State data disparity creates IT challenges

Quality, timeliness vary widely across the country

NASHVILLE, TN – It’s difficult for healthcare organizations to make informed, data-driven decisions when the data they receive from state agencies is incomplete or slow to arrive.

“If organizations wait to use the hospital discharge data compiled by state agencies and sent to the Agency for Healthcare Research and Quality (AHRQ), it’s going to be pretty dated by the time they get their hands on it,” said Nancy Foster, the American Hospital Association’s vice president of quality and patient safety.

“That’s why many hospitals rely on ORYX-certified data aggregators – including state hospital associations and the Veterans Health Administration – to collect data from facilities all over the country.”

“Some states do a much better job than others,” said Jason Moore, president of Nashville-based Stratasan. “Florida is one of the best in the nation in providing hospital discharge data that’s timely, comprehensive and reasonably priced. And Virginia will likely be the first state to release first quarter 2012 discharge data. But the quality and timeliness of the data varies widely from state to state.”

Stratasan serves its hospital clients by purchasing raw state data, running quality checks, and putting the reams of information into a usable format.

“Hospitals are looking for information that’s timely and actionable,” added Moore. “I’m not aware of any hospital that makes strategic decisions based on the AHRQ report. It provides more of an overview, not an action plan.”

There are now major federal initiatives that are bypassing the states to disseminate hospital discharge data and much more. The National Hospital Care Survey (NHCS) will soon be integrating data from the National Hospital Discharge Survey and a variety of other sources.

“In 2011, the NCHS recruited a nationally representative sample of 500 hospitals to directly submit UB-04 administrative claims,” said Carol J. DeFrances, CDC’s team leader at the National Center for Health Statistics.

“In 2013, participating hospitals will also be asked to provide healthcare data on a sample of visits to their emergency and outpatient departments, as well as their ambulatory surgery locations.”

As the scope of NCHS widens, state data may one day be seen as “too little, too late.”

“NCHS will soon be collecting Protected Health Information (PHI) to allow linkage of patient data across hospital settings and to other data sources such as the National Death Index (NDI) and the Medicare and Medicaid claims databases,” said DeFrances. “Linkage to the NDI will allow researchers to conduct a wide range of outcome studies, such as 30-day mortality from hospital discharge.”

Some observers say that getting faster, more accurate data will have a greater impact on hospital financial performance than on quality efforts.

“Right now, it’s difficult for IT systems to collect reliable quality data,” said Foster. “Most of the quality measures in place today assume that a clinically savvy person will be the one extracting the information from electronic records. But we haven’t been able to make that marriage work yet. We either have to retool the quality measures or improve the savvy of the machines so they can make some of those judgments.”