Using Health IT Standards: Learning from USHIK
17
Using Health IT Standards: Learning from USHIK Public Health Data Consortium’s 2010 Annual Meeting J. Michael Fitzmaurice, Ph.D. Agency for Healthcare Research and Quality November 4, 2010
description
Using Health IT Standards: Learning from USHIK. Public Health Data Consortium’s 2010 Annual Meeting J. Michael Fitzmaurice, Ph.D. Agency for Healthcare Research and Quality November 4, 2010. Agency for Healthcare Research and Quality (AHRQ). Mission - PowerPoint PPT Presentation
Transcript of Using Health IT Standards: Learning from USHIK
Using Health IT Standards: Learning from USHIK
Public Health Data Consortium’s 2010 Annual Meeting
J. Michael Fitzmaurice, Ph.D.Agency for Healthcare Research and Quality
November 4, 2010
2
Agency for Healthcare Research Agency for Healthcare Research and Quality (AHRQ)and Quality (AHRQ)
MissionMission
Improve the quality, safety, efficiency and Improve the quality, safety, efficiency and effectiveness of health care for all Americanseffectiveness of health care for all Americans
New Redskins Wide ReceiverNew Redskins Wide Receiver
A Turkey?A Turkey?
3
AgendaAgenda
What is USHIKWhat is USHIK– A metadata registryA metadata registry– Supporting the HHS Secretary’s InitiativesSupporting the HHS Secretary’s Initiatives
Why is it important?Why is it important?– To AHRQTo AHRQ– For Quality MeasuresFor Quality Measures
Who developed it?Who developed it? How is USHIK relevant to Quality MeasuresHow is USHIK relevant to Quality Measures
4
What is a Metadata Registry?
Metadata is data about data—data element information such as semantics and Metadata is data about data—data element information such as semantics and representationsrepresentations
A A metadata registrymetadata registry is a central location where data elements and their metadata is a central location where data elements and their metadata (names, definitions, representations, other characteristics(names, definitions, representations, other characteristics) are stored and maintained in ) are stored and maintained in a controlled method. For example, birth date may have the following metadata:a controlled method. For example, birth date may have the following metadata:
AttributesAttributes ExamplesExamples– NamesNames Birth dateBirth date– DefinitionsDefinitions Year, day, time of a person’s birthYear, day, time of a person’s birth– RepresentationsRepresentations 201020100808132137 or YYYYMMDDHHMM132137 or YYYYMMDDHHMM– Contextual meaningContextual meaning When was your baby born?When was your baby born?– Other informationOther information e.g., When is it in effect? Who is the authority? e.g., When is it in effect? Who is the authority?
ISO/IEC 11179 is an international standard for metadata registries, and widely used ISO/IEC 11179 is an international standard for metadata registries, and widely used
Metadata registries are used [and desirable] whenever data must be used consistently Metadata registries are used [and desirable] whenever data must be used consistently within an organization or group of organizationswithin an organization or group of organizations
6
What is the US Health Information What is the US Health Information Knowledgebase (USHIK)?Knowledgebase (USHIK)?
AHRQ-USHIK is an AHRQ-funded and managed metadata AHRQ-USHIK is an AHRQ-funded and managed metadata registry ofregistry of– Data elements endorsed, accepted, and recognized by the Data elements endorsed, accepted, and recognized by the HHS HHS
Secretary Secretary for federal agencies’ uses, for federal agencies’ uses, plus moreplus more USHIK contains data elements from:USHIK contains data elements from:
– The President’s National Interoperability StandardsThe President’s National Interoperability Standards HIPAA transactionsHIPAA transactions Consolidated Health Informatics domainsConsolidated Health Informatics domains HITSPHITSP
– Quality MeasuresQuality Measures Meaningful Use Performance MeasuresMeaningful Use Performance Measures HITSP Quality MeasuresHITSP Quality Measures
– State All Payer Claims Data Metadata State All Payer Claims Data Metadata USHIK is publicly available atUSHIK is publicly available at ushik.ahrq.gov ushik.ahrq.gov
Brief History of USHIK
USHIK was developed by DoD and CMS as a clone to DoD’s metadata registry (MDR), with AHRQ monitoring its progress
From its inception in1998 to the present, USHIK has been supported at times by CMS, DoD, AHRQ, NCI, and VA
It is currently managed and financed (since 2004) by AHRQ– With CMS and VA as partners
USHIK is based on metadata registry implementations at DoD,
EPA, and the Australian Institute of Health and Welfare – That correspond to ISO/IEC 11179 Pt. 3, Ed. 2
Why is USHIK important to AHRQ?Why is USHIK important to AHRQ?
Good health research requires—and USHIK promotes— Good health research requires—and USHIK promotes— uniform, accurate, valid, computerized health datauniform, accurate, valid, computerized health data
Improving health data improves the quality of AHRQ’s health Improving health data improves the quality of AHRQ’s health researchresearch
More specifically, improving health data More specifically, improving health data improvesimproves– Communication about patient careCommunication about patient care– Quality of AHRQ’s health research findingsQuality of AHRQ’s health research findings– Robustness of tools developed by AHRQ to use these findingsRobustness of tools developed by AHRQ to use these findings– Uniform and consistent application of quality and other performance Uniform and consistent application of quality and other performance
measures throughout our health systemmeasures throughout our health system– Ability of health practitioners to integrate AHRQ’s research findings and Ability of health practitioners to integrate AHRQ’s research findings and
tools in their daily practicetools in their daily practice
8#
What does USHIK have: 3 What does USHIK have: 3 Portals, 2 Pilot PortalsPortals, 2 Pilot Portals
1.1. USHIK:USHIK: Contains all the data elements in all USHIK’s portalsContains all the data elements in all USHIK’s portals2.2. HITSP:HITSP: ANSI-HITSP data elements linked to all use cases, ANSI-HITSP data elements linked to all use cases,
interoperability specifications, and other documents—as of July 15, interoperability specifications, and other documents—as of July 15, 2009 and beyond2009 and beyond
3.3. Patient Safety Common FormatPatient Safety Common Formatss: Specifications for electronically : Specifications for electronically reporting patient safety events among AHRQ-designated Patient reporting patient safety events among AHRQ-designated Patient Safety OrganizationsSafety Organizations
4.4. Meaningful Use (pilot): Meaningful Use (pilot): Example Example quality measures quality measures and the data and the data elements associated with their numerators, denominators, inclusions, elements associated with their numerators, denominators, inclusions, and exclusions, Incentive payment performance measuresand exclusions, Incentive payment performance measures
5.5. State All-Payer Claims Data (pilot): State All-Payer Claims Data (pilot): Data element specifications from Data element specifications from two states’ all payer data basestwo states’ all payer data bases
What is the Relevance of USHIK to Quality Measures?
When Quality Measures (QM’s) and their metadata are loaded expertly into USHIK– Their specifications are made public– Their specifications are made clear
What is fully specified What is not
– Specific data elements with the same name can be compared accurately across QM’s for consistency—of meaning and representation
Data elements of multiple QM’s can be easily compared to see if “they” are identical The QM’s The data elements The exclusion criteria The source standards for the data elements, e.g., do they use the same coding system?
QM data elements can be compared with those in existing EMRs to determine if a specific EMR can validly produce a specified QM
11
What data elements are needed for What data elements are needed for ARRA meaningful use?ARRA meaningful use?
X12N NCPDPHL7 HITSP
USHIK
AHRQ Patient Safety
12
Do the data elements in my EHR fit Do the data elements in my EHR fit HITSP specifications?HITSP specifications?
X12N NCPDPHL7 HITSP
USHIK
Are My EHR data defined the same as HITSP’s?
13
How does each authority express How does each authority express gender?gender?
X12N NCPDPHL7 HITSP
USHIK Gender
14
Do the data elements in my EHR fit Do the data elements in my EHR fit HITSP specifications?HITSP specifications?
X12N NCPDPHL7 HITSP
USHIK
Are My EHR data defined the same as in Meaningful Use?
Meaningful Use
15
Comparison Matrix Aids in Harmonizing Data Elements
www.USHIK.org
In FY 2011In FY 2011
USHIK.AHRQ.GOV will remain publicly availableUSHIK.AHRQ.GOV will remain publicly available ACPD portal will be expanded with data elements from more statesACPD portal will be expanded with data elements from more states Patient Safety Common Formats portal will Patient Safety Common Formats portal will
– Be updated as the formats are enhancedBe updated as the formats are enhanced– Include common formats for reporting adverse device eventsInclude common formats for reporting adverse device events
AHRQ will work with CMS and ONC to AHRQ will work with CMS and ONC to – improve Health IT data element uniformityimprove Health IT data element uniformity– Promote one-stop-shopping for required data elementsPromote one-stop-shopping for required data elements– Reduce work effort for researchers and other Health IT data usersReduce work effort for researchers and other Health IT data users
AHRQ will develop more working relationships with HHS agenciesAHRQ will develop more working relationships with HHS agencies
16
Using Health IT Standards: Learning from USHIK
Public Health Data Consortium’s 2010 Annual Meeting
J. Michael Fitzmaurice, Ph.D.Agency for Healthcare Research and Quality
November 4, 2010
