California Department of Health Care Services Newborn Hearing Screening Program HCC Semi Annual Meeting June 14, 2010 Sacramento, CA & June 15, 2010 Walnut Creek, CA Bay Area/Northern California Hearing Coordination Center Regions A & B

California Department of Health Care Services Newborn Hearing Screening Program Agenda Introductions Overview of the Newborn Hearing Screening Program (NHSP) Goals of the NHSP/EDHI Tracking and Monitoring Challenges Who is Neometrics? Overview of the Data Management Service Next Steps

California Department of Health Care Services Newborn Hearing Screening Program DHCS  Joleen Heider-Freeman, RD, Chief, Statewide Programs Section  Hallie Morrow, M.D., M.P.H., NHSP Medical Consultant  Katherine Neto, Chief, Hearing & Audiology Services Unit  Jennifer Sherwood, M.A., Audiology Consultant, NHSP  Ursula Pareja, Contract Manager (Regions A/B)  Deborah Hunt, Ph.D., CSUS HCC  Beth Lannon, Director, BA/NC HCC Neometrics  Bill Mince, Vice President Operations  Joe Amato, General Manager  Gena Curtis, Client Service Manager Introductions

California Department of Health Care Services Newborn Hearing Screening Program Agenda Introductions Overview of the Newborn Hearing Screening Program (NHSP) Goals of the NHSP/EDHI Tracking and Monitoring Challenges Who is Neometrics? Overview of the Data Management Service Next Steps

California Department of Health Care Services Newborn Hearing Screening Program Established in 1998 by California Law as the Newborn and Infant Hearing Screening, Tracking and Intervention Act. Requirements of the 1998 law:  Every CCS-Approved general acute care hospital with licensed perinatal services shall offer a hearing screening test using protocols approved by the State. Expansion in 2008:  The law was further amended to include: every general acute care hospital with licensed perinatal services shall administer to every newborn, upon birth admission, a hearing screening test. Overview of NHSP

California Department of Health Care Services Newborn Hearing Screening Program Implemented in 2000 NHSP follows the national EHDI guidelines Requires all hospitals with licensed perinatal services and/or NICU to report to DHCS or designee Overview of NHSP (continued)

California Department of Health Care Services Newborn Hearing Screening Program Hearing Coordination Centers  Unique to California  Assures families are linked with services, minimizing the number of babies lost to follow-up  Regional support to all hospitals by: Providing technical assistance and consultation to hospitals in setting up and maintaining programs Certifying inpatient screening providers Collecting data Overview of NHSP (continued)

Hearing Coordination Centers (continued)  Tracking Infants Screening/rescreening Diagnostic services Notification of PCP Early Start referrals  Quality assurance activities Monitor hospital screening and referral rates Provide feedback to hospitals Identify training opportunities  Education and community outreach California Department of Health Care Services Newborn Hearing Screening Program Overview of NHSP (continued)

California Department of Health Care Services Newborn Hearing Screening Program Agenda Introductions Overview of the Newborn Hearing Screening Program (NHSP) Goals of the NHSP/EDHI Tracking and Monitoring Challenges Who is Neometrics? Overview of the Data Management Service Next Steps

Why We Are Here Why is Data Management Service (DMS) critical to the NHSP?  Manual tracking system  Expansion of the program  HCCs databases  Consolidation of requirements Hospital insight  Limited resources  Mandatory fields  Risk factors

California Department of Health Care Services Newborn Hearing Screening Program 1 – 3 – 6 Goals  1 month of age: hearing screening to all newborns  3 months of age: diagnostic audiologic evaluation to all newborns who do not pass the screening  6 months of age: entry into early intervention services, for newborns with hearing loss Informational materials to families Results to primary care providers Goals of the Program

California Department of Health Care Services Newborn Hearing Screening Program DHCS to CDC  Mandatory reporting required to the CDC (Federal Centers for Disease Control and Prevention) HCCs to DHCS  Mandatory reporting to DHCS quarterly on all activities including data reported by hospitals, as well as ad-hoc reports Hospitals to HCCs  Patient-specific demographic data  Results of screens Reporting Requirements

California Department of Health Care Services Newborn Hearing Screening Program Hearing loss occurs more frequently than any other congenital condition Negative consequences of late identification of hearing loss Early identification and intervention by 6 months of age has shown to result in age- appropriate language development Why We Screen

California Department of Health Care Services Newborn Hearing Screening Program Agenda Introductions Overview of the Newborn Hearing Screening Program (NHSP) Goals of the NHSP/EDHI Tracking and Monitoring Challenges Who is Neometrics? Overview of the Data Management Service Next Steps

California Department of Health Care Services Newborn Hearing Screening Program Difficulties when: Manually tracking and reviewing of records Tracking babies transferring to another hospital Identifying babies not screened as inpatient Hospital monitoring screen and refer rates Reporting process Current Reporting Challenges

California Department of Health Care Services Newborn Hearing Screening Program Current system:  In manual form, you are unable to Search Report Collate Review DMS Benefits:  Hospitals get real-time data on screen status  Ad-hoc reports can be generated by hospital users  Hospital users can generate work lists as needed  Hospital can monitor screener performance Challenge: Manual Review of Data

California Department of Health Care Services Newborn Hearing Screening Program Current system:  Receiving hospital not always aware of screen status  Receiving hospital not always aware if baby is in non NICU unit  Required to send in status reports for all transferred babies DMS Benefits:  Transfers are recorded as they occur  Hospitals are no longer required to generate transfer reports  Real-time status is available for State, HCC and hospital users  Audit trail details the history of movement  Automatic action creation helps curb lost to follow-up Challenge: Managing Transfers

California Department of Health Care Services Newborn Hearing Screening Program Current system:  Hospital birth log is the only mechanism that can be used to determine whether or not a baby has been missed  Easy to miss babies No central collection point for data DMS Benefits :  Reports can be generated to reconcile birth log to the DMS data  Immediate ID of infants not screened Challenge: Identifying Missed Babies

California Department of Health Care Services Newborn Hearing Screening Program Current system:  It is not possible to easily determine screen and refer rates for a hospital. DMS Benefits:  Central data collection point captures screen and refer rates.  Data can be used for QA for hospital staff to improve screening process  Data can be used for staff education Challenge: Monitoring of Hospital Screen & Refer Rates

California Department of Health Care Services Newborn Hearing Screening Program Current system:  Hospitals are required to report information via paper and FAX: IRF Weekly reports Monthly report Transfer Status Reports DMS Benefits:  Hospitals are no longer required to report information via paper and FAX: IRF forms Weekly reports Monthly report Transfer Status Reports Challenge: Reporting Process

California Department of Health Care Services Newborn Hearing Screening Program Agenda Introductions Overview of the Newborn Hearing Screening Program (NHSP) Goals of the NHSP/EDHI Tracking and Monitoring Challenges Who is Neometrics? Overview of the Data Management Service Next Steps

California Department of Health Care Services Newborn Hearing Screening Program Who is Neometrics? Leading provider of data management software for Newborn Screening market In business since 1978 Acquired by Natus Medical in 2003 Staff has over 100 years experience in the Newborn Screening market Working with NLM, HRSA and government agencies to maintain compliance with state and federal initiatives

California Department of Health Care Services Newborn Hearing Screening Program Neometrics Products StateMSDSCMSiCMSEDTSRVFIMdCMSVRSHearing AlabamaXX2011 XX ArizonaXXXX CaliforniaXX DelawareXXXXXXX LouisianaXXX MissouriXX New JerseyXXX New YorkXXXXXX OklahomaXX2011 XXXX OregonXX2011X TennesseeXXXXX TexasXX WashingtonXXXX West VirginiaX

California Department of Health Care Services Newborn Hearing Screening Program Agenda Introductions Overview of the Newborn Hearing Screening Program (NHSP) Goals of the NHSP/EDHI Tracking and Monitoring Challenges Who is Neometrics? Overview of the Data Management Service Next Steps

Overview will cover the following topics:  Critical Information on Data Requirements for Hospitals  Help for Hospitals to select Data Transmission Modes  Brief review of DMS Functionality California Department of Health Care Services Newborn Hearing Screening Program Overview of the Data Management Service

Overview will cover the following topics:  Critical Information on Data Requirements for Hospitals  Help for Hospitals to select Data Transmission Modes  Brief review of DMS Functionality California Department of Health Care Services Newborn Hearing Screening Program Overview of the Data Management Service

Infant last name Infant DOB Infant gender Infant birth order Screener name Screen type (right/left) Screen result (right/left) California Department of Health Care Services Newborn Hearing Screening Program Required Fields for All Infants

California Department of Health Care Services Newborn Hearing Screening Program Hospitals will no longer be required to print the Infant Report Form (IRF) Hospitals will no longer be required to submit the weekly transmittal form to the HCC Hospitals will be phased-out of the option for faxing information to the HCCs as the system is implemented The number of reports hospitals are now required to submit will be significantly lower Reporting Requirements: What YOU Want to Know

California Department of Health Care Services Newborn Hearing Screening Program Outpatient screening providers will continue to report screening results using the ORF Diagnostic providers will continue to report diagnostic evaluation results using the DRF OP and DX providers will continue to receive hard copies of IP screen results from the hospital Reports will be faxed to the HCC at least weekly At this time, OP and DX providers will not have access to the DMS Outpatient and Diagnostic Providers

California Department of Health Care Services Newborn Hearing Screening Program No new NHSP standards will be issued Policies and procedures will need to be updated to reflect the new reporting procedures HCCs will assist with this process Standards, Policies and Procedures

Overview will cover the following topics:  Critical Information on Data Requirements for Hospitals  Help for Hospitals to Select Data Transmission Modes  Brief review of DMS Functionality California Department of Health Care Services Newborn Hearing Screening Program Overview of the Data Management Service

California Department of Health Care Services Newborn Hearing Screening Program Computer Hardware and Software  The hospital is required to provide a PC with access to the DMS website  The hospital is responsible for configuring the interface for data transmission  Technical assistance will be provided Equipment Requirements

California Department of Health Care Services Newborn Hearing Screening Program Hospital Staff have access to a PC with Internet access to DMS website? Screening Device  Export capable?  What Data Fields are captured? Hospital HIS  Able to send data after admission of newborn?  Able to load result data from device?  Able to send data after device upload? Data Transmission Selection

Screening Device Export Cart Based Screening Devices ALGO 5, ABaer, and IHS screeners are capable of exporting to a local network location Contact the tech support group for your device manufacturer for more details Device Device Export Mode Intermediary Software Output ALGO 5Network / median/aHi-Track, XML IHSNetwork / median/aHi-Track ABaer/HSSNetwork / median/aHi-Track A2eMediaADAMHi-Track A2e colorMediaADAMHi-Track ALGO 3MediaADAMHi-Track

California Department of Health Care Services Newborn Hearing Screening Program Screening Device Export Handheld Screening Devices Echoscreen and A3i devices require intermediary software to move data off of the devices. Contact the tech support group for your device manufacturer for more details Device Device Export Mode Intermediary Software Output EchoScreenManualEcholinkHi-Track A3iManualDUSHi-Track

California Department of Health Care Services Newborn Hearing Screening Program Data Transmission Selection Can your screening device?Is the hospital HIS capable of: Is there a PC with internet access in your nursery? Export data? Capture required demographic fields? Sending admission data? (ADT) Loading screening results from the device Transmitting screening data (ORU) Your Transmission mode YesNo Manual Yes No Semi-Automatic (Upload) Yes No Semi-Automatic (single, batch) YesNo YesNo Semi-Automatic (EDT) Yes No Fully Automatic (batch) Yes Fully Automatic (batch,HL7)

California Department of Health Care Services Newborn Hearing Screening Program Transmission Mode: Manual DHCS Hospital Hearing Screener INTERNET Data Entry DMS HIS Face Sheet Birth Log Risk Factors Demographic Data –Data entered into the DMS in the manual demographic entry module Hearing Result Data –Data entered into the DMS in the manual hearing screening results module Risk Factors –Data entered manually Can your screening device?Is the hospital HIS capable of: Is there a PC with internet access in your nursery? Export data? Capture required demographic fields? Sending admission data? (ADT) Loading screening results from the device Transmitting screening data (ORU) Your Transmission mode YesNo Manual

California Department of Health Care Services Newborn Hearing Screening Program Transmission Mode: Semi-Auto (upload) DHCS Hospital Hearing Screener INTERNET Data Entry DMS HIS Face Sheet Birth Log Risk Factors Upload Can your screening device?Is the hospital HIS capable of: Is there a PC with internet access in your nursery? Export data? Capture required demographic fields? Sending admission data? (ADT) Loading screening results from the device Transmitting screening data (ORU) Your Transmission mode Yes No Semi-Automatic (Upload) Demographic Data –Data entered into the DMS in the manual demographic entry module Hearing Result Data –Uploaded from the device into the DMS Risk Factors –Data entered manually

California Department of Health Care Services Newborn Hearing Screening Program Transmission Mode: Semi-Auto (single) DHCS Hospital Hearing Screener INTERNET Data Entry DMS HIS Face Sheet Birth Log Risk Factors Upload Can your screening device?Is the hospital HIS capable of: Is there a PC with internet access in your nursery? Export data? Capture required demographic fields? Sending admission data? (ADT) Loading screening results from the device Transmitting screening data (ORU) Your Transmission mode Yes No Semi-Automatic (single, batch) Demographic Data –Entered into the DMS in the manual demographic entry module Hearing Result Data –Uploaded from the device into the DMS Risk Factors –Data entered manually OR

California Department of Health Care Services Newborn Hearing Screening Program Transmission Mode: Semi-Auto (batch) DHCS Hospital Hearing Screener INTERNET Data Entry DMS HIS Face Sheet Birth Log Risk Factors Upload Can your screening device?Is the hospital HIS capable of: Is there a PC with internet access in your nursery? Export data? Capture required demographic fields? Sending admission data? (ADT) Loading screening results from the device Transmitting screening data (ORU) Your Transmission mode Yes No Semi-Automatic (single, batch) Demographic Data –Entered into the DMS in the manual demographic entry module Hearing Result Data –Uploaded from the device into the DMS Risk Factors –Data entered manually OR Face Sheet Face Sheet Face Sheet

California Department of Health Care Services Newborn Hearing Screening Program Transmission Mode: Semi-Auto (EDT) DHCS Hospital Hearing Screener INTERNET Data Entry DMS HIS Face Sheet Birth Log Risk Factors HL7 (ADT) Can your screening device?Is the hospital HIS capable of: Is there a PC with internet access in your nursery? Export data? Capture required demographic fields? Sending admission data? (ADT) Loading screening results from the device Transmitting screening data (ORU) Your Transmission mode YesNo YesNo Semi-Automatic (EDT) Demographic Data –Transmitted to the DMS via HL7 ADT message Hearing Result Data –Entered into the DMS Hearing Screening Result module Risk Factors –Data entered manually

California Department of Health Care Services Newborn Hearing Screening Program Transmission Mode: Fully Auto (batch) DHCS Hospital Hearing Screener INTERNET Data Entry DMS HIS Face Sheet Birth Log Risk Factors Upload HL7/ ADT Can your screening device?Is the hospital HIS capable of: Is there a PC with internet access in your nursery? Export data? Capture required demographic fields? Sending admission data? (ADT) Loading screening results from the device Transmitting screening data (ORU) Your Transmission mode Yes No Fully Automatic (batch) Face Sheet Face Sheet Face Sheet Face Sheet OR Demographic Data –Transmitted to the DMS via HL7 ADT message Hearing Result Data –Uploaded from the device into the DMS Risk Factors –Data entered manually

California Department of Health Care Services Newborn Hearing Screening Program Transmission Mode: Fully Auto (HL7) DHCS Hospital Hearing Screener INTERNET Data Entry DMS HIS Face Sheet Birth Log Risk Factors HL7 Can your screening device?Is the hospital HIS capable of: Is there a PC with internet access in your nursery? Export data? Capture required demographic fields? Sending admission data? (ADT) Loading screening results from the device Transmitting screening data (ORU) Your Transmission mode Yes Fully Automatic (batch,HL7) Demographic Data –Transmitted to the DMS via HL7 ADT message Hearing Result Data –Screening Results are transmitted to the HIS –Screening Results are transmitted to the DMS via HL7 ORU message Risk Factors –Data entered manually

Overview will cover the following topics:  Critical Information on Data Requirements for Hospitals  Help for Hospitals to select Data Transmission Modes  Brief review of DMS Functionality California Department of Health Care Services Newborn Hearing Screening Program Overview of the Data Management Service

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview - Functionality Main DMS Tasks Data Entry Optimization Search Capabilities Daily Worklist Transfers

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview - Functionality Main DMS Tasks Data Entry Optimization Search Capabilities Daily Worklist Transfers

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview - Functionality Data Entry Optimization Mandatory Fields are clearly defined Data Controls speed entry and promote data integrity

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview - Functionality Main DMS Tasks Data Entry Optimization Search Capabilities Daily Worklist Transfers

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Search Capabilities Search criteria allows users to use wildcard searches Multiple criteria entry Multiple results are displayed to refine selection options

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Search Capabilities Data Grids support Pivot technology

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Search Capabilities Data Grids support Pivot technology

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Search Capabilities Data Grids support Pivot technology

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview - Functionality Main DMS Tasks Data Entry Optimization Search Capabilities Daily Worklist Transfers

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Daily Worklist Staff uses DMS to view daily work list

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview - Functionality Main DMS Tasks Data Entry Optimization Search Capabilities Daily Worklist Transfers

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Transfers DMS allows users to initiate transfers on-line

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Transfers 1-click functionality to accept transfers

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Transfers Minimal clicks required to accept transfers

California Department of Health Care Services Newborn Hearing Screening Program DMS Overview – Functionality Transfers Transfer Status screen replaces weekly status report

California Department of Health Care Services Newborn Hearing Screening Program Agenda Introductions Overview of the Newborn Hearing Screening Program (NHSP) Goals of the NHSP/EDHI Tracking and Monitoring Challenges Who is Neometrics? Overview of the Data Management Service Next Steps

California Department of Health Care Services Newborn Hearing Screening Program Hospital data transmission mode  Communication within hospital  Communication with NHSP (CSUS)  Communication from Neometrics Training  Schedule  Manuals  Help line Next Steps

Implementation  HCC Pilot  Statewide HCC roll out  Pilot hospitals  Statewide hospitals roll out Implementation

Data collected through the County Vital Statistics cannot be used for the NHSP That data is not available in the timeframe required by the NHSP to meet the goals of Collection of NHSP data is time sensitive HIPAA concerns California Department of Health Care Services Newborn Hearing Screening Program Other Questions

California Department of Health Care Services Newborn Hearing Screening Program Thank you!