oshpd update: what's new, what's here, and what's coming · pdf filecalifornia...

California Health Information AssociationCalifornia Health Information Association

Anthony Tapney, MBALead Analyst

Patient Data SectionAnthony.Tapney@oshpd.ca.gov

Michael TagupaResearch Program Specialist II

Healthcare Information Resource CenterMichael.Tagupa@oshpd.ca.gov

Starla Ledbetter, MHSA, RHIA, PMPChief

Enterprise Services SectionStarla.Ledbetter@oshpd.ca.gov

OSHPD Update: What’s New, What’s Here, and What’s Coming

Wednesday, November 9, 2016

CaliforniaHIA.org

Presentation Topics

• Changes to Data Elements for 2017

• Computer Based Training

• Social Security Numbers (SSN)

• Future Data Element Changes

• Healthcare Information Resource Center

• Information Governance

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Changes to Data Elements for 2017

• Source of Admission → Point of Origin + Route

• Type of Admission

• Sex

• Date Format

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Source of Admission: Point of OriginCode Point of Origin for patients with Type of Admissionother than “Newborn”1. Non-Health Care Facility Point of Origin

2. Clinic or Physician’s Office

4. Transfer from a Hospital (Different Facility)

5. Transfer from a SNF, ICF, or Assisted Living Facility (ALF)

6. Transfer from another Health Care Facility

8. Court/Law Enforcement

9. Information Not Available

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Point of Origin, Continued

D. Transfer from One Distinct Unit of the Hospital to anotherDistinct Unit of the Same Hospital Resulting in aSeparate Claim to the Payer

E. Transfer from Ambulatory Surgery Center

F. Transfer from a Hospice Facility

Must be used with Type of Admission 4 - Newborn5. Born Inside this Hospital

6. Born Outside of this Hospital

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Source of Admission: Route of Admission

Route of admission:

(A) Your Emergency Department. Any patient admitted as an inpatient after being treated or examined in this hospital’s emergency department.

(B) Another Emergency Department. Any patient directly admitted as an inpatient after being transferred from another hospital’s emergency department.

(C) Not admitted from an Emergency Department.

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Type of AdmissionCode Type of Admission

1 Emergency2 Urgent3 Elective4 Newborn5 Trauma9 Information not available

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Sex

F Female

M Male

U Unknown

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Date Format

For online file transmissions 4-digit year / 2-digit month / 2-digit day (CCYYMMDD)

Date of Birth Admission Date Discharge Date Procedure Dates

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Computer Based Training

• Updated in March 2016

• Automated Certificate of Completion

• User-friendly resource

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Status on Physician ID

• Senate Bill (SB) 275

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Edit Changes

• ICD-10

• Coding Edits

• New Edits

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External Cause Codes

• Y92.9 Place of Occurrence not Specified

• Use of Y92.9, Y93.9, and Y99.9

• Y92.89 Other Specified Places

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ICD-10 Findings

• Reporting issues

• Possible under reporting of External Causes of Morbidity codes

• Comparing ICD-9 and ICD-10

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Unknown Social Security Numbers

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Unknown Social Security Numbers

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What’s Coming

Potential Data Element Changes:

• External Causes of Morbidity: allow up to 12

• Present on Admission exempt codes: report as ‘blank’

• Other Procedure: allow up to 24

• Procedure Dates: add to ED/AS data

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What’s Coming

• Race & Ethnicity: align IP values with ED/AS

• Race: allow more than one

• Total Charges: increase to 8 digits

• Total Charges: add to ED/AS data

• ZIP Code: align ED/AS values with Inpatient

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Survey: We need your feedback!OSHPD: Potential Data Elements Update Survey

Survey will be sent out shortly after the presentation

We are asking that one representative from each facility or hospital system respond

Please consult with your facility's appropriate departments to complete the survey

Respond by November 18, 2016

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MIRCal Resources

MIRCal – Home Page:http://www.oshpd.ca.gov/HID/MIRCal/

MIRCal – Manuals and Guides:http://www.oshpd.ca.gov/HID/MIRCal/ManualsGuides.html

MIRCal – Laws and Regulations:http://www.oshpd.ca.gov/HID/MIRCal/LawsRegs.html

MIRCal – Best Practices:http://www.oshpd.ca.gov/HID/MIRCal/BestPractices.html

California Health Information AssociationCalifornia Health Information Association

OSHPD Update: What’s New, What’s Here, What’s Coming

November 9, 2016

Michael TagupaResearch Program Specialist II

Healthcare Information Resource Center (HIRC)Michael.Tagupa@oshpd.ca.gov

CaliforniaHIA.org

*Goals/Objectives*

To teach you about the role of OSHPD’s Healthcare Information Resource Center (HIRC) so you have an understanding of:

1. What healthcare data OSHPD collects2. What standard products OSHPD makes

available from that data3. Who you can call for support finding or

obtaining the data you need4. Users and uses of the data

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Why is DATA important?

• It “informs” discussions

• It “empowers” decision-makers and planners(i.e. data-driven decisions!)

• It “raises” questions

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“29.3% of statistics are made up on the spot.”

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HIRC’S Organization within the State

• Agency: CA Health and Human Services Agency (CHHS)• Department: CA Office of Statewide Health Planning and

Development (OSHPD)• Division: Healthcare Information Division (HID)

• Section: Healthcare Information Resource Center (HIRC)HID also includes…….• Patient Data Section (PDS)• Accounting & Reporting Systems Section (ARSS)• Healthcare Outcomes Center (HOC)

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HIRC’S Public Role

1. Make “Objective” Healthcare Data Available

2. Improve “Accessibility” to the Data

3. “Support” the Users of the Data

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(8) Facility-Level Databases+

(3) Record-Level Databases+

Other Data

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(8) Facility-Level Databases(3) Hospital

(2) Long-Term Care(2) Clinic

(1) Home Health Agency/Hospice

+(3) Record-Level Databases

Patient Discharge DataEmergency Department

Ambulatory Surgery

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(8) Facility-Level Databases(3) HOSPITALS:1. Hospital Annual Financial Disclosure Report (468 reports)

• Financial Data – income statement, financial ratios, deductions from revenue, financial and utilization data by payer category, balance sheet, labor productivity data

2. Hospital Quarterly Financial Report (440 x 4)• Summary Financial and Utilization Data – income

statement, financial ratios, discharges days, revenue by payer

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(8) Facility-Level Databases(3) HOSPITALS:3. Annual Utilization Report of Hospitals (510)

• Licensed Bed Utilization Data – number of beds/bed designations, patient days, discharges, occupancy rates

• ED Data - treatment stations, visits by severity• Surgery Data - cardiology and cardiovascular surgical

services

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(8) Facility-Level Databases(2) LONG-TERM CARE:4. LTC Annual Financial Disclosure Report (1240)

• Financial Data – income statement; revenue and expenses, financial ratios, gross revenue by payer

• Utilization Data – licensed LTC beds, admits/discharges, occupancy rate

• Labor Information-productive hours, salaries and wages, labor turnover data

5. Annual Utilization Report of Long Term Care Facilities (1200)

• Discharges, patient days, licensed beds, patient demographics

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(8) Facility-Level Databases(2) CLINICS:6. Annual Utilization Report of Primary Care Clinics (1090)

(Community and Free Clinics)• Encounters, staffing, patient demographics, financial data

7. Annual Utilization Report of Specialty Clinics (550)(Surgical, Chronic Dialysis, Rehab, Psychology, and ABC Clinics)

• Encounters, Financial data-income statement

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(8) Facility-Level Databases(1) OTHER:8. Annual Utilization Report of Home Health Agencies and

Hospices (1920)• Home Health Utilization – special services provided, visits

by age, principal diagnosis, payer• Hospice – services provided, patient information, income

statement

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(3) Record-Level Databases9. Patient Discharge Data (PDD/IP) – 3.8M discharges/year

• 1983-201510. Emergency Department Data (ED) – 12.3M encounters/year

• 2005-2015• Treat-and-release encounters only (admits from ED

included in PDD)11. Ambulatory Surgery Data (AS) – 2.1M encounters/year

• 2005-2015• Freestanding and Hospital-based Ambulatory Surgery

Centers (excludes physician-owned surgery centers)

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

(3) Record-Level DatabasesStandard Data Reported per IP Discharge/ED and AS Encounter• Date of Birth, Admission Date, Discharge Date, Service Date• SSN, Patient ZIP Code• Sex, Ethnicity, Race, Preferred Language Spoken• Source of Admission (PDD Only), Disposition of Patient• Diagnoses, Procedures, External Causes of Injury/Morbidity• Expected Source of Payment• Total Charges (PDD Only)

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HIRC Role: Make Objective Healthcare Data AvailableWhat Data does OSHPD collect?

Other Data Reported to OSHPD

• Hospital Chargemasters and Charges for 25 Common Outpatient Procedures (410)

• Hospital Community Benefit Plans (220)

• Hospital Discount Payment Policies (Fair Pricing Policies) (405)

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HIRC’S Public Role

1. Make “Objective” Healthcare Data Available

2. Improve “Accessibility” to the Data

3. “Support” the Users of the Data

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HIRC Role: Improve Accessibility to the DataHow?

• By posting complete facility-level databases to the web in easy-to-use formats, such as Excel

• By creating aggregated summary products (Statewide, County-level, Hospital-level) and useful subsets

• By assisting researchers, hospitals, and local health departments through the process of getting approved for nonpublic data (IPA/AB2876 processes*)

• By offering custom run services from our nonpublic data which avoids the need for going through the process of getting approved for a nonpublic data set

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HIRC Role: Improve Accessibility to the Data*Standard Data Products Generated from PDD/ED/AS*

Full Product Listing: http://www.oshpd.ca.gov/HID/Product-Listing.html

• *Facility Summary Reports• *Pivot Profiles – annual summarized data

(Statewide/County/Hospital)• ICD-9/10-CM Code Frequency Reports (Statewide)• Patient Origin/Market Share Tools• Case Mix Index (PDD) – measure average patient acuity level• *Individual Hospital Top 25 MS-DRGs (PDD)• County Frequencies by Patient County of Residence

* Product Demo

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HIRC Role: Improve Accessibility to the DataOther Notable Products

• Facility Listings – name, address, county, licensed beds• AHRQ Quality Indicators (area-level)

• Prevention Quality Indicators (PQIs)• Pediatric Quality Indicators (PDIs)• Inpatient Quality Indicators (IQIs)

• Hospital Volume & Utilization Indicators• Hospital Inpatient Mortality Indicators (IMIs)

• Patient Safety Indicators (PSIs)• Cancer surgery volume• CABG outcomes/Hip Fracture Repair outcomes• 30-day Readmission Rates for AMI, Heart Failure, and

Pneumonia Patients in CA hospitals, 2007-2013

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HIRC’S Public Role

1. Make “Objective” Healthcare Data Available

2. Improve “Accessibility” to the Data

3. “Support” the Users of the Data

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HIRC Role: Support the Users of the DataHow?

• By making resources readily available that help you understand how the data was reported; includes Reporting Forms, Reporting Manuals/Instructions, Glossaries and Data Documentation

• By helping you identify the databases or data products that meet your needs

• By consulting internally with expert staff in the sections that collect the data

• By providing custom run services from large unwieldy databases

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Who Uses the Data?

• Healthcare Providers and Healthcare Facilities• County Health Departments• Government• Universities• Law Firms• Insurers• Investors• Media• Consultants• General Public

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Other Uses of PDD/ED/AS Data• Mental Health• Valley Fever• Preventable Hospitalizations for Ambulatory Care Sensitive

Conditions (e.g. asthma, diabetes, dehydration, heart failure)• MRSA• Cancer• Firearm Injuries• CDPH’s EpiCenter - California Injury Data Online

http://epicenter.cdph.ca.gov/

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Research Studies Using PDD/ED/AS Data

• Comparative Effectiveness of Moving to a Low-versus-High Poverty Neighborhood for Health Care Utilization and Costs of Care [Johns Hopkins]

• The California Maternal Data Center: Establishing a Statewide Data Center for Use in Rapid Cycle Maternity Care Improvement Programs [Stanford]

• The Affect of Air Quality Alerts on Respiratory Hospitalizations [UC Santa Cruz]

• Factors Associated with the Closure of Emergency Services Impact on Patient Outcomes; Effect of Unemployment on Emergency Department Utilization in California [UCSF]

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Summary

• Data, Data, Data!• Products, Products, Products!• Help is available!• Thank you for your commitment to reporting

QUALITY healthcare data!

Website: www.oshpd.ca.govFull Product Listing: http://www.oshpd.ca.gov/HID/Product-Listing.htmlEmail: HIRCweb@oshpd.ca.govPhone: 916.326.3802

California Health Information AssociationCalifornia Health Information Association

OSHPD Update: What’s New, What’s Here, What’s Coming

November 9, 2016

Starla LedbetterChief

Enterprise Services SectionStarla.Ledbetter@oshpd.ca.gov

CaliforniaHIA.org

Information Governance

• AHIMA IG Pilot Site

• CHHS Information Strategic Plan

• Data Governance at OSHPD

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AHIMA IG Pilot

• OSHPD was a site for AHIMA’s Information Governance pilot

• Tool: HealthRate

• Focusing on enhancing Data Governance

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CHHS Strategic Plan

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Driving Strategic Value

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Driving Strategic Value

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Roadmap

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OSHPD Data Governance

• Sub-committee of Strategic Governance

• Manages data for the Open Data Portal

• Active workgroups focusing on data issues

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OSHPD Data Bytes

• Snapshot of data

• Twitter: @CA_OSHPD

• Monthly Topics

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CHHS Open Data Portal

• Data Categories

• Data Visualizations

• Data News – Informative Blog

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chhs.data.ca.gov

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Data Catalog

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Dataset – ED by Disposition 2010-14

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Dataset – ED by Disposition, LA

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Data News

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OSHPD is Moving!