synthetic data
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Advancing Advancing Excellence in Excellence in Health CareHealth Care
Agency for Healthcare Research and QualityAgency for Healthcare Research and QualityAdvancing Excellence in Health CareAdvancing Excellence in Health Care • • www.ahrq.govwww.ahrq.gov
Input Your Data. Input Your Data. Output Your Website.Output Your Website.
Visit our Website at: www.monahrq.ahrq.gov
For technical assistance or to join the MONAHRQ mailing list, email: [email protected]
Advancing Advancing Excellence in Excellence in Health CareHealth Care
OverviewOverview
Overview of MONAHRQOverview of MONAHRQ
The MONAHRQ reporting Website
Input Your Data. Input Your Data. Output Your Website.Output Your Website.
The MONAHRQ host application: how to generate your reporting Website
Advancing Advancing Excellence in Excellence in Health CareHealth Care
RationaleRationale
Why should it be so expensive to generate and put out basic information?
Why should information be so hard to get?
Why does every organization have to reinvent the wheel?
Advancing Advancing Excellence in Excellence in Health CareHealth Care
From Data to Information From Data to Information to Actionto Action
Information Information can be used to can be used to
make make decisionsdecisions
Hospital Hospital discharge data discharge data
are already being are already being collectedcollected
Hospital discharge Hospital discharge data can generate data can generate
valuable health care valuable health care informationinformation
Quality of care in hospitals
Rates of diseasesin particular areas
Utilization and costs in hospitals
Rates of proceduresin particular areas
Preventable hospital stays suggesting breakdowns in primary care
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Introducing MONAHRQIntroducing MONAHRQ
─ Input your data, output your reporting Website─ Integrate local data with national datasets ─ Report data in a friendly, accessible format ─ Report without reinventing the wheel
MONAHRQ is a free desktop software tool from MONAHRQ is a free desktop software tool from AHRQAHRQ
MONAHRQ helps convert health care data into MONAHRQ helps convert health care data into useful information useful information
MONAHRQ helps you quickly and easily generate MONAHRQ helps you quickly and easily generate your own health care reporting Websiteyour own health care reporting Website
MONAHRQ is a desktop tool, not a service – you MONAHRQ is a desktop tool, not a service – you control your data and you host your Websitecontrol your data and you host your Website
Advancing Advancing Excellence in Excellence in Health CareHealth Care
What Does MONAHRQ Do?What Does MONAHRQ Do?
MONAHRQ takes health care data and information…MONAHRQ takes health care data and information…
Local hospital discharge data
Hospital Compare inpatient measure results from CMS
HCAHPS survey of patients’ experiences
Mortality Readmissions Process of care
Advancing Advancing Excellence in Excellence in Health CareHealth Care
What Does MONAHRQ Do?What Does MONAHRQ Do?
1. Hospital quality ratings
……and turns it into a Website that reports:and turns it into a Website that reports:
2. Hospital utilization and costs
– AHRQ Quality Indicators– Hospital Compare measures– HCAHPS patient survey measures
3. Potentially avoidable hospital stays by county– AHRQ Quality Indicators
4. County rates of hospital use
You host the Website yourselfYou host the Website yourself
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Who Can Use MONAHRQ?Who Can Use MONAHRQ?
Who can use MONAHRQ?Who can use MONAHRQ?─ Hospital AssociationsHospital Associations─ Health plansHealth plans─ Individual providersIndividual providers─ Local data organizationsLocal data organizations─ Local public health departmentsLocal public health departments
Who can use a MONAHRQ reporting Website?Who can use a MONAHRQ reporting Website?─ ConsumersConsumers─ ProvidersProviders─ AnalystsAnalysts─ Policy makersPolicy makers
Advancing Advancing Excellence in Excellence in Health CareHealth Care
How to Use MONAHRQHow to Use MONAHRQ
9
Load hospital discharge data and/or
Hospital Compare measure results
Download the free MONAHRQ software from
AHRQ’s Website
Select data analysis and
Website options, and run
MONAHRQ
MONAHRQ generates your Website onto your own computer
Host your MONAHRQ Website as you prefer
InternalInternal: better understand your data and answer questions
Private: Private: provide a password-protected site for member organizations
Public:Public: report healthcare information to the community
Advancing Advancing Excellence in Excellence in Health CareHealth Care
More on How to Use MONAHRQMore on How to Use MONAHRQ
Step 1: Step 1: Download Download MONAHRQMONAHRQ
Step 2: Step 2: Load dataLoad data
Step 4: Step 4: Calculate Calculate
resultsresults
Step 5: Step 5: Generate Generate
your Websiteyour Website
You download You download the Hospital the Hospital Compare fileCompare file
You load the You load the Hospital Hospital
Compare fileCompare file
Step 3: Step 3: Specify Specify
hospitalshospitals
Load your own hospital discharge data … Load your own hospital discharge data …
You link You link hospitalshospitals
You load your local data
You specify local hospital information
MONAHRQ analyzes your
local data
… … and/or load pre-calculated results from Hospital Compareand/or load pre-calculated results from Hospital Compare
MONAHRQ MONAHRQ calculates local calculates local
benchmarksbenchmarks
Advancing Advancing Excellence in Excellence in Health CareHealth Care
More on Hospital Compare More on Hospital Compare Measures and MONAHRQMeasures and MONAHRQ
Download from CMS Download from CMS Hospital Compare files when they are available.
Clean and format Clean and format the files to work with MONAHRQ.
Post Post the formatted files on the MONAHRQ Website, monahrq.ahrq.gov.
Download from the MONAHRQ WebsiteDownload from the MONAHRQ Website a formatted Hospital Compare file. Files from other sources may not load correctly into MONAHRQ.
LoadLoad the formatted Hospital Compare file into MONAHRQ.
What AHRQ does … What AHRQ does …
What you do … What you do …
You can load your own hospital discharge data as well.Now you’re ready to process your data and generate a reporting Website.
Advancing Advancing Excellence in Excellence in Health CareHealth Care
OverviewOverview
Overview of MONAHRQOverview of MONAHRQ
The MONAHRQ reporting Website
Input Your Data. Input Your Data. Output Your Website.Output Your Website.
The MONAHRQ host application: how to generate your reporting Website
Advancing Advancing Excellence in Excellence in Health CareHealth Care
The MONAHRQ Reporting WebsiteThe MONAHRQ Reporting Website
■ Hospital Quality RatingsHospital Quality Ratings■ Maps of Avoidable Hospital StaysMaps of Avoidable Hospital Stays
■ Hospital UtilizationHospital Utilization■ County Rates of Hospital UseCounty Rates of Hospital Use
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Quality RatingsHospital Quality Ratings
Hospital quality ratings can include:• AHRQ provider-level Quality
Indicators• Hospital Compare inpatient
measures • HCAHPS patient survey
measures
Two quality paths to choose from:• one friendlier path for the public• one path with statistical details for
other audiences
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Quality Ratings: Hospital Quality Ratings: Search PageSearch Page
Select hospitals by name, ZIP Code, or region
Select quality measures by health topic
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Quality Ratings: Hospital Quality Ratings: Classification TableClassification Table
* Available from HealthData.gov
Understandable icons
Sortable columns
Choose national or local benchmarks
Help popups
Drill down to details
Shows quality ratings for each indicator and
hospital selected
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Quality Ratings: Hospital Quality Ratings: Classification TableClassification Table
A closer look at the classification table
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Quality Ratings: Hospital Quality Ratings: Detailed Classification TableDetailed Classification Table
The detailed version includes rates and confidence intervals
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Quality Ratings: Hospital Quality Ratings: Bar ChartsBar Charts
Bars ordered from best to worst
Bars labeled with the numeric value
Benchmarks shown in contrast color
– Synthetic data –
One bar chart per indicator
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Quality Ratings: Hospital Quality Ratings: Detailed Bar ChartsDetailed Bar Charts
The detailed version includes confidence intervals, if available
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Quality Ratings: Hospital Quality Ratings: Detailed Statistical TableDetailed Statistical Table
Provides statistics for specific measures, as available:
• numerator• denominator• observed rate • expected rate• risk-adjusted rate• confidence intervals
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital UtilizationHospital Utilization
Hospital utilization statistics (similar to AHRQ’s HCUPnet)
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Utilization: Hospital Utilization: Search PageSearch Page
Select hospitals by name, Zip Code, region,
or all combined
Select discharges by condition, procedure, MDC, DRG,
or all combined
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Utilization: Hospital Utilization: One Hospital, One ConditionOne Hospital, One Condition
– Synthetic data –
Stratified by:• age group• gender• payer• race
Includes national and regional benchmarks
Shows:• discharges• charges• estimated costs• length of stay
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Utilization: Hospital Utilization: All Hospitals, One ConditionAll Hospitals, One Condition
Shows information for the selected condition
for each hospital
Sortable columns
Drill down to stratified tables showing one hospital, one
condition
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Utilization: Hospital Utilization: All Conditions, One HospitalAll Conditions, One Hospital
Shows information for the selected hospital
for each condition individually
Sortable columns
Drill down to stratified tables showing one hospital, one
condition– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Hospital Utilization: Hospital Utilization: All Hospitals, All ConditionsAll Hospitals, All Conditions
Shows information for the selected condition for all hospitals combined
Sortable columns
Drill down to stratified tables for all hospitals combined, one
condition– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Maps of Avoidable Hospital Maps of Avoidable Hospital StaysStays
Includes the AHRQ area-level Quality Indicators
Denominators are county populations from Census data
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Maps of Avoidable Stays: Maps of Avoidable Stays: Search PageSearch Page
Choose a health topic
These topics group the area-level AHRQ Quality Indicators
Indicators measure the quality of community care, not hospital care
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Maps of Avoidable Stays: Maps of Avoidable Stays: County MapsCounty Maps
Drilldown for more details
Shows rates of potentially avoidable hospital stays by
county
Higher rates are darker blue
Rates are based on patient residence, not hospital location
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Maps of Avoidable Stays: Maps of Avoidable Stays: Potential Cost SavingsPotential Cost Savings
Shows rates of potentially avoidable hospital stays by
county
– Synthetic data –
Estimates cost savings from reducing these stays
Can be downloaded to Excel
Advancing Advancing Excellence in Excellence in Health CareHealth Care
County Rates of Hospital UseCounty Rates of Hospital Use
Rates of health conditions and procedures by county
Denominators are county populations from Census data
Advancing Advancing Excellence in Excellence in Health CareHealth Care
County Rates of Hospital Use: County Rates of Hospital Use: Search PageSearch Page
Select hospitals by county or all combined
Select discharges by condition, procedure, MDC,
DRG, or all combined
Advancing Advancing Excellence in Excellence in Health CareHealth Care
County Rates of Hospital Use: County Rates of Hospital Use: All Counties, One ConditionAll Counties, One Condition
Sortable columns
Drill down to map display
– Synthetic data –
Shows for each county:•number of discharges•discharge rate•estimated costs
Includes national and local benchmarks
Rates are based on patient residence, not
hospital location
Advancing Advancing Excellence in Excellence in Health CareHealth Care
County Rates of Hospital Use: County Rates of Hospital Use: County MapsCounty Maps
Shows rates by county in quintiles
Higher rates are darker blue
Rates are based on patient residence, not hospital location
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
OverviewOverview
Overview of MONAHRQOverview of MONAHRQ
The MONAHRQ reporting Website
Input Your Data. Input Your Data. Output Your Website.Output Your Website.
The MONAHRQ host application: how to generate your reporting Website
Advancing Advancing Excellence in Excellence in Health CareHealth Care
How Do I Import Local Data How Do I Import Local Data into MONAHRQ?into MONAHRQ?
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Import Local Data WizardImport Local Data Wizard
The Import Data Wizard helps you: •import your data•map it to the format required by MONAHRQ•analyze the data
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Select Your Local Data FileSelect Your Local Data File
Accepted formats:•text (.csv)•Microsoft Excel (.xls)•Microsoft Access (.mdb)
Browse to and select your data file
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Map Data ElementsMap Data Elements
Click and drag data elements to map your data to the format
required by MONAHRQ
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Map Input ValuesMap Input Values
Recode your data elements to values understood by MONAHRQ, based on the
UB04 standard
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Load Your Local DataLoad Your Local Data
MONAHRQ loads and error checks your data
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Run AnalysisRun Analysis
MONAHRQ uses your data to calculate: •AHRQ Quality Indicators •hospital utilization•county rates of hospital use•local benchmarks
Advancing Advancing Excellence in Excellence in Health CareHealth Care
How Do I Load Hospital Compare How Do I Load Hospital Compare Measures into MONAHRQ?Measures into MONAHRQ?
Using Hospital Compare measure results in MONAHRQ is optional
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Load Hospital Compare MeasuresLoad Hospital Compare Measures
Next, browse to and select your Hospital Compare data file
First, download a specially-formatted CMS Hospital Compare data file from
the MONAHRQ Website at monahrq.ahrq.gov
Advancing Advancing Excellence in Excellence in Health CareHealth Care
How Do I Define Local How Do I Define Local Regions & Hospitals?Regions & Hospitals?
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Define Regions & Define Regions & Hospitals WizardHospitals Wizard
The Define Regions and Hospitals Wizard helps you: •define regions used in hospital selection•assign hospital information such as region or cost-to-charge ratio•crosswalk local hospitals with hospitals in the Hospital Compare data, if needed
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Define RegionsDefine Regions
Define regions to use for hospital selection in:•the hospital quality ratings path•the hospital utilization path
Regions can be:•Dartmouth Atlas Hospital Referral Regions (HRRS)•Dartmouth Atlas Hospital Service Areas (HSAs)•custom defined by you
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Load HospitalsLoad Hospitals
Mask hospital names if desired
Assign hospital cost-to-charge ratios using CMS provider ID
– Synthetic data –
Assign hospitals to regions
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Link HospitalsLink Hospitals
If needed, crosswalk your local hospitals to hospitals in the
Hospital Compare data
– Synthetic data –
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Select Hospitals to ReportSelect Hospitals to Report
Choose which hospitals to include in your reporting
Website
Advancing Advancing Excellence in Excellence in Health CareHealth Care
How Do I Build My Website?How Do I Build My Website?
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Website WizardWebsite Wizard
The Website Wizard takes you step by step through the process of building your MONAHRQ reporting Website
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Set Reporting ParametersSet Reporting Parameters
Set thresholds for cell suppression (to protect confidentiality) and other
reporting parameters
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Select Measures to ReportSelect Measures to Report
MONAHRQ tells you which measures are endorsed by the
National Quality Forum
Choose which measures to include in your reporting
Website
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Customize Your WebsiteCustomize Your Website
Specify Website options:• where to output it• which pages to generate• style specifics• your logo to display in
the site• your organization’s name
to display in the site
Advancing Advancing Excellence in Excellence in Health CareHealth Care
Host Your WebsiteHost Your Website
Now you’re done!Your MONAHRQ-generated Website
is yours to host as you prefer
Advancing Advancing Excellence in Excellence in Health CareHealth Care
For more information or to visit our live demo site:For more information or to visit our live demo site:
For technical assistance or to join the MONAHRQ For technical assistance or to join the MONAHRQ mailing list email:mailing list email:
http://www.monahrq.ahrq.govhttp://www.monahrq.ahrq.gov
[email protected]@ahrq.gov
Questions?Questions?
Input Your Data. Input Your Data. Output Your Website.Output Your Website.