New Data Quality Reporting Is On the Way
December 1, 2017 | Blog post by Jordan Vigliarolo
There’s a new tool available to help Hospitals with the difficult task of ensuring that they are producing high quality clinical and administrative data: the recently released “Data Surveillance Program Report” (“DSP”).
The DSP was developed by the Canadian Institute for Health Information (“CIHI”), on behalf of the Ministry of Health and Long-Term Care (“MOHLTC”), to provide in-depth data quality analysis of the Discharge Abstract Database submissions Hospitals submit. The tool has a focus on data used for Health System Funding Reform (“HSFR”). It is intended to supplement existing data quality reports, but is unique in that it produces data quality scores with supporting information; this allows the user to dig deeper into unexpected patterns and trends. According to the Ontario Hospital Association (“OHA”), the goals of the DSP are to:
- “Ensure accuracy in facility-level data that is used to determine health system funding and create an equitable funding system in the province,
- Create a mechanism for the ministry to detect and monitor system-level trends/variances and ensure accountability for improving on data reporting practices, and to
- Enable potential evidence-based policy adjustments to address system-level reporting variances…”
By now, all Hospitals in Ontario should have received some form of formal communication regarding this reporting, which has been produced for the fiscal year ended 2016/17 as well as Q1 of 2017/18.
Data Quality Scores
The first (draft) versions of the DSP contain indicators highlighting areas where variances from expected values (based on regression models) warrant further investigation. In the future, the DSP is expected to summarize a series of composite data quality scores relating to different domains or data quality topics which have a large effect on HSFR calculations:
- Special Care Units
- Quality-based Procedures
- Discharge to Home Care
- Case Mix
There are several individual indicators that will roll up to the broad level domain categories listed above. CIHI is currently finalizing the methodology for normalizing and weighting the final scores that will ultimately be used for comparisons between peer hospitals and monitoring changes over time.
Documentation regarding the methodologies and indicators can be found on both the OHA’s website and on the Ministry of Health and Long-Term Care Financial Management Branch’s website (account and login information is required for both).
What Does This Mean for Small Hospitals?
While small hospitals are not currently funded under HSFR, some aspects of the DSP report will still be a useful tool for evaluating the quality of data submitted to CIHI.
It is anticipated that the DSP will eventually be used by the MOHLTC to identify outliers in specific areas and used as a basis for follow up and further investigation. For the first year of implementation however, it is expected that no audit process will be put in place and the dissemination of the tool will be more akin to a pilot project in nature.
Some parts of the tool may even have operational value to review. For example, the 2017/18 Q1 version of the tool contains data for trend analysis back to 2014/15 Q2. Looking at chart 4 on the Case Mix domain report, each Hospital would be able to see a nice summary of their Expected Length of Stay (“LOS”) in Hospital compared to their Actual (Acute only) LOS, with a comparison to the provincial average. This is useful operational data, presented in a manner that would be new for many. The tool also allows Hospitals to select any Hospital in Ontario, thus the results from logical peers could quickly be reviewed by individual Hospitals for comparison.
For those Hospitals which are funded through HSRF, it is also important to note that while the DSP reports cover several areas which are important to your HSFR funding, it is not an exhaustive list. Some areas which greatly affect HSRF funding, such as flagged interventions, are not fully covered by this tool. Also, the tool only covers DAD data at this time, so day surgery, emergency department and other important statistics such as medical trainee days are not covered by this tool.
DSO Involvement and Support
The Northwest Health Alliance’s DSO was represented on the provincial DSP Task Group which was created to provide input to the Ministry regarding this tool. We tried to bring a small, rural and northern Hospital perspective to this initiative and we thank all involved for allowing us to be a part of this important work. This is part of our role as a shared service in the North West LHIN.
Now that the tool has been released we will continue to seek opportunities to utilize the tool to benefit SRN Hospitals. Also, we have access to these data through provincial databases and we can provide deeper analysis into these results. Let us know if we can be of service to your Hospital – we would be happy to help you investigate!