Agency for Healthcare Research and Quality

Advancing Excellence in Health Care • www.ahrq.gov

A Web-Based Tool for Quality and Utilization Reporting

Anne Elixhauseranne.elixhauser@ahrq.hhs.gov

December 14, 2009

Advancing Excellence in Health Care

MONAHRQ – My Own Network, powered by AHRQTransforming your health care data into information

about health, costs, and quality of care.

Advancing Excellence in Health Care 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?

Advancing Excellence in Health Care

From Data to Information to Action

Hospital discharge data

can generate valuable

healthcare information

Information can be

used to make decisions

Hospital discharge data

are already being

collected

Utilization and

costs of care

in hospitals

Quality of care

in hospitalsRates of diseases

in particular areas

Rates of procedures

in particular areas

Preventable hospital

stays that indicate

breakdowns in care

Advancing Excellence in Health Care

Key features of MONAHRQ...

Currently based

on hospital

discharge data

Host user downloads

MONAHRQ software from

AHRQ website

Host

user

applies

software to

own data

locally

Software

Host user creates

local website on

their own serverHost user makes

website 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

State Healthcare Information Portal

Advancing Excellence in Health Care

Select the information

you want:

• QUALITY INDICATORS

• AVOIDABLE

HOSPITALIZATIONS

• RATES

• UTILIZATION

The End User Website - Demo

State Healthcare Information Portal

Advancing Excellence in Health Care Two quality paths to choose from

State Healthcare Information Portal

Advancing Excellence in Health Care

Consumer path on Quality Indicators

State Healthcare Information Portal

Arrays information on up to

four hospitals for the

indicators selected.

Click on any indicator and

get detailed information in

graphic form.

Advancing Excellence in Health Care Details in graphic form

Get details for each hospital

in rank order, compared to

the state average.

Advancing Excellence in Health Care Detailed path on Quality Indicators

State Healthcare Information Portal

The detailed path provides

more information for each

indicator.

Advancing Excellence in Health Care Overall results for the state

State Healthcare Information Portal

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

Advancing Excellence in Health Care Results by individual hospital

State Healthcare Information Portal

Information on:

• numerators

• denominators

• observed, expected and risk-adjusted rates

• confidence intervals

Advancing Excellence in Health Care

Potentially Avoidable Hospitalizations

State Healthcare Information Portal

Potentially Avoidable

Hospitalizations –

based on AHRQ’s

Prevention Quality

Indicators

(PQIs – ambulatory care

sensitive conditions)

Advancing Excellence in Health Care

Potentially Avoidable Hospitalization Path

Rates for avoidable

admissions by county –

Highest rates in dark blue,

lowest rates in light blue

Click on Summary Table

for more details

Advancing Excellence in Health Care

Potential cost savings associated with reducing preventable admissions

Details on avoidable

admissions by county,

including cost savings.

Can download to Excel.

Advancing Excellence in Health Care

Rates of Conditions and Procedures Path

State Healthcare Information Portal

Rates of health conditions

and procedures –

Use county populations

as the denominator in

prevalence rates

Advancing Excellence in Health Care

Groupings of diagnoses and procedures

State Healthcare Information Portal

Can get information on

prevalence of conditions

or procedures by DRG,

MDC, or CCS

Advancing Excellence in Health Care Search function

State Healthcare Information Portal

Advancing Excellence in Health Care Tabular results by county

For all counties in the

state: numbers of

discharges and rate per

1,000 population.

Click on Map to view

graphic display.

Advancing Excellence in Health Care Map of rates by county

Rates for specific

conditions and

procedures by county –

Highest rates in dark blue,

lowest rates in light blue

Advancing Excellence in Health Care Utilization path

State Healthcare Information Portal

Utilization statistics

(similar to information

from HCUPnet)

Advancing Excellence in Health Care

Utilization across all conditions, entire state

All conditions for entire database, listed by

number of discharges

Click on any column header to re-sort by:

• charges/costs

• LOS

• percent died or

• condition/procedure

Advancing Excellence in Health Care

Utilization on individual conditions…

State Healthcare Information Portal

Can also search for

utilization information on

individual conditions

Advancing Excellence in Health Care … for individual hospitals

Advancing Excellence in Health Care Detailed utilization for all hospitals

Information on:

• numbers of discharges,

• charges,

• costs,

• length of stay,

• percent died

for all hospitals individually.

National, regional, and state

benchmarks included.

Advancing Excellence in Health Care

More details for individual hospitals

The same information is available

for individual hospitals, by

• age group

• gender

• payer

• race

Advancing Excellence in Health Care How do you get there?

Advancing Excellence in Health Care 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.

Advancing Excellence in Health Care Select your data file

Advancing Excellence in Health Care Map data elements

You map your data to the

format required by MONAHRQ

by clicking and dragging data

elements.

Advancing Excellence in Health Care Map input values

You then define your data

elements to values understood

by MONAHRQ (based on UB04

standard).

Advancing Excellence in Health Care Load your data

Advancing Excellence in Health Care Run analysis

Advancing Excellence in Health Care Build your website

Advancing Excellence in Health Care

The Website Wizard takes you through a step-

by-step process of processing your data and

building your website.

MONAHRQ Website Wizard

Advancing Excellence in Health Care

Cell suppression and other parameters

Set thresholds for cell suppression

(to protect confidentiality) and other

parameters.

Advancing Excellence in Health Care

Select which measures to include in website

Can specify which QIs to include.

Measures endorsed by the National

Quality Forum are identified.

Advancing Excellence in Health Care Customize your website

Specify your website:

• where it should be stored

• which pages you want to include

• specifics about the style

• insert your logo

• what the website calls your data

Advancing Excellence in Health Care The final product

State Healthcare Information Portal

Advancing Excellence in Health Care What’s next?

Release version 1.0 in winter 2009/2010

Feasibility studies to explore other data and measures

Continued development of user interface – usability testing of end user website

Continued development of data and website wizard

MONAHRQ

To get on the mailing list: monahrq@ahrq.gov