The National E-Health Transition Authority (NEHTA)From Data Quality to Clinical Safety

Tatiana Stebakova

19 April 2010

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Role of NEHTA

• NEHTA was set up and funded by Federal, State and

Territory Governments as a separate entity in 2005

• We facilitate and progress e-health for Australia

• Our Board comprises heads of health departments in all

Australian States and Territories

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E-health foundations

• Right information – Terminology

• Right patient, Right provider – Healthcare Identifiers

• Right technological standards – Secure Messaging

• Complementary legislation – Authentication

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• Identifiers for Individuals, Providers and Organisations

• Ensures that the right information is associated with the right person

• Healthcare Identifiers Bill 2010 legislation currently before parliament

• Operational July 2010 pending legislation

New Healthcare Identifiers

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The Healthcare Identifiers (HI) Service has three primarycore service components:

1. Individual Healthcare Identifier (IHI)

2. Healthcare Provider Identifier – Individual (HPI-I)

3. Healthcare Provider Identifier – Organisation (HPI-O)

Healthcare Identifiers

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Model Healthcare Community

Video

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Data quality in healthcare

Click to add text

DQ Impact Clinical Scenario DQ Problem

Clinical

A letter of invitation for the follow-up service or a check-up was sent to a patient, who recently died from cancer

No Date of Death recorded

Inability to manage patients with chronic diseases Multiple identities

Mismatch of patient’s information No single source of truth

Avoidable Costs

Increasing costs of mail-outs with little business impact Addresses missing, incorrect or out of date

Operational costs of data cleansing and manual data validation

High costs of duplicate resolution process

Service efficiency

Diminishing number of patients registered with the practice

Lack of knowledge on service demand

Difficulties in inviting people for the service or follow-up Contact details are missing or incorrect

A new service was created or improved, but there is not have enough utilization

Inaccurate information Overestimation of the demand

due to duplicate entries

Change

Management Difficulties in DQ improvement Data Quality governance is missing.

Too hard

HI Service data quality challenges

1. Existing Mental Models on Data Quality

2. Interoperability within Federated Community

3. Quantification and DQ Measurement

4. Leveraged Solution-Legacy data and systems

5. Privacy/Legal

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Existing mental modes on data quality

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Federated community

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Data quality strategy

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Data Quality Strategy: maturity & implementation roadmapMCA DQ CMM Initial Assessment

1

3

3

22

2

1

0

1

2

3

4

5

Governance

Dimensions

Standards & Practices

PoliciesProtocols

Technology & Operations

Performance Management

Data Quality Framework: Governance

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http://members.ozemail.com.au/~enigman/australia/tas.html

WA DQ Forum

SA DQ Forum

NT DQ Forum

VIC DQ Forum

TAS DQ Forum

DQ Steering Committee

4 members

QLD DQ Forum

ACT DQ Forum MCA HI Operations

Review Forum NEHTA DQ Forum Workgroups (9 members in each group)Public and Private Hospitals WorkgroupTrusted Data Sources (TDS) WorkgroupDiagnostics and Pharmacy Workgroup Primary Care Workgroup (includes allied health)

Jurisdictional Working Party Structure(5 members - each workgroup representative and a chairPublic and Private Hospitals WorkgroupTrusted Data Sources (TDS) WorkgroupDiagnostics and Pharmacy Workgroup Primary Care Workgroup (this will include allied health)

NEHTA DQ Forum Structure:

DQ Forum Director

DQ Technical Certification and Audit

Group5 members

DQ Technical Advisory Group

5 members

DQ Oversight Board

DQ Standards Advisory Group

5 members

NSW DQ Forum

Data Quality Framework: Dimensions

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1. Semantic

2. Structure

3. Provenance

4. Completeness

5. Consistency

6. Timeliness

7. Accuracy

8. Fitness for Use

9. Quality Rating

Data Quality Framework: Standards and practices

• Structure and format standards for data exchanges

• Certification of trusted data sources

• Community-wide data standards & metadata management

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Data Quality Framework: Policies & Protocols

• Policy-based Data Quality management on

a centralised system and community level

• Data validation protocols

• Data provenance management

Data Quality Framework: Technology and operations guidelines (in progress)

• Standardisation of technology components across the community

• Design and service use guidelines

• Standardised techniques and procedures for data validation, certification, quality assurance, and reporting

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Data Quality Framework: Performance measurement- Metrics

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Dimension Characteristic Number of Metrics

Semantic Data Definitions 3

Name Ambiguity 3

Structure Structural Consistency 22

Provenance Originating Data Source 3

Completeness Optionality 41

Population density 35

Consistency Capture and collection 14

Presentation 4

Currency Age/Freshness 17

Temporal 1

Time of Release 1

Timeliness Accessibility 3

Response Time 3

Accuracy Precision 15

Value Range 44

Fitness for Use Coverage 49

Identifier Uniqueness 40

Search and match 27

Summary: Best Advice1. Data quality means clinical safety in healthcare systems.

2. Write clear and detailed DQ requirements, measurements and KPIs .

3. Make sure they are included in the design and operational contract.

4. Define a clear DQ Strategy and Blueprint. Try to involve the best DQ practitioners.

5. Focus on the quality of attributes, which are strategic for your business.

6. Define a capability maturity model and a roadmap on how to achieve the desired level of maturity.

7. Participate in all specification reviews to ensure that strategic quality components, e.g. information validation, are addressed in design and operational policies.

8. Know the systems design well. Precise knowledge will help you to develop DQ architecture.

9. Do not compromise on data standards – it will save you money on the system integration.

10. Be brave and persistent.

11. http://www.telegraph.co.uk/news/newsvideo/7577801/Organ-donor-register-blunder.html

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Thank you and Questions