Breakout Session 15 Using HER Data for Community Health Assessment

Transcription

1 Breakout Session 15 Using HER Data for Community Health Assessment 2015 Minnesota e-health Summit June 17, 2015, 1:45 p.m. 1

2 Minnesota E-Health Summit Wednesday, June 17th Joan Pennington, MBA, HealthEast Care System Melanie Countryman, MPH, Dakota County Public Health

3 Overview and History

4 CCH Partners Public Health Agencies Anoka County Community Health Carver County Public Health City of Bloomington, Division of Health Dakota County Public Health Hennepin County Human Services & Public Health Minneapolis Health Department St. Paul-Ramsey County Public Health Scott County Public Health Washington County Public Health & Environment Health Plans Blue Cross Blue Shield/Blue Plus of MN HealthPartners Medica Metropolitan Health Plan PreferredOne UCare Minnesota Council of Health Plans Hospitals/Health Systems Allina Health: Abbott; Regina Medical Center; United Hospital; Unity & Mercy Hospital Northwest Metro Children s Hospitals and Clinics Fairview Health HealthEast: St. Joseph s, St. John s, Bethesda & Woodwinds Hospitals HealthPartners : Methodist, Regions & Lakeview Hospitals; & Park Nicollet Medical Clinics Hennepin County Medical Center Maple Grove Hospital North Memorial Medical Center Minnesota Hospital Association Ex Officio Minnesota Department of Health Vision: Using data and assessment tools, health plans, hospitals and governmental public health agencies will achieve the Triple Aim of improving the patient experience of care (including satisfaction); improving the health of populations (quality) and reducing the per capita cost of health care. Mission: To improve the health of our community by engaging across sectors and serving as a catalyst to align the community health assessment process and the development of action plans to impact priority issues and increase organizational effectiveness. 4

5 Anoka County Community Health Carver County Public Health City of Bloomington, Division of Health Dakota County Public Health Hennepin County Human Services & Public Health Minneapolis Health Department St. Paul-Ramsey County Public Health Scott County Public Health Washington County Public Health & Environment MN Council Health Plans Hospitals/Health Systems Allina Health Fairview Health Services HealthEast Care System HealthPartners : Methodist, Regions & Lakeview Hospitals Children s Hospitals and Clinics Hennepin County Medical Center Maple Grove Hospital North Memorial Medical Center Minnesota Hospital Association Health Plans Blue Cross Blue Shield/Blue Plus of MN HealthPartners Medica Metropolitan Health Plan PreferredOne UCare Minnesota Council of Health Plans Public Health Agencies Hospitals / Health Plans

6 Assessment Alignment (co-chairs: Rina McManus, Ramsey County Public Health and Joan Pennington, HealthEast) Collective Action (co-chairs: Janny Brust, MN Council of Health Plans and Donna Zimmerman, HealthPartners/Regions Hospital)

7 Purpose: Co-chairs: Janny Brust, MN Council of Health Plans; Donna Zimmerman, HealthPartners/Regions Hospital Develop and implement a collective action plan, that addresses a shared priority area based on the community health needs assessments (CHNA) to be done by the CCH organizations in the 7-county Twin Cities metropolitan area. Focus on Mental Health: Support program and efforts that help keep individuals within a zone of mental health stability. Pre-Crisis Crisis Point Zone of Stability 7

8 Co-chairs: Rina McManus, St. Paul Ramsey County Public Health Joan Pennington, HealthEast Care System Design a framework with common language and processes to: Guide members in conducting assessments Allow for aggregate analysis of community health needs and priorities across the Twin Cities 7-county metro region Facilitate more effective use of data by: Identifying opportunities for collaborative data collection and analysis Eliminating barriers to data sharing among members

9 Phase I Accomplishments

10 Minnesota (Statute 145A A.10) PHAB (Domain 1) Assess community health needs and assets Seek public input At least once every five years Establish local health priorities Complete a community health assessment using data from a variety of sources Community input and review Dated within the past five years Process to set community health priorities Collaborative process to develop community health assessment Findings made available to the public

11 Complete both community health assessment and organizational assessment Deliverables to the Minnesota Department of Health (most recent cycle: March 2015) Organizational priorities Community health priorities Community Health Improvement Plan Strategic plan Quality improvement plan

12 Passed in March 2010 with new reporting requirements for private non-profit hospitals to maintain 503(c)3 tax exempt status. For tax years beginning after March 2012, each hospital must: Conduct a Community Health Needs Assessment at least once every three years. Must include public health Must include community voice Develop and obtain Board of Director approval action plans to address unmet community needs. Report the process and plan to the community and on IRS 990 s.

13 Framework: Public Health Mobilizing for Action through Planning and Partnership (MAPP) Hospitals Basic assessment model Data sources: 66 sources for example MDH U.S. Census MN Compass Behavioral Risk Factor Surveillance System (BRFSS) SHAPE (metro adult health survey) MN Student Survey

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15 Developed by National Association for City and County Health Officials (NACCHO) Collaborative process to complete a community health assessment and community health improvement plan Mobilizing for Action through Planning and Partnership (MAPP)

16 Community Health Status Assessment What is the health status of the community? Community Themes and Strengths Assessment What is important to the community? What assets do we have that can help improve health? (Asset mapping) Local Public Health System Assessment What is the capacity of the local public health system as a whole? Forces of Change Assessment What are the external factors that may affect health of the community? Outcome: a list of challenges and opportunities from each assessment that will lead to identification of strategic issues (health priorities)

17 Compile a list of core indicators that all CCH members will use for community health assessment Based on: Healthy People 2020 Leading Health Indicators Healthy Minnesota 2020: Statewide Health Improvement Framework and Chronic Disease and Injury Plan Locally-identified needs Identify data sources for each indicator Look at gaps that could be filled by EHR data Where can EHR data be used to confirm data from existing sources

18 Testing the process at HealthEast

19 Review available data sources for each core indicator to identify: Gaps that could be filled by EHR data (ex. cancer screening data) Where EHR data could be used to confirm data from existing sources (ex. BMI from survey data) Extract data for one health system to test the concept and develop a format that other health systems could use

20 Enhance general health surveillance by providing information on the prevalence, treatment, and control of health conditions that are typically managed in a primary care setting Provides data not currently available from other sources Data is based on objective measurement and clinical diagnoses (current: self-reported survey measures) Real-time data allows for faster outcome measurement (current: lag because surveys are conducted every 3-4 years) Allows for analysis of data at more discrete levels, ex. zip code, race, ethnicity, other social determinants of health

21 Established data definition and rules for an initial set of variables that align with population health measures Percentage of patients overweight and/or obese Percentage of patients who use tobacco Piloted multiple approaches to identify patients with high health needs Charlson Comorbidity Index Repeated inpatient visits High number of emergency department visits Engaged stakeholders in discussion of most meaningful unit of analysis (clinic vs. county)

22 Metro Dakota Ramsey Washington Obese 25.1% 25.8% 24.4% 26.0% Overweight 36.5% 34.0% 38.5% 35.0% Not overweight 38.4% 40.2% 39.3% 39.0% Obese 32.3% Overweight 28.9% Not overweight 27.7% Missing/unknown 11.1% HealthEast Primary Care patients Source: Metro Adult Health Survey, 2010 Source: HealthEast patient data *analysis of unique adult patients age 18-74, valid BMI

23 Mapping was a useful tool in prioritizing geographic areas for primary data collection Ongoing work is underway to: Determine HealthEast s definition for behavioral health data Explore availability of other key measures that align with Healthy Minnesota 2020 framework Identify key metrics to review as intervention strategies are implemented

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25 New roles and responsibilities for staff, particularly IS and analytics team: Ex. Who determines definitions? Who is responsible for data quality? Data limitations Ex. Are mental health/substance use diagnoses and procedure codes a good measures of prevalence? Ex. Unique patient data points Challenges interpreting data: Ex. What are the needs of residents not served by HealthEast? Should HealthEast focus in areas where they serve the most patients or where community health needs are highest?

26 Continue to explore options for aggregating EHR data from multiple health systems Identify or create a data portal to provide easy access to data from multiple sources Develop common language across sectors

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28 Joan Pennington, MBA System Director, Community Health HealthEast Care System Melanie Countryman, MPH Epidemiologist/Senior Informatics Specialist Dakota County Public Health