Measures change and health plan mergers limit the ability to trend

over time• Some measures are reported as inverted rates and caution should

be used when analyzing these measures• Plans with fewer than 30 eligible members are excluded from the

statistical calculations

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Questions

Quality Measurement and Evaluation UnitBureau of Health Services EvaluationOffice of Quality and Patient SafetyNYS Department of HealthCorning Tower, Rm. 878Albany, NY 12237

Phone: (518) 486-9012E-mail: [email protected]

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Cardiac Reporting System

Kimberly S. Cozzens

Cardiac Services Program

Office of Quality and Patient Safety

New York State Department of Health

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Background - NYSDOH Cardiac Data Systems

• Clinical data registries for all Cardiac Surgery and PCI (coronary angioplasty) performed in NYS.

• Carefully audited for completeness and accuracy.

• Robust statistical analysis to create risk-adjusted mortality rates.

• NYS is a leader in public reporting of cardiac outcomes. More than 20 year history of public reports.

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Cardiac Surgery and PCI by Hospital

Hospital-level outcome data for patients undergoing cardiac surgery or PCI.

Primary outcome: Risk-adjusted in-hospital /30-day mortality rate (RAMR)

The dataset also contains:• Number of cases performed at each hospital• Number of deaths• Observed and expected mortality rates• Hospital region• Indicator for RAMR significantly above or below the NYS rate

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Additional Data Sets

Cardiac Surgery by Surgeon

and

PCI by Cardiologist

Contain similar information at the physician level.

Data currently available from 2008 - 2010.

Data through 2011 expected in May.

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How Are the Data Used?

• Providers - monitor their performance relative to others and identify opportunities for improvement.

• Referring physicians - inform decisions about where to refer patients.

• Consumers - inform selection of a hospital or physician.

• Department of Health – assess quality of care and satisfactory outcomes across NYS.

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The Challenge

• Can these data be presented in a way that is more accessible to patients making decisions about their care? Can they be used to better help patients in selecting a hospital or physician for these procedures?

• Can these data be used to help inform health system planning with respect to finding the right balance between regional procedural volume and need?

• Is there a relationship between cost and quality? If so, how can this information be used to maintain or improve quality of care while increasing efficiency of resource utilization?

• Is there a relationship between regional use-rates of these invasive procedures for advanced cardiac disease and prevention quality indicators?

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Limitations

• Provider results should be compared to the NYS result. It is important to look at the “Comparison Result” data when assessing outcomes. These data indicate which results are statistically different from the statewide results.

• Some providers may have made important changes in the time period since the data were collected. Historical results may not reflect current performance.

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Thank You!

Cardiac Services ProgramOffice of Quality and Patient Safety

NYS Department of Health

1 University Place, Suite 218

Rensselaer, NY 12144

Phone: (518) 402-1016

E-mail: [email protected]

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Prevention Agenda 2013 -2017 Tracking Indicators

State and County Trend DataState and County Most Recent Data

Public Health Information Group - Practice

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BackgroundThe New York State Prevention Agenda 2013-2017 serves as the

blueprint for state and local community action to improve the health of New Yorkers and address health disparities. One overall and five priority specific areas are included. The Prevention Agenda establishes goals for each priority area and defines indicators to measure progress toward achieving these goals, including reductions in health disparities among racial, ethnic, and socioeconomic groups and persons with disabilities.

These datasets consist of the 2017 targets and trend data for state and county level tracking indicators included in the Improve Health Status and Reduce Health Disparities and five specific priority areas: Prevent Chronic Diseases, Healthy and Safe Environment, Healthy Women, Infants and Children, Prevent Mental Health and Substance Abuse and Prevent HIV, STDs, Vaccine Preventable Diseases and Healthcare Associated Infections.

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What is included in the datasets? Prevention Agenda Tracking Indicators – State Trend and Most Recent Year Data

Field

Number

Field Name Field

Size

Format note Description

1 Priority Area Number 1 Integer Prevention Agenda priority area ID number

2 Priority Area 120 Text Full title for the specific Prevention Agenda priority area

3 Focus Area Number 1 Integer Prevention Agenda focus area ID number (focus area within priority area)

4 Focus Area 120 Text Full title for the specific focus area

5 Indicator Number 6 Text Unique indicator identifier

6 Indicator 200 Text Full text description of the health tracking indicator

7 Disparity 3 Text Indicate disparity indicator or not

8 Event Count/Rate 12Integers with commas or

numeric with decimalEvent counts for rate computations (numerators) or the high-risk group rate for ratio computations

9Average Number of

Denominator/Rate12

Integers with commas or

numeric with decimalDenominator for rate computations or the reference group rate for ratio computations

10 Measure Unit 12 Text Result type, rate or percentage

11 Percentage/Rate/Ratio 12 Numeric with decimal Numerical indicator value estimate

12 Lower Limit of 95% CI 8 Text Lower limit of 95% Confidence Intervals for percentage estimates from survey data

13 Upper Limit of 95% CI 8 Text Upper limit of 95% Confidence Intervals for percentage estimates from survey data

14 2017 Objective 12 Numeric with decimal Target value for the health tracking indicator, as specified by the Prevention Agenda

15 Objective Region 12 Text Region of NYS that the objective pertains to

16 Data Years 100 Text Time period for raw data used in indicator computation

17 Date Source 300 Text Data sources for the raw data used in indicator computation

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What is included in the datasets? Prevention Agenda Tracking Indicators – County Trend and Most Recent Year Data

Field Number Field Name Field Size Format note Description

1 County Name 35 Text Full county name

2 Priority Area Number 1 Integer Prevention Agenda priority area ID number

3 Priority Area 120 Text Full title for the specific Prevention Agenda priority area

4 Focus Area Number 1 Integer Prevention Agenda focus area ID number (focus area within priority area)

5 Focus Area 120 Text Full title for the specific focus area

6 Indicator Number 6 Text Unique indicator identifier

7 Indicator 200 Text Full text description of the health tracking indicator

8 Disparity 3 Text Indicate disparity indicator or not

9 Event Count/Rate 12 Integers with commas or numeric with decimal Event counts for rate computations (numerators) or the high-risk group rate for ratio computations

10 Average Number of Denominator/Rate 12 Integers with commas or numeric with decimal Denominator for rate computations or the reference group rate for ratio computations

11 Measure Unit 12 Text Result type, rate or percentage

12 Percentage/Rate/Ratio 12 Numeric with decimal Numerical indicator value estimate

13 Lower Limit of 95% CI 8 Text Lower limit of 95% Confidence Intervals for percentage estimates from survey data

14 Upper Limit of 95% CI 8 Text Upper limit of 95% Confidence Intervals for percentage estimates from survey data

15 Data Comments 20 Text Indicate when the county data is unstable or suppressed due to small number of events

16 Quartile 20 Text Quartile(s) that indicator estimate falls within

17 2017 Objective 12 Numeric with decimal Target value for the health tracking indicator, as specified by the Prevention Agenda

18 Objective Region 12 Text Region of NYS that the objective pertains to

19 Data Years 100 Text Time period for raw data used in indicator computation

20 Data Sources 300 Text Data sources for the raw data used in indicator computation

21 Mapping Distribution 1 IntegerGrouping of county rates for color shades in the map (value of "1" indicates the best group and "3"

indicates the worst group)

22 Location 30Lat/Long coordinates separated by a comma,

within parenthesesLat/Long decimal degree coordinates for the region covered by the indicator, for use in mapping

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How are the data used?• These datasets provide interested parties, including state and local health partners and

the general public information about the most recent data points and trend data for the 2013-2017 Prevention Agenda tracking indicators and the objectives/targets that state and communities are working toward.

• Interested parties can utilize the local data to assess and identify local priorities, to set reasonable local level targets, and to monitor progress to collectively contribute toward the state’s overall progress in the five Prevention Agenda Priority Areas.

• Data can be used in conjunction with other data sources for research, grant applications, community engagement, educational materials, identifying and communicating local priorities for interventions.

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Limitations

This dataset consists of various types of indicators with different units of measurement such as rates per 10,000 population, percentages, and ratios. Therefore, comparison of data across indicators might not be valid.

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Thank You!Office of Public Health Practice

[email protected]

(518) 473-4223

Department of Health

Corning Tower – ESP

Albany, NY 12237

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Using APIs withHealthDataNY

andOpenNY

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What is an API

• An application programming interface (API) specifies how some software components should interact with each other.

• In addition to accessing databases or computer hardware, such as hard disk drives or video cards, an API can be used to ease the work of programming graphical user interface components

* Wikipedia

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Socrata’s Open Data APIs

* From Socrata.com/open-data-portal

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Socrata’s Open Data APIs

* From Socrata.com/open-data-portal

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Socrata’s Developer Resources

* From dev.socrata.com

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Socrata Open Data API

* From dev.socrata.com

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Socrata Open Data API

* From dev.socrata.com

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Featured NYS APIs

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HealthDataNY Featured APIs

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HealthDataNY Featured APIs

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HealthDataNY Featured APIs

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HealthDataNY Featured APIs

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First, get dataset identifier

Example Code

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Then use identifier in request URL

Use .csv to return CSV file

Example Code

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Example Code

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Thank You!

HealthDataNY Team

[email protected]

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Challenge Details

• Pre-registration Form• Official Submission Requirements

• A text description (500 to 1500 words)• Power Point (5 to 10 slides)• Link to working Solution

• Awards• $15,000 First Prize• $3,500 Second Prize• $1,500 Third Prize

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Evaluation Criteria

• Entries will be judged on the following:• Decision Making (20%)• Creativity (30%)• Feasibility of Implementation (20%)• Target Audience (15%)• Utilization of Open Data (15%)

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Timeline

• Submission phase ends: July 24, 2014• Judging period: August 2014• Winners announced: September 2014

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Thank You! Q & A

Contact Us

[email protected]

[email protected]

Visit http://bit.ly/NYSInnov for more information


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