Agency for Healthcare Research and Quality Advancing Excellence in Health Care A Web-Based Tool for Quality and Utilization Reporting Anne Elixhauser September 14, 2009

Advancing Excellence in Health Care MONAHRQ – My Own Network, powered by AHRQ Transforming your health care data into information about health, costs, and quality of care.

Advancing Excellence in Health Care Rationale Why should it be so expensive to generate and put out basic information? Why should it be so expensive to generate and put out basic information? Why should information be so hard to get? Why should information be so hard to get? Why does every organization have to reinvent the wheel? Why does every organization have to reinvent the wheel?

Advancing Excellence in Health Care From Data to Information to Action Hospital discharge data can generate valuable healthcare information Information can be used to make decisions Hospital discharge data are already being collected Utilization and costs of care in hospitals Quality of care in hospitals Rates of diseases in particular areas Rates of procedures in particular areas Preventable hospital stays that indicate breakdowns in care

Advancing Excellence in Health Care Currently based on hospital discharge data Host user downloads MONAHRQ software from AHRQ website Host user applies software to own data locally Software Host user creates local website on their own server Host user makes website available Internally to better understand own data and to answer questions Internally to better understand own data and to answer questions To member organizations, e.g., through a password protected site To member organizations, e.g., through a password protected site Publicly to provide information to the community Publicly to provide information to the community State Healthcare Information Portal Key features of MONAHRQ…

Advancing Excellence in Health Care Select the information you want: QUALITY INDICATORS AVOIDABLE HOSPITALIZATIONS RATES UTILIZATION S tate H ealthcare I nformation P ortal The End User Website

Advancing Excellence in Health Care Two quality paths to choose from S tate H ealthcare I nformation P ortal

Advancing Excellence in Health Care Consumer path on Quality Indicators S tate H ealthcare I nformation P ortal Arrays information on up to four hospitals for the indicators selected. Click on any indicator and get detailed information in graphic form.

Advancing Excellence in Health Care Details in graphic form Get details for each hospital in rank order, compared to the state average.

Advancing Excellence in Health Care Detailed path on Quality Indicators S tate H ealthcare I nformation P ortal The detailed path provides more information for each indicator.

Advancing Excellence in Health Care Overall results for the state S tate H ealthcare I nformation P ortal Information on specific indicators for the entire dataset: numerators denominators observed, expected and risk-adjusted rates confidence intervals Click on indicator for hospital-specific information

Advancing Excellence in Health Care Results by individual hospital S tate H ealthcare I nformation P ortal Information on: numerators denominators observed, expected and risk-adjusted rates confidence intervals

Advancing Excellence in Health Care Potentially Avoidable Hospitalizations S tate H ealthcare I nformation P ortal Potentially Avoidable Hospitalizations – based on AHRQ’s Prevention Quality Indicators (PQIs – ambulatory care sensitive conditions)

Advancing Excellence in Health Care Potentially Avoidable Hospitalization Path Rates for avoidable admissions by county – Highest rates in dark blue, lowest rates in light blue Click on Summary Table for more details

Advancing Excellence in Health Care Potential cost savings associated with reducing preventable admissions Details on avoidable admissions by county, including cost savings. Can download to Excel.

Advancing Excellence in Health Care Rates of Conditions and Procedures Path S tate H ealthcare I nformation P ortal Rates of health conditions and procedures – Use county populations as the denominator in prevalence rates

Advancing Excellence in Health Care Groupings of diagnoses and procedures S tate H ealthcare I nformation P ortal Can get information on prevalence of conditions or procedures by DRG, MDC, or CCS

Advancing Excellence in Health Care Search function S tate H ealthcare I nformation P ortal

Advancing Excellence in Health Care Tabular results by county Counties For all counties in the state: numbers of discharges and rate per 1,000 population. Click on Map to view graphic display.

Advancing Excellence in Health Care Map of rates by county Rates for specific conditions and procedures by county – Highest rates in dark blue, lowest rates in light blue

Advancing Excellence in Health Care Utilization path S tate H ealthcare I nformation P ortal Utilization statistics (similar to information from HCUPnet)

Advancing Excellence in Health Care Utilization across all conditions, entire state All conditions for entire database, listed by number of discharges Click on any column header to re-sort by: charges/costs LOS percent died or condition/procedure

Advancing Excellence in Health Care Utilization on individual conditions… S tate H ealthcare I nformation P ortal Can also search for utilization information on individual conditions

Advancing Excellence in Health Care … for individual hospitals

Advancing Excellence in Health Care Detailed utilization for all hospitals Counties Information on: numbers of discharges, charges, costs, length of stay, percent died for all hospitals individually. National, regional, and state benchmarks included.

Advancing Excellence in Health Care More details for individual hospitals The same information is available for individual hospitals, by age group gender payer race

Advancing Excellence in Health Care How do you get there?

Advancing Excellence in Health Care Import Data Wizard The Import Data Wizard takes you through a step-by-step process of: importing your data, mapping it to the format required by MONAHRQ, analyzing the data, and defining your hospitals and regions.

Advancing Excellence in Health Care Select your data file

Advancing Excellence in Health Care Map data elements You map your data to the format required by MONAHRQ by clicking and dragging data elements.

Advancing Excellence in Health Care Map input values You then define your data elements to values understood by MONAHRQ (based on UB04 standard).

Advancing Excellence in Health Care Load your data

Advancing Excellence in Health Care Run analysis

Advancing Excellence in Health Care Build your website

Advancing Excellence in Health Care The Website Wizard takes you through a step- by-step process of processing your data and building your website. MONAHRQ Website Wizard

Advancing Excellence in Health Care Cell suppression and other parameters Set thresholds for cell suppression (to protect confidentiality) and other parameters.

Advancing Excellence in Health Care Select which measures to include in website Can specify which QIs to include. Measures endorsed by the National Quality Forum are identified.

Advancing Excellence in Health Care Customize your website Specify your website: where it should be stored which pages you want to include specifics about the style insert your logo what the website calls your data

Advancing Excellence in Health Care The final product S tate H ealthcare I nformation P ortal

Advancing Excellence in Health Care What makes MONAHRQ unique? Organizations create and host Organizations create and host their own website and upload their own data Local organizations do quality reporting using a standard, validated method Local organizations do quality reporting using a standard, validated method End users draw together multiple data sources End users draw together multiple data sources providing information at the local level organizations and consumers to use data to make informed decisions Empowers organizations and consumers to use data to make informed decisions MONAHRQ