Public Health Data Standards Consortium http://www.phdsc.org

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PUBLIC HEALTH DATA STANDARDS CONSORTIUM~ PHDSC 2012 ANNUAL BUSINESS MEETING ~

November 8-9, 2012, Hyattsville, MD

NEXT STEPS: Towards Public Health Sector Transformation and Sector Unity

Report from Data Standards Committee

Maiko MinamiHLN Consulting, LLC

Public Health Data Standards Consortiummaiko@hln.com

Data Standards Committee OverviewCo-Chairs: Robert Davis, Starla Ledbetter

Subcommittees Health Care Services Data Reporting Guide

(HCSDRG) - Chair: Robert Davis

Payer Typology - Chair: Roxanne Andrews

Oversees activities - Implementation of Business Use Case: HIT Standards Web-Resource Center

PHDSC & Strategic Plan Overview

PHDSCBuild “Coordinated Voice” from Public Health for HIT Standards Bring Voice to HIT Standardization Efforts Achieve Interoperability of Public Health &

Healthcare Systems

Disease-Based Model of Care

Health-Based / LHS Model of Care

Mission

Partner with

Stakeholders

Align System Functionality with

PH needs

Enable System Interoperability via

HIT StandardsObjectives

Catalyst

Strategic Initiatives Tasked toData Standards CommitteeStrategic Initiative 1

Unify PH to Support Health-Based Model (HBM) / Learning Health System (LHS)

Goal Align data gathering practices across PH using

standards-based Information Systems (IS)

Objectives Advocate need for transformation and migration Form PH Transformation Coalition

Strategic Initiatives Tasked toData Standards Committee

Strategic Initiative 2Unify PH Information Systems

Goal Transform and align PH-IS to support information

exchange across PH & partners

Objective Build a Coordinated Voice and bring the Voice to

HIT Standardization efforts

Strategic Initiatives Tasked toData Standards Committee

Strategic Initiative 3Align/Integrate PH with Other Healthcare

Sectors, including Admin Data Systems Goal

Enable integration with PH, clinical, and administrative information systems

Objective Monitor and participate in national initiatives that

align PH and healthcare Influence direction of activities w/ PHDSC vision

Data Standards Committee

Purpose Data Standards Committee coordinates data

standards activities for PHDSC Goals

Identify current and future public health data needs

Work with standards development organizations to support those needs

Educate PH stakeholders about these standards and to promote their usage

Project 1: Assure HIT Standards for Public Health (Business Case: Role of Public Health in National HIT Standardization)

Project 2: PHDSC Participation in Health Data Standards Development for Administrative Data Exchanges

Project 3: Public Health Functional Requirements Project

Project 4: Standards for Early Hearing Detection and Intervention (EHDI) Program

Project 5: Standards for Public Health Laboratory (PH-Lab) Data Exchange and Case Reporting 

Project 6: Standards for Occupational Health Data Exchanges

Project 7: University-based Public Health Informatics Training

 

PHDSC Projects: 2012-2013Assuring Health IT Standards for Public Health

Participation in Health Data Standards Development for Administrative Data Exchanges

Participate in standards development activities:

Maintain the Health Care Service: Data Reporting Guide Develop standards harmonization GAP ASSIST on-line tool

Collaborate with AHRQ and ANSI X12 to populate USHIK with All Payer Claims Database metadata

Develop IHE White Paper: Assuring Interoperability of EHR Systems and Administrative Data

Data Standards (Project 2) Activities

Accredited Standards Committee (ASC) X12 Activities

ASC X12 Purpose Develop messaging standards for over 275

business transactions, including standards for health care service data

PHDSC X12 Activities Participate in X12 standards development

activities Health Care Service: Data Reporting Guide

(HCSDRG) Gap Assist Tool

Health Care Service: Data Reporting Guide (HCSDRG)

Purpose of HCSDRG ACS X12 Implementation Guide to support Public

Health reporting of health care service data Based on HIPAA adopted standard compatible guide

Health Care Claim: Institutional (837) Same billing reporting requirements with addition of PH

requirements (e.g. race/ethnicity, county) X12 837 + PH requirements 837R

PHDSC Activity Maintain and continue to sync the HCSDRG with current

X12 standards

Gap Assist Tool

Purpose of Gap Assist Tool Visual tool that provides a meta data perspective

to see what data elements are supported in the HCSDRG across the different versions of the X12 standards

PHDSC’s way to let the public know of what the changes are across versions

PHDSC Activity As the HCSDRG is updated, Gap Assist Tool is

updated

Gap Assist Tool

Gap Assist Tool

National Uniform Billing Committee (NUBC)National Uniform Claim Committee (NUCC)

Purpose of NUBC and NUCC NUBC develops a standardized data set for use

nationwide by institutional providers and payers for handling health care claims

NUCC develops a standardized data set for use by the non-institutional health care community for handling health care claims

PHDSC Activity Participate in standards development activities Bring PH requirements to NUBC/NUCC

USHIK All Payer Claims Database (APCD) Portal: Background

Purpose of APCD All Payer Claims Databases (APCDs) are

databases, created by state mandate, that typically include data derived from medical, pharmacy, and dental claims with eligibility and provider files from private and public payers:

Insurance carriers (medical, dental, TPAs, PBMs) Public payers (Medicaid, Medicare)

USHIK All Payer Claims Database (APCD): Typically Included Information

• Patient demographics (DOB, gender, residence, relationship to subscriber)

• Type of product (HMO, POS, Indemnity, etc.)

• Type of contract (single person, family, etc.)

• Diagnosis codes (including E-codes)

• Procedure codes (ICD) • NDC codes for pharma Rx• Revenue codes

• Service dates • Rendering provider (name,

tax id, payer id, specialty code, city, state, zip code)

• Prescribing physician • Plan charges & payments• Member liabilities (co-pay,

coinsurance, deductible)• Date paid • Type of bill • Facility type

Current APCD States

USHIK All Payer Claims Database (APCD) Portal

Purpose of APCD Portal APCD Portal in USHIK compares corresponding

data elements of each state's APCD with the national standard for each data element.

APCD Portal was originally modeled after Gap Assist Tool

USHIK All Payer Claims Database (APCD) Portal

Partners in design and building of APCD Portal Centers for Disease Control and

Prevention/National Center for Health Statistics (CDC / NCHS)

Agency for Healthcare Research and Quality (AHRQ)

APCD Council (www.apcdcouncil.org) Washington Publishing Company PHDSC

USHIK All Payer Claims Database (APCD) Portal

Today, APCD Portal compares state APCD data and ASC X12 Data Standards

APCD Portal will include data elements from: Each state's All-Payer Claims Database (APCD) ASC X12 5010 standard ASC X12 Post-Adjudicated Data Reporting Guides

(published in August 2012) National Council for Prescription Drug Programs

(NCPDP) Uniform Healthcare Payer Standard Implementation Guide Version 1.0.

USHIK All Payer Claims Database (APCD) Portal

PHDSC Activity Develop and maintain APCD Portal with partners

Plan to work with 6 APCD states to solicit feedback about the portal over the next 9 months

IHE White Paper: Assuring Interoperability of EHR Systems and Admin Data

Purpose Describes areas where clinical health data from EHRs

and administrative health data from Admin Systems must be better aligned to meet future reporting needs of public health programs.

Roadmap for developing interoperability standards for data exchanges of administrative health data between EHRs, admin data systems, and public health programs

PHDSC Activity Developed IHE White Paper from Nov 2011 to Aug 2012 For review by IHE QRPH Domain for eventual publication

Assure HIT Standards for Public Health - Business Case:Role of Public Health in National HIT Standardization

Educate Public Health Community about Health Informatics and HIT Standards through HIT Standards Web-Resource Center (http://www.phdsc.org/standards/resource-center.asp)

Obtain Voice of the Customer feedback through JD Power and Associates survey to improve PHDSC website and HIT Standards Web-Resource Center

Improve design and information of PHDSC website

Improve Analytics on PHDSC Website to better understand usage

Business Case (Project 1) Activities

HIT Standards Web-Resource Center

Purpose Educate the public health community on Health

Informatics and HIT standards 4 Different Modules

PHDSC Activity Updated and maintained information in 3 Modules Specifications for 4th Module completed. Launch in May

2013.

PHDSC Health Information Technology Standards Web-Resource Center(http://www.phdsc.org/standards/resource-center.asp)

Assuring Health IT Standards for Public Health

Assuring Health IT Standards for Public Health

Assuring Health IT Standards for Public Health

Assuring Health IT Standards for Public Health

Strategic Initiatives Tasked toData Standards CommitteeStrategic Initiative 1

Unify PH to Support Health-Based Model (HBM) / Learning Health System (LHS)

Strategic Initiative 2Unify PH Information Systems

Strategic Initiative 3Align/Integrate PH with Other Healthcare

Sectors, including Admin Data Systems

Data Standards Committee:Future Directions

Continue to strategize activities to meet strategic initiatives

Continue to work with Standard Development Organizations to bring public health requirements to the table

Continue to educate the public health community about HIT standards and efforts

Specific issues to continue to think aboutHow to get clinical and admin data for public

health needs; align existing standardsWhat is the “consensus” of public health?