Essential Data Elements Survey Findings. Trish Harkness, CISSP, CHPS KALHD HIE Workshop November 13, 2013
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1 Essential Data Elements Survey Findings Trish Harkness, CISSP, CHPS KALHD HIE Workshop November 13, 2013
2 Acronyms GIS: Global Information Systems HIE: Health Information Exchange KALHD: Kansas Association of Local Health Departments KHIE: Kansas Health Information Exchange (now handled by the Kansas Department of Health and Environment) KHIN: Kansas Health Information Network KMAP: Kansas Medical Assistance Program LHD: Local Health Department
3 Agenda Essential Data Elements Project Survey Findings General Info Data Elements Data Sharing Population Data
4 Essential Data Elements Project Kansas Health Foundation Grant Fund enhancements to KIPHS PHClinic to improve functionality Develop an interface to KHIN (an approved HIE) for LHDs using PHClinic Determine the data set to be shared between LHDs and the HIE Discuss policy implications of sharing data
5 Essential Data Elements Project KALHD Essential Data Elements Survey Developed by Synōvim and KALHD Conducted by Synōvim Sent participation invitations to 105 LHDs 70 staff members at LHDs responded to a portion of the survey 63 staff members at LHDs finished the survey Thank you to everyone who responded!
6 Survey Findings General Info Most Applicable Position at the LHD 70 responses 1 (1.4%) 1 (1.4%) 1 (1.4%) 4 (5.7%) 6 (8.6%) Billing Clerk Director/Administrator Office Manager Public Health Nurse Chief Financial Officer Application Manager 57 (81.4%)
7 Survey Findings General Info Electronic Billing and/or Patient Care System Being Utilized 70 Respondents 2 (2.9%) 4 (5.7%) 8 (11.4%) 14 (20.0%) 38 (54.3%) KIPHS PHClinic NetSmart Insight None ASK/PC ACE Pro 32 KMAP Other 4 (5.7%) KMAP and ASK/PC ACE were Other responses
8 Survey Findings General Info Electronic Billing and/or Patient Care System Being Utilized (cont.) Only 2 respondents use an EHR that was not designed specifically for LHDs At least 4 respondents use a combination of products
9 Survey Findings General Info Capabilities of Electronic Systems 54 responses (96.3%) (61.1%) Billing and Demographics Scheduling (38.9%) Patient Care Documentation 10 0 Billing and Demographics Scheduling Patient Care Documentation
10 Survey Findings General Info Capabilities of Electronic Systems (cont.) 17 respondents using an electronic system indicated it had all 3 capabilities All respondents using: NetSmart Insight (4) Vitera Intergy (1) Healthland (1) 11 respondents using KIPHS PHClinic
11 Survey Findings Data Elements Common HIE Data Elements Approved HIEs in Kansas are obligated to accept the common HIE data elements KHIE Conditions of Participation policy established the minimum data set If respondents did not have an electronic system, we asked them to answer from the perspective of data they would like to access or share with other healthcare providers
12 Survey Findings - Data Elements Frequency of Use of Common HIE Data Elements responses Daily 30 Weekly Monthly Quarterly Annually Not Used 0 Unsure Identity of data source Patient demographics Problem list Medication list Allergies Diagnostic test results Immunizations Procedures
13 Survey Findings - Data Elements Frequency of Sharing Common HIE Data Elements responses Daily 15 Weekly Monthly 10 Quarterly Annually 5 Not Used 0 Unsure Identity of the data source Patient demographics Problem list Medication list Allergies Diagnostic test results Immunizations Procedures
14 Survey Findings - Data Elements Other LHD Data Elements Ability to exchange these data elements is likely to be contingent on data that can be accepted by the HIE If respondents did not have an electronic system, we asked them to answer from the perspective of data they would like to access or share with other healthcare providers
15 Survey Findings - Data Elements Frequency of Use of Other LHD Data Elements 63 responses Daily Weekly Monthly Quarterly Annually Not Used Unsure 5 0 Guarantor demographics Family planning information Care plan objectives
16 Survey Findings - Data Elements Frequency of Sharing Other LHD Data Elements responses Daily Weekly Monthly Quarterly Annually Not Used Unsure 0 Guarantor demographics Family planning information Care plan objectives
17 Survey Findings - Data Sharing Primary Data Sharing Needs 63 responses 34 (54.0%) 43 (68.3%) 41 (65.1%) 36 (57.1%) Immunization registry 2 (3.2%) Traditional communication (telephone, fax, etc.) 2 (3.2%) 6 (9.5%) Share entire clinical documentation with co workers 1 (1.6%) No needs 1 (1.6%) Directly share with medical/health officer Directly share data with other healthcare providers Share data in an electronic information exchange Obtain data for population mgmt/education Other 20 LHDs indicated that all four elements are data sharing needs
18 Survey Findings - Data Sharing Secondary Data Use Essentially the use of data by someone who may not have gathered it for a purpose that was not originally intended Example: A healthcare provider will keep a list of diagnoses for a patient so that appropriate care can be provided Secondary use of this data could include aggregate population health reporting to determine areas of Kansas that would benefit from targeted chronic disease management education
19 Survey Findings - Data Sharing Concerns Regarding Electronically Sharing Patient Data 63 responses (93.7%) (60.3%) 35 (55.6%) 18 (28.6%) 19 (41.3% 26 (41.3%) Patient Privacy Rights was the only Other response 4 (6.3%) 1 (1.6%) The cost of implementing data sharing technology Ensuring the privacy of sensitive shared data Ensuring the security of sensitive shared data Loss of control of your patient data Lack of trust in data shared by other sources Uncertainty surrounding secondary data use No concerns about electronically sharing data. Patient Privacy Rights
20 Survey Findings Data Sharing Concerns Regarding Electronically Sharing Patient Data (cont.) 6 respondents were concerned about all 6 listed concerns 30 respondents were concerned about 4 or more of the listed concerns
21 Survey Findings Data Sharing Potential Impact of Electronic Data Sharing on Healthcare 15 responses to an open ended question (53.3%) (40.0%) 5 (33.3%) 3 (20.0%) 4 (26.7%) 1 0 Save Money Improve Care More Efficient Concern Regarding Cost of Implementation Concern Regarding Patient Privacy
22 Survey Findings Data Sharing Potential Impact of Electronic Data Sharing on Healthcare (cont.) This is a critical element toward improving quality of care and reducing the overall cost of health care in this country by reducing duplication of services. I think the concept is excellent and would provide for much easier patient care. However, I think to achieve that goal the health information would have to be collected, stored and shared properly by everyone. There would have to be uniform systems and I don't see how that can be accomplished.
23 Survey Findings Data Sharing Potential Impact of Electronic Data Sharing on Healthcare (cont.) I do have some reservations in the sharing of PHI. I think it is based on lack of trust in other providers. In our community, we have several patients who come to our office rather than the local clinic specifically because they do not want their private information available to the entire staff at the health clinic. I do understand their concerns. I am not sure that I agree with some data being shared across the board; I believe that it should be shared with patient discretion only. (Paraphrased) Small Local Health Departments have NO extra funding. My biggest concern is how will we pay for it.
24 Survey Findings Population Data Benefit of Access to Population Health Data 63 responses 2 (3.2%) 4 (6.3%) 24 (38.1%) 33 (52.4%) Very beneficial Somewhat beneficial Not beneficial I'm not sure 57 respondents think access to population health data would be beneficial
25 Survey Findings Population Data Population Health Data that Would Be Most Beneficial 62 responses (87.1%) 61 (98.4%) 56 (90.3%) (41.9%) 32 (51.6%) 4 (6.5%) Chronic disease data Immunization data Illness outbreak data Medication data Mental health data Other
26 Survey Findings Population Data Population Health Data that Would Be Most Beneficial (cont.) Other responses included: Environmental Health (such as water, food, lead, radon, and air quality) GIS data for more than disease, income and health services Insurance coverage
27 Survey Findings Population Data Filtering Options for Population Health Data that Would Be Most Beneficial 62 responses (56.5%) City 60 (96.8%) County 26 (41.9%) Geographic Region 31 (50.0%) Zip Code or Census Tract 60 (96.8%) 48 (77.4%) 36 (58.1%) 30 (48.4%) 1 (1.6%) Risk Factor was the only Other response Age Range Gender Race Ethnicity Risk Factor
28 Survey Findings Population Data Filtering Options for Population Health Data that Would Be Most Beneficial (cont.) 13 respondents were interested in all of the filtering options 37 respondents were interested in 5 or more of the filtering options
29 Survey Findings Key Points 20% of respondents have no electronic billing or patient care systems. Respondents understand the data they need to provide their LHD services; they are much less certain about data that should be shared with other healthcare providers. The potential benefits of electronically sharing patient data are understood.
30 Survey Findings Key Points The cost of implementing electronic systems is a significant barrier. Privacy and security of electronically shared patient data is a significant concern. Respondents are very interested in access to population health data and the ability to filter it by multiple criteria.
31
32 Trisha Harkness, CISSP, CHPS Senior HIT Privacy and Security Consultant LinkedIn: harkness/5/b3/410/ Synōvim Healthcare Solutions, Inc., is a not for profit organization sponsored by the Kansas Foundation for Medical Care (KFMC) and the Kansas Association for the Medically Underserved (KAMU). Synōvim, comprised of Regional Extension Center staff, is in partnership with these organizations to help assist Kansas providers with their health information technology and quality improvement needs once federal funding has ceased for REC services. SYNREC_2013_48
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