Advancing Excellence in Health Care
2.0ETA December 2010
Carol SniegoskiAHRQ Annual Conference
September 27, 2010
Preview:
Advancing Excellence in Health Care
Future MONAHRQs (Estimated)
Jan Feb Mar Apr May Jun Jul Aug SepJun Jul Aug Sep Oct Nov Dec
2 0 1 0 2 0 1 1
MONAHRQ 1.0
• 47 AHRQ QIs• Hospital rates and
costs• Area rates and costs
MONAHRQ 2.0• More AHRQ QIs• More measures• Updated user interface
MONAHRQ 3.0• TBD
MONAHRQ 2.1• FY11 coding updates• Even more AHRQ
QIs
MONAHRQ 1.1• FY10 coding updates• Additional AHRQ QIs
Advancing Excellence in Health Care
MONAHRQ 1.0
Hospital Quality Path Hospital Utilization Path
Area Preventable Hospitalizations Path
Area Rates Path
• Many AHRQ Inpatient QIs (provider level)• Many AHRQ Patient Safety QIs (provider
level)
• AHRQ Inpatient QIs (area level) • AHRQ Patient Safety QIs (area level)• AHRQ Prevention QIs
• Procedure and condition rates and costs by area
• Procedure and condition rates and costs by hospital
Advancing Excellence in Health Care
MONAHRQ 2.0
Hospital Utilization Path
Area Preventable Hospitalizations Path
Area Rates Path
Hospital Quality Path
• All AHRQ Inpatient QIs (provider level)• All AHRQ Patient Safety QIs (provider level)• Hospital Compare inpatient measures
• AHRQ Inpatient QIs (area level) • AHRQ Patient Safety QIs (area level)• AHRQ Prevention QIs
• Procedure and condition rates and costs by area
• Procedure and condition rates and costs by hospital
Advancing Excellence in Health Care
Quick Guide: AHRQ Quality Indicators in MONAHRQ
AHRQ Inpatient QIs
AHRQ Patient Safety QIs
2.0(2010)
AHRQ Neonatal QIs
AHRQ Pediatric QIs
3.0(2011)
AHRQ Prevention QIs
1.0(2010)
included some included
not included
Advancing Excellence in Health Care
Quick Guide: Hospital Compare Measures in
MONAHRQ
CMS Process Measures, Inpatient
CMS Outcome Measures (30-Day Mortality and Readmissions)
CMS Hospital Acquired Conditions (Sep 2010)
Surgical care improvementHeart attackHeart failurePneumoniaChildren’s asthma care
Heart attackHeart failurePneumonia
CMS Structural Measures
CMS Outpatient Imaging Efficiency Measures
Medicare Payment and Volume Information
2.01.0
HCAHPS Measures
CMS Process Measures, Outpatient
included some included
not included
Advancing Excellence in Health Care
Hospital Compare Measure Results and MONAHRQ
MOHAHRQ 1.0 model:
Step 1
You download MONAHRQ
Step 2
You load your data
You calculate measure results
Step 3
You generate a
Website
Step 4
Calculate your own measure results
Advancing Excellence in Health Care
Hospital Compare Measure Results and MONAHRQ
MOHAHRQ 2.0 model:
Calculate your own measure results
You download CMS measure
results
You load CMS
measure results
You link hospitals
Load precalculated measure results
Step 1
You download MONAHRQ
Step 2
You load your data
You calculate measure results
Step 3
You generate a
Website
Step 4
and/or
Advancing Excellence in Health Care
Handling Hospital Compare Measure Results
We download the publicly available Hospital Compare measure results file from CMS
We clean, format, and test the file to make sure it works with MONAHRQ
We post the cleaned file to the MONAHRQ site
You go to the MONAHRQ site and download the cleaned CMS measure results file
You load the CMS measure results file and/or your own administrative data into MONAHRQ and generate a website
Advancing Excellence in Health Care
Update Cycles
CMS inpatient process measure results*
CMS inpatient outcome measure results*
HCAHPS results*
Annual refresh dates
MONAHRQ software updates• FY coding updates• Updates to internal
supplemental files
* According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database
Mar Jun Sep Dec
Advancing Excellence in Health Care
New Search Page
Select health topic
Tab between consumer and professional
paths
Select hospitals
Advancing Excellence in Health Care
New Hospital Search
Select radius in miles
Enter ZIP codeSearch by ZIP code or by region
Find hospitals
Advancing Excellence in Health Care
New Hospital Search
Select Hospitals for Comparison
Hospital list appears
Select one or more hospitals
Advancing Excellence in Health Care
New Health Topic Search
Select health topic
Topic description
appears
Advancing Excellence in Health Care
New Search Page
Select Hospitals for Comparison
Submit to go to classification table
page
Advancing Excellence in Health Care
New Classification Table
Consumer path: red / yellow / green
icons
Professional path: numbers with
confidence intervals
Two-way scrolling
Advancing Excellence in Health Care
New Classification Table
Tab for outcome measures
Tab for process measures
Tab between subgroups
Advancing Excellence in Health Care
New Classification Table
Sortable column for each indicator
New classification icons
• Above average• Average• Below average
• Top 10%• Above median• Below median
Switch between benchmarks: input
file and national
Advancing Excellence in Health Care
New Classification Table
Professional path: drill down to either
bar charts or detailed statistics
Consumer path: drill down to bar
charts view
Advancing Excellence in Health Care
MONAHRQ Learning Network
Goals• Facilitate MONAHRQ adoption• Gather feedback
Timeframe• Through June 2011
Participants• MONAHRQ adopters and serious potential adopters
Progress• Recruitment complete: 32 committed participants• Kickoff meeting after NAHDO conference, October 14
Advancing Excellence in Health Care
MONAHRQ Learning Network
Types of MONAHRQ Learning Network Participants
HCUP PartnerCVE
Other
Other State Government
Other University
Individual Hospital
Advancing Excellence in Health Care
MONAHRQ Learning Network
HCUP PartnerCVE
Other
Other State Government
Other University
Individual Hospital
MONAHRQ Learning Network Participant Locations
Advancing Excellence in Health Care
Data Refresh Cycles
CMS process measures* Quarterly(Sep, Dec, Mar, Jun)
12 months
CMS mortality and readmissions measures*
Annually(Jun)
36 months
HCAHPS patient experience measures*
12 months
Refresh rate Data period Data lag
Quarterly(Sep, Dec, Mar, Jun)
9 months
9 months
12 months
Census data for population denominators in area rates and area-level AHRQ QIs
12 monthsAnnually(?)
? months
* According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database
Advancing Excellence in Health Care
MONAHRQ Learning Network
Types of MONAHRQ Learning Network Participants
HCUP PartnerCVE
Other
Other State Government
Other University
Individual Hospital
Advancing Excellence in Health Care
MONAHRQ Learning Network
HCUP PartnerCVE
Other
Other State Government
Other University
Individual Hospital
Types of MONAHRQ Learning Network Participants
Advancing Excellence in Health Care
MONAHRQ Learning Network
HCUP PartnerCVE
Other
Other State Government
Other University
Individual Hospital
Types of MONAHRQ Learning Network Participants
HCUP PartnerCVE
Other
Other State Government
Other University
Individual Hospital
Advancing Excellence in Health Care
Quick Guide: AHRQ Quality Indicators in MONAHRQ
AHRQ Inpatient QIs*
AHRQ Patient Safety QIs*
1.1 (Oct/Nov 2010)
2.0 (Dec 2010)
IQI 2IQI 5IQI 9IQI 12IQI 13IQI 18IQI 19IQI 20IQI 21IQI 33IQI 34
PSI 3PSI 5PSI 7PSI 9PSI 16
AHRQ Neonatal QIsAHRQ Pediatric QIs
All
All
2.1(April/May 2011)
AHRQ Prevention QIs All
1.0 (Jun 2010)
* Any individual AHRQ QIs not listed are already included in MONAHRQ 1.0
included some included
not included
Advancing Excellence in Health Care
Quick Guide: Hospital Compare Measures in MONAHRQ
CMS Process Measures, Inpatient
CMS Outcome Measures (30-Day Mortality and Readmissions)
CMS Hospital Acquired Conditions (Sep 2010)
Surgical care improvementHeart attackHeart failurePneumoniaChildren’s asthma care
Heart attackHeart failurePneumonia
CMS Structural MeasuresCardiac Surgery Registry Participation
CMS Outpatient Imaging Efficiency Measures
Medicare Payment and Volume Information
2.0(Dec 2010)
3.0(Sep 2011)
1.x
HCAHPS Measures
CMS Process Measures, Outpatient (Jun 2010)
Advancing Excellence in Health Care
Data Update Cycles
CMS inpatient process measure results* 12 months
CMS inpatient outcome measure results* 36 months
HCAHPS results* 12 months
Annual refresh dates Data period
Data lag
9 months
9 months
12 months
MONAHRQ software updates• FY coding updates• Census data
• area rates• area-level AHRQ QIs
• Risk-adjustment data• provider-level AHRQ QIs
• FIPS data• areas and maps
12 months, including
yearly historical
data since 1996
? months
* According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database
Mar Jun Sep Dec
Advancing Excellence in Health Care
Update Cycles
CMS inpatient process measure results* 12 months
CMS inpatient outcome measure results* 36 months
HCAHPS results* 12 months
Annual refresh dates Data period
Data lag
9 months
9 months
12 months
MONAHRQ software updates• FY coding updates• Updates to internal
supplemental files
12 months, including
yearly historical
data since 1996
? months
* According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database
Mar Jun Sep Dec