Common Data SetImplementation

By Shawn Bloom and Ameeta Mistry

PACE Quantum Objectives - Recap

• Generate standard quality indicators• Support PACE organizations internal quality improvement

programs• Allow for efficient, meaningful, timely and accurate

benchmarking• Accurately describe and compare PACE enrollees to other

populations in order to demonstrate its value• Support the improvement and universal adoption of PACE

specific Electronic Health Records (EHRs)

PACE Quantum - Recap

The PACE Quantum is a 3 pronged effort initiated for creating a data architecture system to provide PACE solutions

1. Implement a new system called

DataPACE3

2. Develop standardized data

sets called Common Data Set

3. Encourage EHRproducts to support

standardization

Common DataSet I

Common DataSet II

DataPACE3 – The Big Picture

• DataPACE3 (DP3) replaces DP2 which was the former benchmarking system

• It is a wholly owned, designed and implemented, NPA asset• It includes functionality and features not available earlier to

provide data driven support for enhancements in PACE quality, performance, value, outcomes and advocacy

DataPACE3 (DP3) - Platform

Front EndWeb Interface

In the CloudAmazon Web Services

Back EndData Warehouse (DW)

DP3 – The Front End

• Phase I of Front End was launched in July 2017• Provides web interface for PACE organizations to load their data• Member experience has been positive

DP3 – DW, the Back End• Is a relational database; data resides in a series of tables with joins and

can be easily located• Tables created to accommodate DP2 data streams and now being

expanded to include CDS

DP3 - Status

Completed Front end web interface, July 2017 Roll out to members, August 2017 DW structure and schema

WIP and Outstanding Insertion of historical data into DW Reporting structures (in Tableau) Benchmarks and testing

CDS – What is it?

• The CDS is standardized data that is relevant to PACE• The data elements are clearly defined and consistently

recorded across all programs• Developed by NPA under the guidance of PACE professionals

from different disciplines• It consists of data that is grouped in 2 sets

• CDS I: about 100 elements of assessment and demographic data

• CDS II: about 60 elements of service and utilization data

CDS – What it is constituted of?

The CDS will be housed in the Data WarehouseCommon Data Set

Common Data Set IParticipant Characteristics

Common Data Set IIParticipant Experience

• Enrollment• Assessment• Services Received 12

Months Prior to Enroll• Diagnosis List• Medication List• OTC List• Falls• Bladder Devices• Pressure Ulcers

• Services - mostly similar to data feeds currently submitted into DP2

• Admits - expanded version of current submission into DP2

CDS – A Few Thoughts

• The Data Items are not new. These come from assessments used in geriatric care

• The Common Data Set will not impose additional reporting requirements. Rather, it will facilitate the reporting already being done by rendering it more meaningful and comparable

• We are writing a Common Data Set manual that will contain definitions and concise descriptions for all data points and variables

• Engage with your EHR vendor: emphasize the importance of the adoption of Common Data Set to your organization and the PACE market in general

CDS - Status

Completed CDS workgroup calls, September 2017 Data layouts, September 2017 Schema in DW

WIP and Outstanding CDS manual PACE organization acculturation to the CDS PACE organization adoption of the CDS

EHR

• Implementation of CDS is one of the most critical aspects of PACE Quantum

• EHR vendors need to partner with their PACE clients to configure their EHR products

• NPA is engaging vendors in this step• It is in the power and interest of PACE organizations to

encourage vendors to engage in configuring EHR systems with CDS specifications

What You Can Do

• Emphasize the importance of the adoption of CDS to your organization and the PACE market in general

• Elevate the importance and suggest strategies to accomplish this initiative

• Provide the support necessary to complete this initiative• Plan for all the steps that will be required for the successful

completion of the initiative• Understand CDS requirements• Map your data to the CDS requirements• Understand if back-end operations will create the data files

or effort at the front-end is required• Address the gaps

• Engage with your EHR vendor

Implementation PlanThe goal is to completely transition to the CDS in 2019

Action Timeline NPA PO EMRRelease CDS I and II Released

NPA holds webinar for PACE organization (PO) leadership to introduce 'Implementation Plan', announce creation of the CDS Implementation Workgroup and solicit feedback 11/30/2017

PO leadership announces initative to their organization, explains objectives and why the CDS is critical to PACE 12/15/2017

As part of the Implementation Plan, PO identifies staff leader whose role will be to triage between management, data and EMR within the PO. The CDS steward will also be the PO representative to the CDS Implementation Workgroup that will meet monthly to review CDS implementation progress 12/31/2017

CDS steward maps CDS I requirements to existing PO data capture and system capabilities for extracting the data which is in conformance to CDS i 1/31/2018

CDS steward identifes data elements in compliance with CDS I that already exist, can be attained with minimal effort, can be attained with investment of resources 1/31/2018

CDS Implementation Workgroup Session 1 is held. NPA responds to questions and clarifies issues 1/31/2018

PO leadership, CDS steward and EMR vendor collaborate on arriving at an understanding of data elements that are easily available and those for which resources will be required 2/15/2018

Implementation Plan - Continued

The goal is to completely transition to the CDS in 2019Action Timeline NPA PO EMR

CDS steward works with EMR vendor to transform submission of data elements that already exist to CDS I layout. Data that cannot be transformed must continue to be submitted in current formats 2/15/2018

EMR vendor reconfigures system to provide data in CDS I layout 2/15/2018

CDS Implementation Workgroup Session 2 is held. It is a forum for POs and EMR Vendors to share experience and solutions 2/28/2018

NPA issues report on quality, compatabiltiy and completion of data submitted in CDS I lay out 3/15/2018

CDS Implementation Workgroup Session 3 is held to discuss results. NPA uses input to create educational sessions 3/31/2018

PO leadership provide plan on when the complete CDS I data will be available 4/15/2018

NPA works with each PACE organization and EMR vendor to obtain complete CDS I data

CDS Implementation Workgroup Session 4 is held to discuss progress, share chalenges and experience 4/30/2018

CDS steward identifies components of CDS II ready for submission and informs NPA 5/15/2018

CDS Implementation Workgroup Session 5 is held to report on CDS I submission participation and to get ready for CDS II implementation steps 5/30/2018

At the End of It All: Improved System Offerings

Your Average

(D)Average

Peer Group Results

(E)25th

Percentile of Peer Group

Median of Peer Group

(F)75th

Percentile of Peer Group

561.00 387.88 150.00 240.00 465.001703.00 1154.60 441.00 678.00 1342.50

Benchmarking• Benchmarking will be generated from a Business Intelligence tool • Visualization is replacing tabular reporting

Visualization - NOW Tabular Reporting - BEFORE

At the End of It All: Reporting and Analytics

Phased–in capabilities will be created to support• Advanced Analytics• Predictive Analytics• Custom Reporting• Interactive Reporting• Trending

Examples of Reports• Characteristics of high-resource intensive participants• Risk stratification reports• Insights for quality improvement

It Takes a Village: How Can NPA Help?

• Training?• Any suggestions?• Who in your organization should be trained?

• Educational Materials?• What kind?

For more information go to www.npaonline.orgor contact Ameeta Mistry at ameetam@npaonline.org

Thanks!!!