New York Statewide Health Center Controlled Network

CPCI Data Validation Webinar

NYS-HCCN Clinical Quality Improvement and Health IT Committees Webinar

September 21, 2015

www.chcanys.org

Live Meeting Guide • Do not use your HOLD button

• Press *6 please mute your phone

• Press #6 to un-mute your phone

• Please note that the webinar is being recorded

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Presenters

• Amy Grandov, Managing Director NYS-HCCN, CHCANYS

• Greg Augustine, Vice President of Operations, Azara

• Lisa Perry, Senior VP Quality & Technology Initiatives, CHCANYS

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Agenda

• CPCI Technology and Data Quality Overview

• Data Validation Tool and Process

• CPCI Updates

• Q&A

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Welcome • Clinical Quality Improvement and Health IT Committees of the

New York Statewide Health Center Controlled Network (NYS-HCCN) identified data quality as a key priority for health centers – NYS-HCCN Committee Chairs:

• Clinical Quality Improvement Committee: Dr. Warria Esmond, Settlement HC

• Health IT Committee: Patrick Murphy, CFO, Greater Hudson Valley CHC

• Training and resources open to all New York State FQHCs, with particular relevance to centers connected to CPCI

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CPCI Technology and Data Quality - Overview

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Center for Primary Care Informatics (CPCI)

• A statewide reporting and analytics solution for NY’s FQHCs

• Developed by CHCANYS in 2011 in close partnership with Azara (www.azarahealthcare.com) and utilizing the DRVS (“Drives”) analytics platform

• Reporting is available for mandated & regulatory reporting (UDS, Meaningful Use, HEDIS), PCMH support, grants, patient registries, patient visit planning

• Currently 43 New York State health centers are live on CPCI, with several centers in process or in the pipeline to connect

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CPCI Connected FQHCs

Multiple Data Views

Health Center Benchmarks

Individual Center

Provider Benchmarks

Actionable Patient Detail

• Wide range of data views CHCANYS-wide (Benchmarking) Your Health Center Providers; Locations/Sites Patient Level detail

• CPCI drill-through features can be used to identify potential data issues and improve data quality

• To maintain data quality over time, run reports and use your data often, and communicate with Azara and CHCANYS

Data Flows Into CPCI

Data is available in CPCI front-end, a web-based reporting platform accessible from any major browser

Data is mapped according to health center-specific business rules, and unified in EHR-agnostic Data Warehouse. External data is referenced, if applicable

Data is pulled nightly from disparate EHR/EPM* systems

1

3

• EHR: Electronic Health Record

• EPM: Electronic Practice Management

2

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What is data quality? • Generally speaking, good quality data is:

Consistent : data in CPCI is consistent with EHR

Correct : data is free of errors

Current/timely : data is up-to-date

Complete : data is not missing, and is sufficient for analysis

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Causes of Data Quality Concerns • Measure specification details

– Measures with similar names may have significant differences in specifications

– Updated specifications (e.g., 2011 to 2014 version) or codes

– Differences or errors in how a specification was implemented or interpreted

• Mapping

– Incomplete or incorrect initial mapping

– Something has changed in EHR, clinical documentation workflow, or lab interface that CPCI does not know about

• Data capture in EHR

– Free text fields vs. structured format (pick list, etc.)

– Inconsistencies among providers and documentation practices

– Closing the loop on referrals

• Technical issues

– Interruption in the connection between your EHR and CPCI

– EHR or infrastructure upgrade 9/21/2015 www.chcanys.org 12

Data Validation Tool Patient Sampling Template

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Data Validation Tools – Excel Workbook

• Supports patient sampling and analysis to identify root causes of data quality issues

• Validates CPCI data against the source data in the EHR at the patient-level detail

• Can help facilitate work with Azara to further analyze and resolve issues

• May use workbook on your own or collaboratively with Azara and/or CHCANYS

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High Level Steps

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1

2

3

4

Run your report in CPCI.

Select a sample of patient level detail. Copy to the Data Validation Workbook

Compare CPCI data to the EHR for each selected patient. Note discrepancies

Contact Azara if you suspect a mapping issue

1. Run Report in CPCI

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1. Run Report in CPCI (cont) • Select your report parameters

• Tip: For all measures you are validating, use a specific period (i.e., TY December 2014), or at least record the time period you use

This is essential so that when evaluating patients in/out of the denominator, or data that puts patients in/out of compliance, everyone is talking about the same time period

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Review the Measure

Specifications

2. Select Patient Sample for Data Validation

• Drill into the measure to select data to validate in more detail (e.g., look at a provider with many patients qualifying for a measure)

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Optional: Select one provider to examine in

detail

Optional: Group by Provider Display Chart view

Sort by Denominator

2. Select Patient Sample for Data Validation (cont)

• Export to Excel for further analysis

Hover over a name to display patient

details

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Export Patient Level Detail

2. Select Patient Sample for Data Validation (cont)

• All exported patients will be in the Denominator (Y) of the measure • Select

– 5 patients who meet the measure (numerator = Y) – 5 patients who did not meet the measure (numerator =N) – 5 patients who were excluded from the measure (exclusion=Y), if applicable for this

measure

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2. Select Patient Sample for Data Validation (cont)

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• Copy selected data into the Data Validation Worksheet

2. Select Patient Sample for Data Validation (cont)

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Measure Specification

Patients who meet the measure (numerator=Y)

Patients who do not meet the measure

(numerator=N)

Exclusions

3. Compare CPCI and EHR details for each selected patient

• Use the MRN to look up each patient in your EHR.

• Note any discrepancies in the Data Validation Workbook.

– Look at all possible fields in the patient's record to find where a test result may be stored (e.g., include attachments, free text fields, etc.)

– If applicable, be sure to record where in the EHR you found a different result

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3. Compare CPCI Data to EHR

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Pass : CPCI matches EHR Fail: CPCI and EHR do not match

Comments: Note if there is a mismatch. If EHR is correct, where did you find the

data in the EHR?

Use MRN to look up patients in EHR

4. Addressing Issues Suspected Source of Data Quality Issue

Sample Root Cause Possible Next Steps

Missing, inaccurate, or inconsistent documentation in EHR

• Workflow • EHR Configuration • Internal coding practices

• Internal staff training • Workflow redesign (e.g., referral tracking

and followup) • EHR optimization • Reach out to CHCANYS for TA

Data mapping to CPCI • Missing or changed lab names • Incomplete list of procedure codes • Changes to clinical workflow or EHR

• Contact Azara (support@azarahealthcare.com)

Missing data in CPCI for certain time periods

• EHR/CPCI Connector issue • Processing time lag

• Contact Azara (support@azarahealthcare.com)

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4. Addressing Issues (cont.) • Reach out to Azara to report any of the following changes or

requests: New location/site for your health center New lab or change in lab interface New or modified EHR templates; new structured fields Changes to standard clinical documentation workflows Upgrades to EHR software or infrastructure, including hosting

arrangements Request setup or changes to service lines Request new payer group Request new alerts to be added to the Patient Visit Planning report Unexplained sudden change in a measure or report (e.g., a sudden

jump or drop off in a value; missing data)

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4. Addressing Issues (cont.)

• You do not need to contact Azara for

– New providers, patients

– Standard tasks that can be handled by your Health Center Admin/Superuser, including: • Create, modify, disable or unlock CPCI accounts

• Reset passwords

• View or modify provider groups

• Create or modify location groups

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4. Addressing Issues (cont.) Tips for reporting a ticket to Azara:

1. Include the full name of the report/measure you ran

2. Document the filters you used

3. Be specific in your description of the issue, including patient examples. If possible, send a screen shot of the information in your EHR

4. Open multiple tickets if there are multiple issues

5. The Data Validation Workbook can help with troubleshooting and speed up the time to resolution!

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Additional Validation Tools: 2011 to 2014 NQF Measure Updates

• NQF measures were updated from 2011 to 2014 • CHCANYS has partnered with Azara and Primary Care

Development Corporation (PCDC) to create comparison documents for 19 of these measures

• Also available are companion Excel files that list all codes as well as the logic used for both 2011 and 2014

• Resources are available here: – https://www.dropbox.com/sh/grp4m508wlu9uxh/AADvS7

v7lb84uc2KaA8RGUoLa?dl=0

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Tips for Maintaining Data Quality • Patient Visit Planning report for daily huddles provides an

opportunity to notice and report data questions • CPCI Release notes are emailed to all CPCI users. Read release

notes for details on fixes and enhancements that may impact you. – If you are not on the distribution list, email

support@azarahealthcare.org

• If capture of accurate race/ethnicity or other demographics is a challenge, a toolkit is available from Health Research and Educational Trust, endorsed by National Quality Forum: – http://www.hretdisparities.org/

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CPCI Updates

• What’s New: – New User Interface

– HIV/QUAL Reporting

– Referral Management Report

• Impact of ICD-10

• UDS 2015 changes

• Email: support@azarahealthcare.com

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Additional Background

• Data Quality 101 webinar: http://www.chcanys.org/index.php?src=gendocs&ref=Data%20Quality%20Initiatives&category=HIT

• Training on the new CPCI user interface, including documentation and videos: https://drvs.azarahealthcare.com/documentation/help/New_UI_MoreInfo.html

• Tips for documenting demographic data from Health Research and Educational Trust, endorsed by National Quality Forum: http://www.hretdisparities.org/

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List of CPCI Connected FQHCs Health Center Location EHR

ACACIA Bronx NextGen

ACCESS CHC NYC eCW

ANTHONY JORDAN Rochester eCW

BEACON CHRISTIAN Staten Island Success EHS

BEDFORD STUYVESANT Brooklyn eCW

BETANCES NYC eCW

BORIKEN NYC eCW

BRIGHTPOINT HEALTH NYC eCW

BROOKLYN PLAZA Brooklyn eCW

BROWNSVILLE Brooklyn eCW

CHAUTAUQUA Dunkirk Allscripts

CHC BUFFALO Buffalo eCW

CHC OF THE NORTH COUNTRY Staten Island eCW

CHC RICHMOND Staten Island eCW

COMMUNITY HEALTHCARE NETWORK NYC eCW

DAMIAN Briarwood eCW

EZRA MEDICAL CENTER Brooklyn NextGen

EZRAS CHOILIM HEALTH CENTER Monroe Allscripts

FAMILY HEALTH NETWORK OF CENTRAL

NY, INC. Cortland GE Centricity

FINGER LAKES Penn Yan eCW

GREATER HUDSON VALLEY FHC Newburgh GE Centricity

HARLEM UNITED NYC eCW

Health Center Location EHR

HEALTHCARE CHOICES Brooklyn eCW

HOMETOWN Schenectady eCW

HOUSINGWORKS Brooklyn eCW

HUDSON HEADWATERS Glens Falls Athena

HUDSON RIVER HEALTH CARE Peekskill eCW

INSTITUTE FOR FAMILY HEALTH NYC EPIC

LUTHERAN Brooklyn eCW

MORRIS HEIGHTS Bronx eCW

NOCHSI Pulaski Intergy

NORTH COUNTRY FHC Watertown NextGen

OAK ORCHARD CHC Brockport eCW

OPEN DOOR FMC Ossining eCW

PROJECT RENEWAL NYC eCW

REFUAH Spring Valley eCW

RPCN Rochester eCW

SETTLEMENT NYC GE Centricity

SOUTHERN TIER CHC NETWORK Elmira eCW

URBAN Bronx eCW

WHITNEY M. YOUNG, JR. CHC Albany eCW

WILLIAM F. RYAN NYC eCW

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Contact Details • Contact Azara:

– email support@azarahealthcare.com

• Contact CHCANYS:

– Amy Tammam, Health IT Project Manager (atamma@chcanys.org)

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Evaluation

Please complete our brief survey:

https://www.surveymonkey.com/r/KVTKZD3

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