Harnessing the power of enhanced data for healthcare quality improvement: lessons from a Minnesota Hospital Association Pilot Project.

Michael Pine, MD, president, Michael Pine and Associates Inc., Chicago; Mark Sonnebom, FACHE, vice president, information services, Minnesota Hospital Association and Minnesota Hospital Association Pilot Project, St. Paul; Joe Schindler, vice president, finance, Minnesota Hospital Association and Minnesota Hospital Association Pilot Project; Michael Stanek, policy analyst, National Academy for State Health Policy, Portland, Maine; Jared Lane Maeda, PhD, research scientist, Kaiser Permanente, Mid-Atlantic Permanente Research Institute, Rockville, Maryland; and Carrie Hanlon, program manager, National Academy for State Health PolicyEXECUTIVE SUMMARYThe imperative to achieve quality improvement and cost-containment goals is driving healthcare organizations to make better use of existing health information. One strategy, the construction of hybrid data sets combining clinical and administrative data, has strong potential to improve the cost-effectiveness of hospital quality reporting processes, improve the accuracy of quality measures and rankings, and strengthen data systems. Through a two-year contract with the Agency for Healthcare Research and Quality, the Minnesota Hospital Association launched a pilot project in 2007 to link hospital clinical information to administrative data. Despite some initial challenges, this project was successful. Results showed that the use of hybrid data allowed for more accurate comparisons of risk-adjusted mortality and risk-adjusted complications across Minnesota hospitals. These increases in accuracy represent an important step toward targeting quality improvement efforts in Minnesota and provide important lessons that are being leveraged through ongoing projects to construct additional enhanced data sets. We explore the implementation challenges experienced during the Minnesota Pilot Project and their implications for hospitals pursuing similar data-enhancement projects. We also highlight the key lessons learned from the pilot project's success.INTRODUCTIONHealthcare data are essential components of performance assessment strategies and are increasingly relied on for targeting quality improvement efforts. As the United States continues to build and standardize the country's health information technology (IT) infrastructure, information-driven quality improvement and efficiency gains are expected to become easier to achieve (Blumenthal 2009). This vision for the future of healthcare data formed the platform from which the Agency for Healthcare Research and Quality (AHRQ) launched an initiative in 2007 to enhance hospital administrative data with clinical information to improve quality measurement. AHRQ awarded two-year contracts to three state data collecting organizations - the Florida Agency for Healthcare Administration, Virginia Health Information, and the Minnesota Hospital Association (MHA)- to conduct in-depth pilot projects to determine the feasibility of creating powerful data sets by adding clinical data to administrative databases. This effort complemented existing efforts in the Healthcare Cost and Utilization Project (HCUP), which collects all-payer, statewide hospital administrative data through a federalstate-industry partnership in 46 states (HCUP 2012).The purpose of this article is to describe the experiences and insights from the Minnesota Pilot Project, including the business imperative that prompted MHA to participate. We also describe project goals, the process of engaging hospitals and maintaining stakeholder interest, the data collection strategy, organizational and data security challenges, legal issues encountered, and lessons learned.THE MINNESOTA HOSPITAL ASSOCIATION PILOT PROJECTThe Minnesota hospital community has a long history of using healthcare data to assess and improve hospital performance. In the 1980s, select hospitals began reporting abstracts from medical records to a database maintained by MHA, a trade association representing 148 hospitals. …