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Structured Data Capture (SDC) All Hands Meeting. February 14, 2013. Meeting Etiquette. From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute . All Panelists . Remember: If you are not speaking, please keep your phone on mute - PowerPoint PPT Presentation
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Structured Data Capture (SDC)All Hands Meeting
February 14, 2013
Meeting Etiquette
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• Remember: If you are not speaking, please keep your phone on mute
• Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call o Hold = Elevator Music = frustrated speakers and
participants• This meeting is being recorded
o Another reason to keep your phone on mute when not speaking
• Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know.o Send comments to All Panelists so they can be
addressed publically in the chat, or discussed in the meeting (as appropriate).
From S&I Framework to Participants:Hi everyone: remember to keep your phone on mute
All Panelists
AgendaTopic Time Allotted
Welcome and AnnouncementsMeeting RemindersHIMSS Attendance
5 minutes
SDC Project Charter ReviewProject Charter Comment Dispositions on WikiReview Value Statement and Target Outcomes SectionsHomework: Final Review and Comments on Other Sections before voting begins next week
35 Minutes
AHRQ Common Format for Patient Safety Event ReportingAmy Helwig, MD MS 20 Minutes
Next Steps / Contact Information
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Welcome and Announcements• Structured Data Capture (SDC) Initiative holds weekly
community meetings on Thursdays at 3:25 pm EST. – Please see the SDC Wiki Page for meeting information– http://wiki.siframework.org/Structured+Data+Capture+Initiative
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Please check the meeting schedule weekly as the meeting link and call in numbers will change.
Weekly Meetings
HIMSS Attendance• HIMSS Conference being held March 3-7 coincides with
SDC All-Hands meeting planned for March 7th. • The SDC All Hands Meeting scheduled for Thursday,
March 7th has been CANCELLED.• SDC Leads are making arrangements for an informal
meet-and-greet during the conference. More information will be provided to the SDC community in the coming weeks.
SDC Project Charter Review• Thank you to everyone who has commented so far. • A reminder for anyone who has not yet reviewed the Charter - this is
your opportunity to provide input!• Review and comment on the SDC Project Charter here:
– http://wiki.siframework.org/Structured+Data+Capture+Charter+and+Members
• All current comments have been reviewed by the SDC Team and deposed. You can review the SDC Lead responses in the comment spreadsheet at the bottom of the SDC Project Charter Page (same link as above).
Review and Comment
Continue SDC Project Charter Review• Comment Period will CLOSE on Tuesday, February 19, 2013 at
8:00 pm Eastern. • Consensus Voting will OPEN on Thursday 21, 2013 at 8:00 am
Eastern.
• Today– Focus on Value Statement and Target Outcomes– Switch to Word document– Notes / comments / edits will be recorded in-line in the Word
document.
AHRQ Common Formats
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Common Formats
Common language for patient safety event reporting– Common language & definitions– Standardized rules for data
collection
Standardize the patient safety event information collected
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Form Library5
2
xx
John Doe x
x x
x x 6
1
4Provider
EHR System
External DataRepository
SpecifiedForm/Template
CDE Library
AHRQ CDEs[Common Formats]
Clinical ResearchCDEs
DisplayedForm
Structured Captured Data
Selects
form
/template
Inputs data
Stores/ transmits data
Finds form/template
Caches data
3Converts, populates & displays form
7Extract, Transform,
& Load Data by
form/ template
EHRSystem
Provider/End User
Actor Key
End User
Structured Data Capture Conceptual Workflow
Other domainCDEs
Patient SafetyForms
Other domainForms
[Common Formats]
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Current Problem with Adverse Events and Reporting
HHS Office of the Inspector General reports Nov 2010 and Jan 2012:
– OIG reported that 13.5% of hospitalized Medicare beneficiaries experienced serious adverse events; an additional 13.5% experienced temporary harm events
– Hospital staff did not report 86% of events to incident reporting systems
– Inconsistent identification of adverse events
– Confusion among front line staff
– Reporting not identified as a worthwhile use of time
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System Needs: Patient Safety Measurement
Decrease data collection burden to end user – Collect once & supply data to whatever agencies
need reports
Increase value to institution collecting the data, states, Federal agencies, & accreditors– Enhance local patient safety and quality
improvement– Improving benchmarking of local performance with
regional & national means
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Common Formats Authorized by Patient Safety Act in 2005 PSOs
Developed with a Federal work group comprising major health agencies (e.g., CDC, CMS, FDA, DOD, VA)
Incorporates input from public, industry
Reviewed by an NQF expert panel, which provides advice to AHRQ
Promulgated as “guidance” announced in the Federal Register
Approved by OMB (process & Formats)
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Common Formats DevelopmentAHRQ reviews current public and private systems.
AHRQ harmonizes when possible, create new content when needed.
AHRQ presents draft event description to Federal Patient Safety Work Group.
Patient Safety Work Group and subject matter experts help refine Common Formats.AHRQ publishes
Common Formats on the web, announce availability and public comment via NQF in Federal Register.
AHRQ expands Common Formats to new areas based on feedback.
NQF convenes Common Formats Expert Panel to review comments.
AHRQ refines and revises Common Formats based upon feedback.
AHRQ reviews current evidence base.
PSOs and vendors implement Common Formats in electronic systems.
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How do Common Formats work?
Comprehensive set of modules allows for capture of patient safety event data from ANY patient safety concern– Incidents – patient safety events that reached the
patient, whether or not there was harm
– Near misses (or close calls) – patient safety events that did not reach the patient
– Unsafe conditions – any circumstance that increases the probability of a patient safety event
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How do Common Formats work?
Comprehensive modules cover all types of events:– Common events
– Rare events (includes NQF Serious Reportable Events)
Modular design allows for expansion– Addition of new topics
– Expansion to new settings
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How do Common Formats work?
Generic modules – information (CDEs) common to all events– Example- reporter, location, harm level, patient
demographics, contributing factors
Event specific modules– CDEs limited to discrete topic areas:
Blood, Devices (including HIT), Falls, Healthcare Associated Infections, Medications, Perinatal, Pressure Ulcer, Surgery & Anesthesia, VTE
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Common Formats as part of CDE
The Common Formats can be used to create a complete initial patient safety report for healthcare providers and PSOs.
Generic CDEs paired with Event Specific CDEs make a complete patient safety report
AHRQ technical specifications for local data collection using the Common Formats define the form/template to assemble the pertinent data elements for each type of incident in a precise order
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What is a Common Format? What does it look like?
1.1 A fall is a sudden, unintended, uncontrolled downward displacement of a patient’s body to the ground or other object (e.g., onto a bed, chair, or bedside mat).. 1.1.1 Inclusions 1.1.1.1 A fall not known to be assisted 1.1.1.2 Assisted fall - when patient begins to fall
and is assisted to the ground by another person 1.1.2 Exclusions 1.1.2.1 A fall resulting from a purposeful action or violent blow (e.g., a patient pushes another
patient) 1.1.2.2 Near fall – loss of balance that does not result in a fall
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What is a Common Format? What does it look like?
1. Was the fall unassisted or assisted? CHECK ONE
a. Unassisted b. Assisted c. Unknown
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Generic Common Formats
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Generic Common Formats – General Information
Hospital Common Formats
For all events, Common Formats assess general information.
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Generic Common Formats – General Information
Hospital Common Formats
Medication
If the event is covered by an Event-Specific Format,
additional information will be requested
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Generic Common Formats – General Information
Hospital Common Formats
Medication
If the event involves more than one type of adverse action, e.g., a
malfunctioning device that administers too much drug, then more than
one event-specific Format will be invoked.
Device
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Hospital Common Formats
Narratives are collected on all adverse events. While they are not
useful at a national level, they are invaluable at the local level.
Medication Device
Narrative
Generic Common Formats – General Information
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CDEs and AHRQ Common Formats
Providers may have needs for data elements not included in the AHRQ Common Formats– Local requirements (hospital or state specific)
– Specialty details
– Research needs
Modular framework allows for addition of elements that are important to other users
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Event Summary Report
Event Summary Report
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Common Formats Components
Incident – 168 data elements may apply
Near miss – 102 data elements may apply
Unsafe condition – 55 data elements may apply
No more than 65 of these data elements could reasonably be expected to be documented in (& thus accessible from) a mature EHR
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SDC Data Flow: Provider to PSO to NPSD
User: Researchers and Policy
Makers
Privacy Protection
Center (PPC)
Other Qualified Sources
Network of Patient Safety
Databases (NPSD) User:
Provider
User:AHRQ
National Quality Reports
User: Patient Safety
Organization (PSO)
Patient Safety
Organization (PSO)
EHR
Incident Reporting System
Structured Data
Capture
Patient Safety Work Product
Provider Environment
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Common Formats and SDC Challenges
Need to fully align both the formats and CDE used by the Common Formats with those data standards identified for Meaningful Use
Need to identify how to maximally take advantage of the potential for a more direct relationship between the Common Formats and the EHRs:
Is there enough information extractable for auto population of incident reporting system “forms” to make a meaningful difference?
Will structured data capture efficiently fit into the clinical work flow
– Reduce time to complete reports?
– Increase volume of reports to incident reporting systems?
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National Drivers forAdoption of the Common Formats
Institute of Medicine Report on Health IT and Patient Safety, November 2011 – recommends use of the Common Formats, as well as PSOs, for reporting IT-related adverse events
Office of the Inspector General (HHS) – 2011 & 2012 reports on adverse events in hospitals recommend surveyors/accreditors evaluate hospitals regarding their use of the Common Formats
CMS – is working with AHRQ to align CMS programs, including survey & certification, with the Common Formats
FDA – has been working for nearly two years with AHRQ to align its device-reporting system, MedSun, with Common Formats.
Office of the National Coordinator for HIT – requested challenge award proposals for adverse event reporting using Common Formats & PSOs; new S&I Framework Initiative focuses on Structured Data Capture
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Common Formats on the Web
https://www.psoppc.org
Dr. Amy Helwig
Next Steps• HOMEWORK: Comment on the Project Charter:
– http://wiki.siframework.org/Structured+Data+Capture+Charter+and+Members
• Next Work Group Meeting• Thursday, February 21, 2013 from 3:30pm - 4:30pm Eastern
– http://wiki.siframework.org/Structured+Data+Capture+Initiative
• Reminder: All SDC Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Use Case, Project Charter and general information will be posted on the SDC Wiki page– http://wiki.siframework.org/Structured+Data+Capture+Initiative
Contact Information• For questions, please contact your support leads
– Initiative Coordinator: Evelyn Gallego ([email protected])– Project Manager: Jenny Brush ([email protected])– PM Support: Zachary May ([email protected])– Use Case/Requirements Lead: Jennifer Sisto ([email protected])– Standards Development Lead: Caryn Just ([email protected])
