advancing excellence in health care agency for healthcare research and quality advancing excellence...

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]


OverviewOverview

Overview of MONAHRQOverview of MONAHRQ

The MONAHRQ reporting Website


The MONAHRQ host application: how to generate your reporting Website


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?


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


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


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


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


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


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


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


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.


OverviewOverview






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


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


Hospital Quality Ratings: Hospital Quality Ratings: Search PageSearch Page

Select hospitals by name, ZIP Code, or region

Select quality measures by health topic


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


Hospital Quality Ratings: Hospital Quality Ratings: Classification TableClassification Table

A closer look at the classification table

– Synthetic data –


Hospital Quality Ratings: Hospital Quality Ratings: Detailed Classification TableDetailed Classification Table

The detailed version includes rates and confidence intervals



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


One bar chart per indicator


Hospital Quality Ratings: Hospital Quality Ratings: Detailed Bar ChartsDetailed Bar Charts

The detailed version includes confidence intervals, if available



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



Hospital UtilizationHospital Utilization

Hospital utilization statistics (similar to AHRQ’s HCUPnet)


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


Hospital Utilization: Hospital Utilization: One Hospital, One ConditionOne Hospital, One Condition


Stratified by:• age group• gender• payer• race

Includes national and regional benchmarks

Shows:• discharges• charges• estimated costs• length of stay


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



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 –


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 –


Maps of Avoidable Hospital Maps of Avoidable Hospital StaysStays

Includes the AHRQ area-level Quality Indicators

Denominators are county populations from Census data


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


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



Maps of Avoidable Stays: Maps of Avoidable Stays: Potential Cost SavingsPotential Cost Savings

Shows rates of potentially avoidable hospital stays by

county


Estimates cost savings from reducing these stays

Can be downloaded to Excel


County Rates of Hospital UseCounty Rates of Hospital Use

Rates of health conditions and procedures by county

Denominators are county populations from Census data


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


County Rates of Hospital Use: County Rates of Hospital Use: All Counties, One ConditionAll Counties, One Condition

Sortable columns

Drill down to map display


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


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



OverviewOverview






How Do I Import Local Data How Do I Import Local Data into MONAHRQ?into MONAHRQ?


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


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


Map Data ElementsMap Data Elements

Click and drag data elements to map your data to the format

required by MONAHRQ



Map Input ValuesMap Input Values

Recode your data elements to values understood by MONAHRQ, based on the

UB04 standard


Load Your Local DataLoad Your Local Data

MONAHRQ loads and error checks your data


Run AnalysisRun Analysis

MONAHRQ uses your data to calculate: •AHRQ Quality Indicators •hospital utilization•county rates of hospital use•local benchmarks


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


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


How Do I Define Local How Do I Define Local Regions & Hospitals?Regions & Hospitals?


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


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


Load HospitalsLoad Hospitals

Mask hospital names if desired

Assign hospital cost-to-charge ratios using CMS provider ID


Assign hospitals to regions


Link HospitalsLink Hospitals

If needed, crosswalk your local hospitals to hospitals in the

Hospital Compare data



Select Hospitals to ReportSelect Hospitals to Report

Choose which hospitals to include in your reporting

Website


How Do I Build My Website?How Do I Build My Website?


Website WizardWebsite Wizard

The Website Wizard takes you step by step through the process of building your MONAHRQ reporting Website


Set Reporting ParametersSet Reporting Parameters

Set thresholds for cell suppression (to protect confidentiality) and other

reporting parameters


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


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


Host Your WebsiteHost Your Website

Now you’re done!Your MONAHRQ-generated Website

is yours to host as you prefer


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?


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