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Clinical Quality and Integration Work Group Minutes - March 1 2011 

March 1, 2011

James R. Thompson Center, 100 W. Randolph, OHIT Conference Room 2-201, Chicago

Attendees (phone and in-person):

  • Wes Valdes, Office of Health Information Technology (OHIT)/UIC
  • Gwen Smith, HFS/CHIPRA Grant
  • Mary McGinnis, OHIT
  • Marie Brown, American College of Physicians
  • Janna Stansell, Health & Medicine Policy Research Group
  • Paige Pfenninger, Alexian Brothers Health System
  • Stephen Sproul, Advocate Health Care
  • Mary Driscoll, Illinois Department of Public Health
  • Chris Monovich, Pfizer
  • Margaret Gadon, IFMC-IL
  • Gail Amundson, Quality Quest for Health of Illinois
  • Farrell Davies, Heartland Community Health Clinic

Wes Valdes opened the meeting with introductions and roll call. Wes asked for any edits or corrections regarding the minutes from the last meeting. Other than a few minor corrections, the minutes were approved.

Gwen Smith reviewed the elements of the CHIPRA grant that was awarded to HFS in January 2011, in collaboration with Florida. The grant covers a five-year period, with the first year dedicated to planning. There are five categories from which grantees were to select as the focus of their work. Illinois and Florida selected the following four focus areas:

  1. Child Health Measures
  2. Coordination with HIE Efforts
  3. Testing and enhancing provider care models. This is meant to encourage healthcare providers to migrate to the medical home model of care.
  4. Improve Child Health Quality

CMS has established a matrix with a 24-core set of measures that Illinois and Florida are continually working through. This matrix identified Meaningful Use measures with immunizations, BMI, Chlamydia, Laryngitis, NQF measures, pre-school vision screenings, developmental measures, and Data Steward Measures. Laura Zaremba and Ivan Handler are on the state team, coordinating these grant efforts, along with Gwen and several others at HFS.

Wes asked which database the CHIPRA data would be feeding into. Gwen said the data is stored in the Healthcare and Family Services (HFS) Medical Data Warehouse. HFS obtains data from the administrative claims data by processing Medicaid claims.

Wes asked about data collection on the individual claims data level. There was a general discussion about data sets and data needs.

Gail Amundson responded that although linking the data sets would be convenient, the datasets will yield two different answers because there are fundamental differences between the claims systems/data and the practice systems/data. Gail noted that it is important to understand what kind of information both systems are providing, and what the limitations are. For example, the practice system would contain BMI data, where the claim systems will not.

Gwen added that the HFS Medical Data Warehouse is limited to Medicaid beneficiaries. However, HFS is in the process of linking data from other state agencies through inter-agency data sharing agreements. Among the data in the warehouse are data sets on public health, newborns, immunization, and lab results. HFS is working on coordinating these different data sets.

Mary Driscoll was curious as to how HFS is collecting and matching this data. She emphasized that if the information is not linked appropriately, then it is not useful knowledge. Gwen said that HFS has a detailed matching process that assigns ID numbers to the sets of data. Both Wes and Mary McGinnis reiterated that exploring these issues is the purpose of the work group. The work group's responsibility is to review these complex questions, and make recommendations on possible solutions to the newly appointed HIE Authority Board.

On the topic of the ILHIE Authority Board, Janna wanted to know if there were representatives of non-hospital entities on the board. Mary McGinnis provided an overview of the composition of the board and the nomination process. She added that the membership terms are going to be staggered with one-, two- and three-year terms. Mary also provided some information about the HIE Advisory Committee.

Wes initiated a discussion about the quality measures for Meaningful Use. Wes noted that work group members are familiar with many of these quality indicators, but the real issue is how to process this data in a meaningful way. What is the reporting responsibility of the enterprise, local and state HIE's concerning this data, and how will the data be shared?

Gail responded that if the practices are reporting these data sets, then the results are already known. How, then, can we compare reports and performances with other practices? Gwen responded that HFS has a system where they give providers clinical performance through a link. Mary Driscoll said the Illinois Department of Public Health Web site has a hospital report card, so much of their data is already publically reported. Janna added that the work group needs to ensure that the information flows easily for consumers to follow. Janna added, we need to make sure the information follows patients, as well as flows to the clinics, integrated delivery networks, and to the local HIEs. The work group agreed that there are benefits for the information to follow both the patient (for their convenience) and the clinics (for comparative performance).

One of the major tasks for the work group is make recommendations about how to accomplish this, and maintain the integrity of the information reported. Wes emphasized that data sources need to be viewed as trusted sources. Mary Driscoll mentioned that one of the goals of health information exchange is to focus on population health and, in addition, to care coordination. If there is no consistent process, it will not be representative of what is actually going on.

The meeting concluded with Marie Brown's recommendation on how to proceed in tackling the issues discussed. The participants in the meeting should pick a few measures that are easy to track, and that have the greatest validity. For instance, if we used BMI as a unit of measure to use as a pilot, we can track BMIs through the complexity of networks discussed. This pilot can then give us information on the kind of obstacles we may face, and how to further ourselves in the process.

The group's assignment is to e-mail Wes or Mary McGinnis on a few measures they would like to use as pilots. Wes and Mary will then compile a Top Five List of Units of Measures the group would like to track.

The next meeting will be held Tuesday, April 5, 2011, at 9 a.m., at JRTC 2-201.

Meeting adjourned.