1. eHIVQUAL 2016 Overview February 15, 2017
5/15/2018 1:30 AM
eHIVQUAL 2016 Overview February 15, 2017
Christopher Wells
Data Analyst
NYSDOH AIDS Institute
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2. A brief history of eHIVQUAL
Application for reviewing quality of care for HIV+ patients in NYS
Retrospective calendar-year reviews
Microsoft Access versions
Migration to the web in 2010 for 2009 review
Secure site
Registered users
Trend toward including fewer indicators but more patients (EtE and cascade of care focus)
Increased use of data import features to accommodate this (information for those partnering with Azara will be provided at the end of this presentation)

3. Where eHIVQUAL fits this year
In addition to eHIVQUAL, the 2016 quality of care review will include:
Organizational cascades (underway)
Tobacco cessation campaign (pending)
Stigma survey (pending)

4. Why both eHIVQUAL and Cascade?
Linkage data not captured in eHIVQUAL
Cascades can be creative and include elements beyond required measures
Two aspects of capacity building
Querying patient-level data
Reporting findings and conducting QI work
eHIVQUAL will serve as a “reality check” on the cascades, but submission of cascades can occur before eHIVQUAL data are approved

5. Scope of review: open and active patients
Definitions:
Open patients: All patients, regardless of age, with a known diagnosis of HIV who received any clinical service(s) in the organization during the review period. Includes patients seen for routine, urgent, emergent and/or inpatient care.
Active patients: All patients who were enrolled in your HIV program as of the end of 2016 and who were seen for at least one clinical visit in 2016.
Non-active patients: All other patients in your open patient caseload. Includes patients who, as of the end of the year, were deceased, incarcerated, in care elsewhere or of unknown care status.

6. Scope of review: open and active patients (continued)
Open caseload: HIV+ patients who “touched the facility” in 2016.

7. Scope of review: open and active patients (continued)
Active caseload: HIV+ patients who received services in the HIV program and remained enrolled as of 12/31/16.

8. Scope of review: open and active patients (continued)
Required to enter/upload all “open patients” but may sample active patients for STI indicators
Implications for different types of organizations
The ratio of open to active patients may vary depending on variety of services offered
Networks:
Active patients attributed to site of enrollment
Inactive patients entered wherever seen most often
Ratio of open to active patients will vary

9. Care-status categories and required data
Active patients
Non-active patients
Deceased
Incarcerated
In care elsewhere
Unknown care status

10. Care-status categories and required data (continued)
STI data not required

11. Care-status categories and required data (continued)
STI data not required
VLS, ART and most of the patient characteristics data are not required

12. Care-status categories and required data (continued)
STI data not required

13. Care-status categories and required data: complete chart
STI data not required
VLS, ART and most patient characteristics data are not required

14. Care-status categories and required data: summary table

15. Indicators Antiretroviral therapy
Suppressed on last VL of review period
Syphilis treatment
No screening question
Any treatment v. appropriate treatment
Gonorrhea testing and treatment
Extra-genital testing for MSM/MtF (pharyngeal and rectal)
Chlamydia testing and treatment
Extra-genital testing for MSM/MtF (rectal)

16. Other data elements Patient identifying information Care status
Name
DOB
MRN
Sex
Race/ethnicity
Exposure risk
Diagnosed during review period
Care status
Insurance status at last status check
Housing status

17. Options for entering the data
Manual data entry (form pending)
Can use previously entered information in some cases
Some data elements are not required for some patients
Import templates (data dictionary pending)
Data must match specifications exactly
Some elements may be difficult to query from medical records systems
No typing required!
Hybrid approaches

18. Guidance and support: documentation
eHIVQUAL documentation
Indicator guide and algorithms (posted)
User guide (pending)
Sampling methodology (pending)
Import instructions (pending)
Webinars (announcement pending)
Importing data
Running reports
Validating and submitting data

19. Guidance and support: obtaining further help
Group account
Role of principal AI staff
Chris Wells, Data Analyst
Daniel Belanger, Director, NYS Quality of Care Program
Role of QI coaches (including other AI staff)
Steven Sawicki
Susan Weigl
Nanette Brey Magnani
Nova West
Clemens Steinbock

20. Timeline
Registration: 2nd half of February (ongoing support as needed)
Application launch: late February
Webinars: March
Data entry and import options
Reports
Validation and submission
Submission deadline: extended to 4/30/17
But, cascade deadline remains 3/31/17

21. This concludes the main portion of our presentation….
QUESTIONS?

22. A word to our colleagues who are working with Azara Healthcare
At the request of CHCANYS, Azara Healthcare, a data analytics company based in Burlington, MA, has contracted with 18 FQHCs to facilitate extraction of data for the eHIVQUAL review (not cascades)
Two extracts to be produced by Azara
Initial: 3/1/17
Final: 3/31/17
Now is the time to review EHR mappings with Azara (sample extracts and CPCI reports)
FQHCs will need to specify which patients are active, deceased, incarcerated or in care elsewhere
We will be pilot testing the data handling processes for this as soon as possible