Vermont Explor Annual Meeting

May 1, 2006

Capitol Plaza Hotel

AGENDA• Introductions all around• Review of 2005 Data• HIDI ~ Kevin and Ken• Birth Information Network ~ Peggy Brozicevic, VDH• Cancer Registry ~ Ali Johnson, VDH• Uses of data at federal level: AHRQ• 12:30 PM: Lunch• 1 PM: VITL, health information exchange and e-HIM ~ Greg Farnum• 1:30 PM: Dian Kahn, Pat Jones & Mike Davis, BISHCA

– Data uses at state level: Act 53 financial reports and quality measures– Expansion of outpatient data collection

• 2:15 PM: HospitalData.org - Strategic planning tool• 2:30 PM: Roundtable discussion

– Best practices/problem-solving– Networking:

• Web site? Listserv? Conference calls? More meetings?

Introductions

Review of 2005 Data

• Excellent in all areas except for:– Line item charges and HCPCS/CPTs

3-Year Trend by Type of Visit

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

1 2 3 4 1 2 3 4 1 2 3 4

2003 2004 2005

Invasive OP Procedures

ER Visits

Observation Stays

Inpatient Stays

Hospital (All)

dyear QUARTER

Data

Note: A patient visit can fall into more than one category

3-Year Trend by Payer

0

5,000

10,000

15,000

20,000

25,000

1 2 3 4 1 2 3 4 1 2 3 4

2003 2004 2005

Blue Cross / Blue Shield Champus Commercial Medically Indigent / Free Other Government Plans

Self Pay Workers Comp HMO Medicaid Medicare

Hospital (All)

Visits

dyear QUARTER

title

3-Yr Trend by Admit Type

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

1 2 3 4 1 2 3 4 1 2 3 4

2003 2004 2005

Elective

Emergent

Newborn

Urgent

Hospital (All) Bill Type (All) Payer (All)

Sum of Discharges

dyear Qtr

Admit Type

25,097 26,946 27,997

Admit Type by Bill Type

0

2,500

5,000

7,500

10,000

12,500

15,000

17,500

20,000

22,500

25,000

1 2 3 4 1 2 3 4 1 2 3 4

2003 2004 2005

111 - Elective

111 - Urgent

131 - Elective

131 - Urgent

Hospital (All) Payer (All)

Sum of Discharges

dyear Qtr

Bill Type

Admit Type

Outpatients

Inpatients

21,45419,703 22,297

3-Yr Trend by Disposition

8,7629,274 9,167 8,878 8,841 8,956 9,057

8,658 8,875 8,902 8,7968,173

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

1 2 3 4 1 2 3 4 1 2 3 4

2003 2004 2005

Died

Discharged / transferred to another short-term generalhospital for IP care

Discharged / transferred to another type of institution forIP care or referred for OP services

Discharged / transferred to intermediate care facility (ICF)

Discharged / transferred to skilled nursing facility (SNF)

Discharged to home health services

Discharged to home or self care

Discharged/transferred to another type of institution for IPcare or referred for Rehab Services

Discharged/transferred within this institution to hospital-based Medicare approved Swing bed.

Left against medical advice

Hospital (All)

Sum of Discharges

dyear q

title

Inpatients Only

Notable Outpatient Procedures

Procedures: Change from ’02 to ‘05

Procedure Classes provided by AHRQ

Procedures: Change from ’02 to ‘05

CCS: Clinical Classification Software, provided by AHRQ

Discharge records grouped on principal procedure

Diagnoses: Change from ’02 to ‘05

Discharge records grouped on principal diagnosis

HIDI ~ Ken Kuebler and Kevin Stock

Birth Information Network ~Peggy Brozicevic

Cancer Registry ~ Ali Johnson

AHRQ’s Uses of the Data

• Health Cost and Utilization Project (HCUP)• Constructs research databases:

– Main dataset, as of 2003:• 37 states’ inpatient stays• 21 states’ ambulatory surgeries• 17 states’ emergency room visits

– National Inpatient Sample– Kids Inpatient Dataset– others

AHRQ’s Publications

• National Healthcare Quality Report

• National Healthcare Disparities Report

• Fact Books (Avoidable Hospitalizations)

• Statistical Briefs (Reasons for ER visits)

AHRQ’s Software

• Quality Indicators (desktop application):– Inpatient Prevention– Patient Safety Pediatric

• Record Groupers (lookup tables):– Clinical Classification Software

• ICD-9 procs/diags, CPT, MHSA

– Procedure Classes– Chronic Condition Indicator – Comorbidity Software

AHRQ Stat Brief #1

• In 2003, percentage of non-childbirth hospitalizations via the ED:– US: 55% VT: 55%

– Payer is Medicaid or Medicare:– US: 66% VT: 63%

Lunch

VITL ~ Greg FarnumHealth information exchange and e-HIM

BISHCA

• Dian Kahn, Pat Jones & Mike Davis– Data uses at state level: Act 53 financial

reports and quality measures– Expansion of outpatient data collection

HospitalData.org

• Strategic planning tool

• Used by marketing and planning to predict utilization by patients from a given geographic area

• By DRG, procedure, and other categories

• Demonstration

Roundtable Discussion

– Best practices/problem-solving• Your questions and answers• What’s going on at your hospital

– Networking among hospitals• Web site? • More Listservs? Datacoordinators@vtexplor.org• Conference calls? • More meetings?

Contacts

Lauri ScharfLauri@vtexplor.org (802) 223-3461 x108Vermont Explor: www.vtexplor.org

Kevin Stock kstock@mail.mhanet.com(573) 893-3700HIDI: http://web.mhanet.com/ Click on “Hospital Data Services”HIDInet: https://www.mhanet.com/hidinet/