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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