SOUTH CAROLINA DHHS

SOUTH CAROLINA DHHS

July 29, 2012

CHIPRA Learning Collaborative

Introduction Truven Name Change Truven Role in CHIPRA Project Data Updates & Findings Next Steps Questions & Discussion

AGENDA

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TRUVEN HEALTH ANALYTICSFormerly the Healthcare Business of Thomson Reuters

2,100 Employees in offices across the US

Ann ArborDenver/Greenwood VillageDurhamChicagoBostonWashington DCSacramentoSanta BarbaraSt. LouisPhiladelphiaNashvilleMilwaukeeAtlantaEagan/MinneapolisNew York City

Our Singular Mission: We integrate complex healthcare data and combine it with powerful analytics to measure performance and improve the efficiency and outcomes of healthcare services.

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STATE MEDICAID CUSTOMERS

SURS/FADS: AK, GA, IL, LA, ND, MD, MI, MO, MS, NE, NH, NJ, NV, NY, OH, SC, WV, VA (ID,ME and NC in implementation)

AK

HI

WA

OR

ID

MT

WY

ND

SD

NE

CAUT

NV

AZ

CO

NM

KS

OK

TX

MN

IA

WI

IL IN

MO

AR

MI

OH

KY

TN

MS

LA

AL GA

SC

VAWV

PA

NY

MEVTNH

MD

DC

DE

NJ CT

MA

NC

FL

ME

RI

State Medicaid Customers

DW/DSS: GA, KS, ND, MO, NE, NH, NV, OH, SC (ID , ME and NC in implementation. New system being installed in ND)

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Analyze Data Requirements for Quality Measures Assess quality metric reporting requirements Work with CareEvolution, SCDHHS and practices to ensure

relevant clinical data is available at point of care Provide quality metric input and ranking based on data availability

Data Management/Technical Expertise Work with CareEvolution to develop edge adapters to Decision

Support System (DSS) Adapt DSS to accept EHR data from providers (data model) Provide initial data assessments

Calculate Quality Metrics Reconcile specifications with data availability (adjust or note) for

baseline and ongoing reporting Develop final quality measures in DSS Maintain continual feedback with providers on metric calculations

Report on Quality Metrics Work with providers and stakeholders to design user-friendly

reports that provide data to improve practice population’s health status

Determine final format for report delivery to stakeholders

TRUVEN INVOLVEMENT IN CHIPRA

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CHIPRA – LEADING EDGE OF USING DATA

We are on the forefront of the movement toward leveraging HIE technology to integrate clinical data from EHRs with administrative data from claims and encounters: the result is powerful new insights into performance measurement.

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Data Receipt UpdatesData Receipt Updates Data Findings Update Data Findings Update

Working with CareEvolution Received initial data files for 3

practices Data includes EMR data,

administrative claims data and Medicaid eligibility

Administrative claims data includes: Medicaid Claims (Fac, Prof, Rx) UB92 Claims (Medicaid & Non-

Medicaid)

Missing administrative data impacting 3 measures (e.g., no pharmacy or revenue codes)

EMR data not reflecting diagnosis or procedure coding

Eligibility data only available for Medicaid population

Wide variation in data entry process across practices Dates of birth (impacts age) Multiple Patient IDs (overstates

population counts) Diagnosis and procedure

documentation (impacts measure calculations

DATA UPDATES

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PROVIDER REPORTING SAMPLE

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Work with CareEvolution on: Receiving replacement data for 3 practices to address data quality

improvements Discussing data quality findings Preparing to receive 4 new practices by August 31st

Assess Data Quality to: Identifying data issues that impact measures Developing measure specification modifications to minimize impact

of data issues Providing initial data assessments to practices in Fall 2012

Developing Practice-level Reports by: Finalizing report template Creating initial reports for practices with data submission

NEXT STEPS

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QUESTIONS & DISCUSSION

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