1. USHIK: Data Standardization to Support Public Health Services Public Health Data Consortium’s 2012 Annual Meeting J. Michael Fitzmaurice, Ph.D. Agency for Healthcare Research and Quality November 8, 2012

2. 2 Agency for Healthcare Research and Quality (AHRQ) Mission Improve the quality, safety, efficiency and effectiveness of health care for all Americans

3. Agenda Collaboration Collaboration – X12 Implementation Guide – Gap Assist Tool—PHDSC web site USHIK -- ushik.ahrq.gov USHIK -- ushik.ahrq.gov – All-Payer Claims Data Portal – Meaningful Use Portal 3

4. Agenda Collaboration on Standards Collaboration on Standards – AHRQ, NCHS, PHDSC, NAHDO/APCD, ASC X12 United States Health Information Knowledgebase United States Health Information Knowledgebase – All-Payer Claims Databases (APCD) – Meaningful Use 4

5. Stds CF MU SIF APCD 5 USHIK Information Models Standards Developing Organizations Health Information Technology Standards Panel Patient Safety Common Formats Meaningful Use All-Payer Claims Data Standards and Interoperability Framework USHIK Portals HITSP

6. USHIK’s APCD Portal What data? All-Payers Claims Data that includes: medical, dental, and pharmacy claims, eligibility files, provider files, What data? All-Payers Claims Data that includes: medical, dental, and pharmacy claims, eligibility files, provider files, – Coming from public and private payers--Medicare, Medicaid, pharmacy benefit managers, dental benefit administrators, CHIP, FEHB, Tricare, private ins., … Purpose? To support State initiatives to harmonize their health data element definitions and codes Purpose? To support State initiatives to harmonize their health data element definitions and codes What can you do in USHIK? What can you do in USHIK? – List the data elements and their metadata from each state, all states, any combination – Compare data element specifications from APDC states, from APCD Council, from ASC X12 – Download the lists and comparison matrices in Excel, pdf, or XML 6

7. ASC X12 Implementation Guide This effort is to coordinate and facilitate the maintenance of an implementation guide for assisting states in reporting their health care service data This effort is to coordinate and facilitate the maintenance of an implementation guide for assisting states in reporting their health care service data – For such uses as quality measures, utilization of services, and public health assessment studies – In accordance with the HIPAA standard—the X12 837 institutional claims standard, version 4010 – Version 5010 is in development; Version 4010 is available now from ASC X12, for a fee – Data elements in addition to those needed for paying claims, such as race and ethnicity, county code, and present on admission, are included in the Guide – The goal is to standardize public health administrative data for care delivered in an institutional setting 7

8. PHDSC: Gap Assist Tool Partnership with: AHRQ-USHIK, NCHS, PHDSC, NAHDO/APCD, ASC X12 Partnership with: AHRQ-USHIK, NCHS, PHDSC, NAHDO/APCD, ASC X12 98 data elements from the ASC X12 Institutional (837) claim standard 98 data elements from the ASC X12 Institutional (837) claim standard This tool lets you know the availability of these 98 data elements and their metadata—in different versions of the X12 837 claims standard This tool lets you know the availability of these 98 data elements and their metadata—in different versions of the X12 837 claims standard – 4050-- 5010 -- 6020 (coming soon)\ And hence in states’ health claims data bases And hence in states’ health claims data bases 8

9. USHIK: Meaningful Use 2 Sources of Truth Sources of Truth – CMS for Clinical Quality Measures [Measure developers, NQF] – NLM for Measure Value Sets [Measure developers, NQF] USHIK—One stop shop USHIK—One stop shop – CQM’s, data elements – QM computational logic – Code values for data elements (Value Sets) – Logical organization – User requested download formats: XML, Excel, pdf, SVS, CSV, CTS2 XML, Excel, pdf, SVS, CSV, CTS2 – Version comparisons—see what changed – CQM comparisons—see what is different – Which CQM’s use a given value set? – Download all Value Sets in one combined file--CVS 9

10. Benefit to AHRQ Leadership in funding clinical quality measure Leadership in funding clinical quality measure – Development – Validation – Public availability in USHIK, NQMC – Organization and computational logic – Informatics application More uniform, accurate, computerized, valid health data More uniform, accurate, computerized, valid health data – Leading to more robust research findings and subsequent greater research tool acceptability A benefit to you A benefit to you 10

11. USHIK: Data Standardization to Support Public Health Services Public Health Data Consortium’s 2012 Annual Meeting J. Michael Fitzmaurice, Ph.D. Agency for Healthcare Research and Quality November 8, 2012