Practical Preparation for the Public Reporting of Benchmark Data

1
Practical Preparation for the Public Reporting
of Benchmark Data

• Stephanie Lenzner, MSHA, MBA
• Director of Clinical Data Management
• Childrens Hospital of Wisconsin
• October 10, 2006

2
Presentation Highlights

• Approach to benchmarking
• Interpretation of public reporting
• Practical preparation
• What is CHW doing?
• How are we doing it?
• Recommendations and next steps

3
CHWs Approach to Benchmarking

• Benchmark where and when we can
• Against ourselves
• Against the evidence
• Against pediatric peers
• National and local agencies/payers (including
  adults)
• If we want to eliminate or increase do not
  waste resources to determine a benchmark when the
  ultimate goal should be 0 or 100

4
CHWs Approach to Benchmarking

• Measure clinical programs and develop measures
  across the 6 dimensions from IOM
• Safe, Effective, Efficient, Equitable, Patient
  Centered and Timely
• Collaborate with clinicians and families for
  interpretation and recommendations
• Transparency is key
• Definitions and assumptions
• Appropriate display and interpretation
• Results internally and externally

5
Interpretation of Public Reporting

• Means a lot of different things to a lot of
  different people
• It is complicated, confusing and conflicting
• Roles are blurred
• It is emotional and political
• Stakes are high

6
Interpretation of Public Reporting

• Wide variation in the methods used to summarize
  hospital and physician performance
• Variation can lead to significantly different
  conclusions
• Voluntary and mandated participation

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Who Cares?

• We all should
• Responsibility to inform consumers of value, not
  just low cost options (quality/safety and cost)
• Impacts contracting, accreditation and
  certification
• Poor presentation could negatively impact
  finances, market share and reputation

8
National Examples

• Agency for Healthcare Research and Quality (AHRQ)
  Indicators
• http//www.qualityindicators.ahrq.gov/
• Leapfrog Hospital Quality and Safety Survey
  http//leapfroggroup.org/
• Healthgrades Physician and Hospital Information
  http//www.healthgrades.com/consumer/
• JCAHO Quality Check http//www.qualitycheck.org/
• CMS Hospital Compare http//www.hospitalcompare.hh
  s.gov/

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National Examples

• HospitalWise Professional Medscape
  http//www.medscape.com/pages/features/hospitalcom
  pare/hospitalcompare
• Hospital Victims http//www.hospitalvictims.com/hv
  _hosp_main.asp?mpn523300
• Subimo http//subimo.com/
• Healthia http//www.healthia.com/
• WebMD Quality Services

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Regional/Payer Examples

• Quality Counts (the Alliance) http//www.allianceh
  ealthcoop.com/
• Checkpoint (WHA) http//www.wicheckpoint.org/
• Pricepoint (WHA) http//www.wipricepoint.org/
• Wisconsin Collaborative for Healthcare Quality
  http//www.wiqualitycollaborative.org
• Humana Business Group Coalition
• United Healthcare Definity Health Plan

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What is CHW doing?

• Created a data management program
• Data quality assurance prior to release
• Proactively survey publicly reported data
• Work actively with reporting organizations
• Develop meaningful quality measures internally
  and collaborate with pediatric peers externally
• Participate in Nationally recognized benchmarking
  programs (NACHRI)

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How are we doing it?

• Created a data management program
• Needs assessment
• Restructured and expanded resources accordingly
• Developed database to log requests and monitor
  future needs
• Involved families in measurement process
• Created a physician advisory panel
• Created an online clinical data request process
• Proactively managed expectations (customers
  including physicians, leaders, staff)

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How are we doing it?

• Data quality assurance prior to release
• Needs assessment
• Inventory of existing data sources
• Critical review of data integrity
• Development of edits prior to submission to
  state/Solucient
• Process improvement on data collection/entry,
  interrater reliability, data definitions
  (negative days of px)

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How are we doing it?

• Proactively surveying our reported data
• Created dynamic document of publicly reported
  data
• Regularly updated
• Presentations at Medical Leadership
• Reported semi-annually to Council for Quality
• Helped drive resource allocation and engaged
  leadership
• Catalyst for conversations with reporting
  entities

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How are we doing it?

• Working with reporting organizations
• Provide feedback based on reported or proposed
  reported data
• Includes data sources, populations, definitions,
  formulas and risk adjustment
• Find a way to be at the table with reporting
  agencies
• Relationships
• Expertise and willingness to provide alternatives
• Attendance at local/regional/national meetings

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How are we doing it?

• Developing quality measures internally and
  collaboratively externally
• Goal is to provide options and alternatives
• Transparency of internal measures (those publicly
  reported should be no different)
• Creates opportunity to engage physicians and
  hospital leaders
• Participation in measure review/validation
• Collaboration with AHRQ, NACHRI, CHCA, ABP, AAP
• Alliance, Definity Health Plan

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Next steps

• Refinement of data management process (PDSA)
• Working with IS to design and build future data
  tools
• Build measures into Decision Support System
• Prepare for physician specific reporting and P4P
• Enhance relationship with PR
• Quality and patient safety measures on web site
• Simulation in preparation of negative publicity
• Continue collaboration with pediatric partners

18
Thank you!