Home Visiting Data System Update

1. Home Visiting Data System Update MCH CLHO Meeting 10/17/12 Kathryn Broderick OHA - MCH Assessment, Evaluation & Informatics Unit

2. Home Visiting Steering Committee & Framework Design Team Charge Deploy a data system that meets the needs of governmental and nongovernmental public health, social service, and education organizations and families engaged in delivering, managing, coordinating, policy development and assessing home visiting services

3. Guiding principles • Collaborative • Accessible • Timely • Best practices • Outcome driven • Efficient • Culturally specific • Family driven

4. Multiple systems used by MIECHV* programs today * Maternal, Infant, and Early Childhood Home Visiting

5. Changing technology environment • You have not been here before • Health Information Exchange - CareAccord • Why build one when Oregon has bought one. • OHIT Direct messaging: can we uses this as module for secure messaging? • Master provider directory: can non-clinical partners use this? • OHIT Master patient index (future, advocate higher priority) • EHR Adoption expanding • Meaningful use is data driven • Clinical EHR users resistant to manual exchange of info • CCO’s dependent on efficient communications. If you can’t communicate you do not exist.

6. Changing information expectations • DMAP data demand increasing • How to remove barriers • 40% requests from public health • Consent management • care coordination and improved outcomes • local interpretations of privacy and risk. Needs collaborative solution • Interoperability based on value of data retrieval, reuse, and sharing • Systems need to use: Digital object identifiers, structured data recording, common data standards, metadata…

7. Timeline • MIECHV start-up/benchmarks data collection 7/12 • RFI 9/12 • HIPAA/FERPA legal discussion ongoing • Systems survey • MIECHV – compilation and analysis ongoing • All Others - under review • Paper charting analysis • CLHO MCH Data Champions - 9/12 ---- • HFA Data Champions – 10/12 ---- • Early Head Start Data Champions – 10/12 ---- • Site visits & focus groups: June-August 2012 • RFP issued 11/12 • Vendor contract 1/13

8. How Do Things Fit Together?

9. Convergence • Parallel projects addressing the same data about the same population • Early Learning Council data system • MIECHV data systems • Oregon Department of Education - Student Longitudinal Data System (SLDS) K-12 • Race to the Top – • Oregon Department of Employment- Child Care Division • HIE common services • Secure messaging • Master provider directory (w/ National Provider Id.) • ACF Systems interoperability planning grant

10. Two similar systems

11. Similar data & functionality needs

12. Common domains

13. Strategy for convergence of projects • Address key policy and standards questions • Politically unencumbered unique ID • HIPAA/FERPA issues • Consent management • Vocabulary and data standards • Harmonize common and program specific data set • Develop shared referral and case management documentation system and practices

14. Planning & Progress

15. Planning: MIECHV • Phase 1 – Performance Reporting System (7/2012) • Define 35 cross-program Benchmarks. Paper reporting • Design simple database to hold and report data pending HVDS. State provides data entry services • MIECHV Grantees only, small number index children each, annually • Phase 2 – HVDS • Define requirements • 11 core functionalities • specialized federal program performance indicators • Phased roll-out for programs • Sequential • Do everything • System retirement

16. Planning: ELC • Increased coordination and collaboration between Home Visiting Data System Working Group and Early Learning Data System Working Group. • ELC accepts report recommending HVDS as ELDS pilot • Early learning data system challenges: • Policy issues: • Master identity management • HIPAA/FERPA sharing and consent management • Define expanded ODE/ALDER linkages • Define shared minimum data set and data model • Identify required standards • Define interoperability requirements for parallel systems

17. Progress to date • Outcomes measures analysis and refinement - ongoing • MIECHV start-up/benchmarks data collection 7/12 • Reporting system and application live (7/12) • HVDS Procurement • Informal look at commercial off the shelf software (COTS): 36 vendors/products identified (10/11) • RFI (9/12): 29 companies accessed RFI • HIPAA/FERPA legal discussion - ongoing • Systems survey • MIECHV – compilation and analysis ongoing • All Others - under review • Paper charting analysis • CLHO MCH Data Champions - 9/12 ---- • HFA Data Champions – 10/12 ---- • Early Head Start Data Champions – 10/12 ----

18. Next steps • Define measures and methods – benchmarks, outcomes, minimum data set • Address key policy and standards questions • Politically unencumbered unique ID, HIPAA/FERPA waiver, consent management… • Complete program assessments and analysis • Map common data set • Complete data dictionary analysis • Develop shared case management documentation system and practices • Acceptable across public health, education and social service programs • Contracting process: RFI and RFP

19. Can we go paper-less? Data Champions process

20. Why we still use paper No acceptable replacement for : • Primary means of documentation, complete record • Case coordination notes and recording of efforts taken • Care plan/goals management and progress monitoring • Place to keep information that has no place in applications • Legal record where applications contain only summary/derived data • Primary source for answering questions about care, methods,and outcomes • entered into other systems • manual chart audits. Many organizations would like to retire paper charts

21. Develop “to be” requirements • Case management • Documentation • Care plan management and coordination necessary to support • modular application development and contracting requirements

22. Objectives • Identify information needed to • find, evaluate and manage a case; • develop and manage a care plan; • coordinate care; • track and measure progress and outcomes • supervise a portfolio or program with metrics. • Identify core components and uses of public health case management, case notes and care plans • Develop user stories for these elements in a work flow • Transition and system retirement issues: ORCHIDS,…. • Develop analytic uses

23. Outputs • Requirements for case management workflow • Minimum data set • Program specific data set • Common vocabulary and data standards • Metadata classes and value sets • Actionable evidence based practice protocols

24. Questions?

25. Overlapping Data Sets

26. ORCHIDS Before • ETO Local Health Dept. • MIECHV • Billing/ • EPIC • ORCHIDS • Billing/ • EPIC • ORCHIDS • Billing/ • EPIC • MIECHV • Family Manager

27. After Local Health Dept. • ETO • MIECHV HVDS • Billing/ • EPIC • Family Manager