The state of Idaho established the Health Quality Planning Commission a few years ago led by eleven individuals selected by the Governor’s office. In July 2013, the Commission published their Annual Report “Creating a Healthy Idaho”.
The annual report discusses the various health issues in the state and points out that it is difficult to get an accurate picture of the health of residents in the state without data. It is also difficult to accurately measure the true impact of any intervention that is designed to address a particular health condition.
For example, statistics show how many individuals in the state die from strokes, but there is no data available on how many have had a stroke and survived, what their care after the stroke entailed, or how many died of complications from a stroke later. Without this data, it is difficult to understand the true burden of stroke in the state.
The Commission invited Denise Love, Executive Director of the National Association of Health Data Organizations, to discuss what options are available for collecting health data, what the other states are doing, and the costs involved in collecting data.
Her conclusion was that the two types of databases are needed in the state to include a hospital discharge database and an all-payer all-claims database. Idaho and Alabama are the only states that don’t have an active statewide hospital discharge database. The estimated cost for building such a database is approximately $300,000.
A hospital discharge database generally has information on patients, their care in terms of diagnoses and procedure,s and data on their stay in the hospital. The advantage to collecting this data is that the information is already in the system and electronic. Also, it can be submitted to a central agency to gather the data where the data is analyzed.
According to Denise Love, if submitting information to the database isn’t mandatory, the database isn’t effective. Several years ago, the Idaho Hospital Association began a voluntary hospital discharge database and found that very few hospitals participated.
The plus side to having the database is that a wealth of information on the health of people in Idaho would become available. It also puts the state in a competitive place to be able to apply for grants the state otherwise might not be qualified for, sets standards for system improvement, gives policy makers the information they need to make informed decisions, provides the ability to assess quality improvement initiatives, and would enable providers to compare their own performance with those of their peers.
Denise Love noted that the all-payer all-claims database is much more complex to establish than the hospital discharge database. However, states that have formed a hospital discharge database usually discover within one to two years, that an all-payer claims database is also needed to cover the entire spectrum of care.
Currently, there are 16 states that have an all-payer all-claims database. Most states begin with a hospital discharge database, soon add emergency department data, and eventually begin to look at ways to move on to an all-payer all-claims database once the value of accessing the data is established.
In March 2013, the Commission recommended that the Idaho legislature authorize the Department of Health and Welfare to investigate creating both a hospital discharge database and an all-payer all-claims database.
Additionally, the Commission requested that the Idaho Department of Health and Welfare establish an advisory committee to create a phased development and implementation plan for both databases and present the proposed plan for funding within one year of the authorization date. The plan would include information on the need for the databases, describe how they would be governed, estimate costs, and propose options for funding.
www.healthandwelfare.idaho.gov/Portals/0/Medical/MedicaidCHIP/HQPC_AnnualReport.pdf has the full annual report published July 2013 by the Health Quality Planning Commission.