Data System Supporting DPH Programs for Efficient Data Collection

A data system supporting DPH programs to collect data from LHD EHRs to satisfy state and federal reporting requirements Health Services Analysis Kathy Dail Local Data and Analysis Branch DHHS/DPH/LCAS November 2024

What we will cover today What we will cover today A Short, Short, Short Background about HSA Respond to Your Questions

HSA: A Legacy System HSA: A Legacy System Health Services Information System (HSIS) Paper reports mailed/faxed to state (pre-2007) Health Information System (HIS) Billing and Clinical Services Electronic Health Record system (2007-2018) Health Services Analysis (HSA) Data collection system for clinical cervices supported by DPH programs to satisfy state & federal reporting requirements (2018 to present)

What is HSA? The Technical Answer What is HSA? The Technical Answer A Central Data Storage and Reporting System for Statewide Local Health Dept Visits in SAS Background NC Dept of Public Health was searching for an alternative to an expensive third-party database system that could import and produce reports on Local Health Dept patients, visits and services provided. Our home-grown system would have to import CSV files from disparate Electronic Health Record (EHR) systems, provide feedback on data errors, and create regular reports on the data collected. Implementation We chose to use our existing SAS software running on Windows. First, we set up an object-oriented dataset design. Then we created CSV import file formats and got buy-in from the EHR vendors to produce these files for us. Next step was to write SAS code to import these CSV files, check for errors and produce feedback, all while keeping data privacy issues in mind. We gathered all the SAS programs (import/error-checking/feedback) into one SAS Enterprise Guide (EG) process flow. Results After creating the new system in SAS, we have more accurate data and fewer data errors, since we catch errors before they are imported. We can also provide improved error feedback and error descriptions to the counties via email, which encourages them to send their data to us more frequently and correctly. State-level program managers can report on fresher data. Description courtesy of Bruce Nawrocki , SAS Developer LHD-HAS 2023

HSA staff work with the EHR vendors serving local health departments. HSA surveys health directors twice annually for changes to their EHR/Dental software vendors. Updated vendor maps are posted on the LHD-HSA website https://schs.dph.ncdh hs.gov/units/ldas/lhd hsa.htm

Semi Semi- -Annual, Three Annual, Three Question Survey Question Survey (July & January) (July & January) What is your current EMR?/Dental Software Vendor? Have you changed vendors in the last 6 months? If yes, who are your current vendors? What vendor do you use for the following? Medical Dental Behavioral Health Other

Responsibilities of DPH HSA Technical Support Update County User Inform local health department users about reporting changes through DPH program managers, consultants, and consultations with HAS technical support Update Record Layouts Work with DPH Program Managers to identify federal reporting requirements and consider new requests or data elements that need to be retired Update Vendors Assist the local health department s vendor with understanding changes to reporting requirements Crush SFTP access Approve Crush Secure File Transfer Protocol (SFTP) access to local health department users

HSA Data: Encounters, Services by DPH Clinical Program # of client visits to a DPH clinical program # of unduplicated (unique) clients seen by DPH clinical program # of unduplicated (unique) clients seen in all DPH clinical programs Frequency counts of service codes by DPH Clinical Program

HSA Reporting Quarterly/Annual Report Insurance Summary Patient Detail Report Program Reports Missing Data by agency Files to Process Provider report

Remember: HSA is not an EHR. HSA receives data files that the LHD vendor creates. Vendors KNOW the requirements. Vendors test their extract with HSA support before generating live files. LHD staff are notified when files are processed. LHD staff receive an email that there are files with errors that need to be reviewed. If errors are detected, the LHD staff must correct the errors or that data will never be captured.

Questions/Comments/Discussion Julie Walker Julie.walker@dhhs.nc.gov Kathy Dail Kathy.dail@dhhs.nc.gov Eric Lai Eric.Lai@dhhs.nc.gov