Public Health Data Standards Consortium http://www.phdsc.org “
Feb 23, 2016
PUBLIC HEALTH DATA STANDARDS CONSORTIUM~ PHDSC 2012 ANNUAL BUSINESS MEETING ~
November 8-9, 2012, Hyattsville, MD
NEXT STEPS: Towards Public Health Sector Transformation and Sector Unity
Report from Data Standards Committee
Maiko MinamiHLN Consulting, LLC
Public Health Data Standards [email protected]
Data Standards Committee OverviewCo-Chairs: Robert Davis, Starla Ledbetter
Subcommittees Health Care Services Data Reporting Guide
(HCSDRG) - Chair: Robert Davis
Payer Typology - Chair: Roxanne Andrews
Oversees activities - Implementation of Business Use Case: HIT Standards Web-Resource Center
PHDSC & Strategic Plan Overview
PHDSCBuild “Coordinated Voice” from Public Health for HIT Standards Bring Voice to HIT Standardization Efforts Achieve Interoperability of Public Health &
Healthcare Systems
Disease-Based Model of Care
Health-Based / LHS Model of Care
Mission
Partner with
Stakeholders
Align System Functionality with
PH needs
Enable System Interoperability via
HIT StandardsObjectives
Catalyst
Strategic Initiatives Tasked toData Standards CommitteeStrategic Initiative 1
Unify PH to Support Health-Based Model (HBM) / Learning Health System (LHS)
Goal Align data gathering practices across PH using
standards-based Information Systems (IS)
Objectives Advocate need for transformation and migration Form PH Transformation Coalition
Strategic Initiatives Tasked toData Standards Committee
Strategic Initiative 2Unify PH Information Systems
Goal Transform and align PH-IS to support information
exchange across PH & partners
Objective Build a Coordinated Voice and bring the Voice to
HIT Standardization efforts
Strategic Initiatives Tasked toData Standards Committee
Strategic Initiative 3Align/Integrate PH with Other Healthcare
Sectors, including Admin Data Systems Goal
Enable integration with PH, clinical, and administrative information systems
Objective Monitor and participate in national initiatives that
align PH and healthcare Influence direction of activities w/ PHDSC vision
Data Standards Committee
Purpose Data Standards Committee coordinates data
standards activities for PHDSC Goals
Identify current and future public health data needs
Work with standards development organizations to support those needs
Educate PH stakeholders about these standards and to promote their usage
Project 1: Assure HIT Standards for Public Health (Business Case: Role of Public Health in National HIT Standardization)
Project 2: PHDSC Participation in Health Data Standards Development for Administrative Data Exchanges
Project 3: Public Health Functional Requirements Project
Project 4: Standards for Early Hearing Detection and Intervention (EHDI) Program
Project 5: Standards for Public Health Laboratory (PH-Lab) Data Exchange and Case Reporting
Project 6: Standards for Occupational Health Data Exchanges
Project 7: University-based Public Health Informatics Training
PHDSC Projects: 2012-2013Assuring Health IT Standards for Public Health
Participation in Health Data Standards Development for Administrative Data Exchanges
Participate in standards development activities:
Maintain the Health Care Service: Data Reporting Guide Develop standards harmonization GAP ASSIST on-line tool
Collaborate with AHRQ and ANSI X12 to populate USHIK with All Payer Claims Database metadata
Develop IHE White Paper: Assuring Interoperability of EHR Systems and Administrative Data
Data Standards (Project 2) Activities
Accredited Standards Committee (ASC) X12 Activities
ASC X12 Purpose Develop messaging standards for over 275
business transactions, including standards for health care service data
PHDSC X12 Activities Participate in X12 standards development
activities Health Care Service: Data Reporting Guide
(HCSDRG) Gap Assist Tool
Health Care Service: Data Reporting Guide (HCSDRG)
Purpose of HCSDRG ACS X12 Implementation Guide to support Public
Health reporting of health care service data Based on HIPAA adopted standard compatible guide
Health Care Claim: Institutional (837) Same billing reporting requirements with addition of PH
requirements (e.g. race/ethnicity, county) X12 837 + PH requirements 837R
PHDSC Activity Maintain and continue to sync the HCSDRG with current
X12 standards
Gap Assist Tool
Purpose of Gap Assist Tool Visual tool that provides a meta data perspective
to see what data elements are supported in the HCSDRG across the different versions of the X12 standards
PHDSC’s way to let the public know of what the changes are across versions
PHDSC Activity As the HCSDRG is updated, Gap Assist Tool is
updated
Gap Assist Tool
Gap Assist Tool
National Uniform Billing Committee (NUBC)National Uniform Claim Committee (NUCC)
Purpose of NUBC and NUCC NUBC develops a standardized data set for use
nationwide by institutional providers and payers for handling health care claims
NUCC develops a standardized data set for use by the non-institutional health care community for handling health care claims
PHDSC Activity Participate in standards development activities Bring PH requirements to NUBC/NUCC
USHIK All Payer Claims Database (APCD) Portal: Background
Purpose of APCD All Payer Claims Databases (APCDs) are
databases, created by state mandate, that typically include data derived from medical, pharmacy, and dental claims with eligibility and provider files from private and public payers:
Insurance carriers (medical, dental, TPAs, PBMs) Public payers (Medicaid, Medicare)
USHIK All Payer Claims Database (APCD): Typically Included Information
• Patient demographics (DOB, gender, residence, relationship to subscriber)
• Type of product (HMO, POS, Indemnity, etc.)
• Type of contract (single person, family, etc.)
• Diagnosis codes (including E-codes)
• Procedure codes (ICD) • NDC codes for pharma Rx• Revenue codes
• Service dates • Rendering provider (name,
tax id, payer id, specialty code, city, state, zip code)
• Prescribing physician • Plan charges & payments• Member liabilities (co-pay,
coinsurance, deductible)• Date paid • Type of bill • Facility type
Current APCD States
USHIK All Payer Claims Database (APCD) Portal
Purpose of APCD Portal APCD Portal in USHIK compares corresponding
data elements of each state's APCD with the national standard for each data element.
APCD Portal was originally modeled after Gap Assist Tool
USHIK All Payer Claims Database (APCD) Portal
Partners in design and building of APCD Portal Centers for Disease Control and
Prevention/National Center for Health Statistics (CDC / NCHS)
Agency for Healthcare Research and Quality (AHRQ)
APCD Council (www.apcdcouncil.org) Washington Publishing Company PHDSC
USHIK All Payer Claims Database (APCD) Portal
Today, APCD Portal compares state APCD data and ASC X12 Data Standards
APCD Portal will include data elements from: Each state's All-Payer Claims Database (APCD) ASC X12 5010 standard ASC X12 Post-Adjudicated Data Reporting Guides
(published in August 2012) National Council for Prescription Drug Programs
(NCPDP) Uniform Healthcare Payer Standard Implementation Guide Version 1.0.
USHIK All Payer Claims Database (APCD) Portal
PHDSC Activity Develop and maintain APCD Portal with partners
Plan to work with 6 APCD states to solicit feedback about the portal over the next 9 months
IHE White Paper: Assuring Interoperability of EHR Systems and Admin Data
Purpose Describes areas where clinical health data from EHRs
and administrative health data from Admin Systems must be better aligned to meet future reporting needs of public health programs.
Roadmap for developing interoperability standards for data exchanges of administrative health data between EHRs, admin data systems, and public health programs
PHDSC Activity Developed IHE White Paper from Nov 2011 to Aug 2012 For review by IHE QRPH Domain for eventual publication
Assure HIT Standards for Public Health - Business Case:Role of Public Health in National HIT Standardization
Educate Public Health Community about Health Informatics and HIT Standards through HIT Standards Web-Resource Center (http://www.phdsc.org/standards/resource-center.asp)
Obtain Voice of the Customer feedback through JD Power and Associates survey to improve PHDSC website and HIT Standards Web-Resource Center
Improve design and information of PHDSC website
Improve Analytics on PHDSC Website to better understand usage
Business Case (Project 1) Activities
HIT Standards Web-Resource Center
Purpose Educate the public health community on Health
Informatics and HIT standards 4 Different Modules
PHDSC Activity Updated and maintained information in 3 Modules Specifications for 4th Module completed. Launch in May
2013.
PHDSC Health Information Technology Standards Web-Resource Center(http://www.phdsc.org/standards/resource-center.asp)
Assuring Health IT Standards for Public Health
Assuring Health IT Standards for Public Health
Assuring Health IT Standards for Public Health
Assuring Health IT Standards for Public Health
Strategic Initiatives Tasked toData Standards CommitteeStrategic Initiative 1
Unify PH to Support Health-Based Model (HBM) / Learning Health System (LHS)
Strategic Initiative 2Unify PH Information Systems
Strategic Initiative 3Align/Integrate PH with Other Healthcare
Sectors, including Admin Data Systems
Data Standards Committee:Future Directions
Continue to strategize activities to meet strategic initiatives
Continue to work with Standard Development Organizations to bring public health requirements to the table
Continue to educate the public health community about HIT standards and efforts
Specific issues to continue to think aboutHow to get clinical and admin data for public
health needs; align existing standardsWhat is the “consensus” of public health?