MONAHRQ: A Web-Based Tool for Quality and Utilization Reporting (Text Version)

On September 27, 2010, Anne Elixhauser made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (4.1 MB). Free PowerPoint® Viewer (Plugin Software Help).

Slide 1

A Web-Based Tool for Quality and Utilization Reporting

Visit our Web site at: http://www.monahrq.ahrq.gov

For technical assistance and to get on the MONAHRQ mailing list, E-mail: monahrq@ahrq.gov

Slide 2

MONAHRQ—My Own Network, powered by AHRQ

Transforming your health care data into information about health, costs, and quality of care.

Slide 3

Overview

• Introduction to MONAHRQ: Anne Elixhauser, AHRQ
• One state's experience: NevadaCompareCare: Joseph Greenway, Director, Center for Health Information Analysis
• The future of MONAHRQ: Carol Sniegoski, AHRQ

Slide 4

Rationale

• Why should it be so expensive to generate and put out basic information?
• Why should information be so hard to get?
• Why does every organization have to reinvent the wheel?

Slide 5

From Data to Information to Action

Flow chart showing process:

Hospital discharge data are already being collected

Hospital discharge data can generate valuable health care information

Information can be used to make decisions

Utilization and costs of care in hospitals

Rates of diseases in particular areas

Quality of care in hospitals

Rates of procedures in particular areas

Preventable hospital stays that indicate breakdowns in care

Slide 6

So how to proceed?

• AHRQ tools could be bundled into a single product (many based on hospital discharge data):
  • QIs
  • WinQI
  • HCUPnet
  • Clinical Classification Software
  • Cost-to-charge ratios
  • Reporting template
• Incorporate other tools and data:
  • ZIP codes
  • Population data
  • DRG grouper

Slide 7

How does MONAHRQ work ...

• Currently based on hospital discharge data.
• Host user downloads MONAHRQ software from AHRQ Web site.
• Software—Host user applies software to own data locally.
• Host user creates local Web site on their own server.
• Host user makes Web site available:
  • Internally to better understand own data and to answer questions.
  • To member organizations, e.g., through a password protected site.
  • Publicly to provide information to the community.

Slide 8

The End User Website

Select the information you want:

• Quality Indicators
  
• Avoidable Hospitalizations
  
• Rate
• Utilization

A screen shot of the State Health Care Information Portal is shown.

Slide 9

Two quality paths to choose from

One path for the lay public and one path for analysts and the health care profession.

A screen shot of the State Health Care Information Portal is shown.

Slide 10

Select a health topic

AHRQ Quality Indicators grouped into health topics that have been consumer-tested for salience and understandability.

A screen shot of the State Health Care Information Portal is shown.

Slide 11

Select specific Quality Indicators

Specific AHRQ Quality Indicators under a health topic— select all or choose indicators of interest.

A screen shot of the State Health Care Information Portal is shown.

Slide 12

Select hospitals

Select hospitals from the entire dataset or from specific regions. Default in MONAHRQ is to list hospitals by name, but names can be masked.

A screen shot of the State Health Care Information Portal is shown.

Slide 13

Consumer path on Quality Indicators*

Arrays information on up to four hospitals for the indicators selected. Click on any indicator and get detailed information in graphic form.

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 14

Details in graphic form*

Get details for each hospital in rank order, compared to the state average.
 

*Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 15

Detailed path on Quality Indicators

The detailed path provides more information for each indicator.

A screen shot of the State Health Care Information Portal is shown.

Slide 16

Overall results for the state*

Information on specific indicators for the entire dataset:

• Numerators
• Denominators
• Observed, expected and risk-adjusted rates
• Confidence intervals

Click on indicator for hospital-specific information

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 17

Results by individual hospital*

Information by hospital on:

• Numerators
• Denominators
• Observed, expected and risk-adjusted rates
• Confidence intervals

Institution names can be masked or unmasked.

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 18

Click to see data graphically*

Risk-adjusted rate by hospital compared to state average

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 19

Utilization path

Utilization statistics (similar to information from HCUPnet)

A screen shot of the State Health Care Information Portal is shown.

Slide 20

Utilization across all conditions, entire state*

All conditions for the entire database, listed by number of discharges

Click on any column header to re-sort by:

• Charges/costs
• LOS or
• Condition/procedure

A screen shot of the State Health Care Information Portal is shown.

* Synthetic data

Slide 21

Utilization on individual conditions...

Can also search for utilization information on individual conditions

A screen shot of the State Health Care Information Portal is shown.

Slide 22

... for individual hospitals

A screen shot of the State Health Care Information Portal is shown.

Slide 23

Detailed utilization for all hospitals*

Information on:

• Numbers of discharges,
• Charges,
• Costs,
• Length of stay for all hospitals individually.

National, regional, and state benchmarks included.

A screen shot of the State Health Care Information Portal is shown.

* Synthetic data

Slide 24

More details for individual hospitals*

The same information is available for individual hospitals, by

• Age group
• Gender
• Payer
• Race

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 25

Potentially Avoidable Hospitalizations

A screen shot of the State Health Care Information Portal is shown.

Slide 26

Ambulatory care sensitive conditions

Potentially Avoidable Hospitalizations— AHRQ's Prevention Quality Indicators (PQIs—ambulatory care sensitive conditions) and ...

A screen shot of the State Health Care Information Portal is shown.

Slide 27

Other area-level indicators

...Area-level patient safety and procedure rates

A screen shot of the State Health Care Information Portal is shown.

Slide 28

Map of rates by county*

Rates for avoidable admissions by county - Highest rates in dark blue, lowest rates in light blue

Click on Summary Table for more details

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 29

Potential cost savings—reducing preventable admissions*

Details on avoidable admissions by county, including cost savings.

Can download to Excel.

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 30

Rates of Conditions and Procedures Path

Rates of health conditions and procedures— Use county populations as the denominator in prevalence rates

A screen shot of the State Health Care Information Portal is shown.

Slide 31

Groupings of diagnoses and procedures.

Can get information on prevalence of conditions or procedures by DRG, MDC, or CCS

A screen shot of the State Health Care Information Portal is shown.

Slide 32

Search function

Search by keyword
 

A screen shot of the State Health Care Information Portal is shown.

Slide 33

Tabular results by county*

For all counties in the state: numbers of discharges and rate per 100,000 population.

Sort by column headers.

Click on Map to view graphic display.

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 34

Map of rates by county*

Rates for specific conditions and procedures by county - Highest rates in dark blue, lowest rates in light blue

* Synthetic data

A screen shot of the State Health Care Information Portal is shown.

Slide 35

How do you get there?

A screen shot of the MONAHRQ home page is shown.

Slide 36

Import Data Wizard

The Import Data Wizard takes you through a step-by-step process of:

• Importing your data,
• Mapping it to the format required by MONAHRQ,
• Analyzing the data, and
• Defining your hospitals and regions.

A screen shot of the MONAHRQ is shown.

Slide 37

Select your data file

A screen shot of the MONAHRQ web site for inputting the data file is shown.

Slide 38

Map data elements

You map your data to the format required by MONAHRQ by clicking and dragging data elements.

A screen shot of the MONAHRQ is shown.

Slide 39

Map input values

You then define your data elements to values understood by MONAHRQ (based on UB04 standard).

A screen shot of the MONAHRQ is shown.

Slide 40

Load your data

A screen shot of the MONAHRQ page showing how to load discharge data is shown.

Slide 41

Run analysis

A screen shot of the MONAHRQ is shown.

Slide 42

Hospital load*

You can mask hospital names and assign Cost to Charge Ratios if you have CMS provider ID.

A screen shot of the MONAHRQ is shown.

* Synthetic data

Slide 43

Build your Web site

A screen shot of the MONAHRQ is shown.

Slide 44

MONAHRQ Website Wizard

The Website Wizard takes you through a step-by-step process of processing your data and building your Web site.

A screen shot of the MONAHRQ Website Wizard is shown.

Slide 45

Cell suppression and other parameters

Set thresholds for cell suppression (to protect confidentiality) and other parameters.

A screen shot of the MONAHRQ is shown.

Slide 46

Select which measures to include in Web site

Can specify which QIs to include.

Measures endorsed by the National Quality Forum are identified.

A screen shot of the MONAHRQ is shown.

Slide 47

Customize your Web site

Specify your Web site:

• Where it should be stored.
• Which pages you want to include.
• Specifics about the style.
• Insert your logo.
• What the Web site calls your data.

A screen shot of the MONAHRQ Website customization page is shown.

Slide 48

A screen shot of the MONAHRQ State Health Information Portal is shown.