UNH Database Aids Healthcare Decision Making
The Accountable Care Project, a program of the NH Citizens Health Initiative, is working to improve its system for sharing information from the state’s all-payer claims database and from electronic medical records. Rather than receiving a standard report, participating organizations—including hospitals and physicians’ groups—can now delve into the data themselves to explore the variables they are interested in.
“We’re creating a mechanism for partners across the state to access reports that are focused on measures they care about and that allow them to better visualize the data,” says Jo Porter, deputy director of the UNH-based Institute for Healthy Policy and Practice (IHPP), which staffs the NH Citizens Health Initiative.
The reports enable the organizations to assess how they’re doing compared to others in New Hampshire on measures related to cost, quality and use. This information guides their healthcare reform efforts as they seek to provide better care for residents while containing spending. It’s a goal that’s becoming more critical in New Hampshire and nationwide as healthcare expenses soar and legislation such as the Affordable Care Act attempts to address the problem. A 2012 report from the New Hampshire Center for Public Policy Studies found that New Hampshire spends more per person on healthcare than the national average and more than other states that provide similar quality care. In fact, health care spending in New Hampshire is growing faster than both the rate of inflation and the total personal income of residents. Another 2012 report from the center concluded that while the quality of New Hampshire’s healthcare system is generally high, the state could do better on some public health measures.
Sharon Beaty, the CEO of Mid-State Health Center in Bristol and Plymouth, says the Accountable Care Project gives her organization a much broader perspective on the quality of care it is providing. Because the data includes all claims for patients (even if they received some of their care elsewhere), she can examine trends in use that she would not have been able to see otherwise. For instance, she can look at the percentage of diabetics who received retinal exams—a measure of whether they are receiving proper care. Or she can determine if patients are following up on their providers’ recommendations to get mammograms.
She can also compare the average monthly costs of caring for similar groups of patients at her facility versus elsewhere in the state. “Before we couldn’t tell what value we were providing the system because we had no data to gauge it from,” she says. “Now we do.”
The data has been particularly helpful in recent months, thanks to a new user-friendly delivery system that is still being refined. In September, UNH acquired SAS Visual Analytics for the Accountable Care Project, which launched in 2011. This software package, being implemented in partnership with the North Carolina-based SAS, allows users to point and click to instantly generate customized reports. Previously, Porter says, she would send them a 700-page PDF that they would have to search through for the information they wanted. Data sharing is an integral part of the Accountable Care Project, which received funding in its first 2½ years from the Robert Wood Johnson Foundation and now relies on other support.
The project’s larger aim is to have an impact that goes beyond individual health organizations, according to those involved. “The important thing is not just the data, but also the conversations that it leads to and the actions that result from them, especially regarding policy,” says IHPP director Ned Helms. “That’s where the rubber meets the road.”