MONAHRQ: A Web-Based Tool for Quality and Utilization Reporting (Text Version)

On September 14, 2009, Anne Elixhauser made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (6.2 MB).

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Slide 1

MONAHRQ: A Web-Based Tool for Quality and Utilization Reporting

Anne Elixhauser
September 14, 2009

Slide 2

MONAHRQ - My Own Network, powered by AHRQ

Transforming your health care data into information about health, costs, and quality of care.

Slide 3

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?

Slide 4

From Data to Information to Action

• Hospital discharge data are already being collected.

• Hospital discharge data can generate valuable healthcare information
  • Utilization and costs of care in hospitals.
  • Quality of care in hospitals.
  • Rates of diseases in particular areas.
  • Rates of procedures in particular areas.
  • Preventable hospital stays that indicate breakdowns in care.

• Information can be used to make decisions.

Slide 5

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.
• Host user creates local website on their own server.
• Host 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.

Slide 6

The End User Website

Select the information you want:

• Quality Indicators.
• Avoidable Hospitalizations.
• Rates.
• Utilization.

Image of the State Healthcare Information Portal Web site.

Slide 7

Two quality paths to choose from

A screen shot of MONAHRQ is displayed.

Slide 8

Consumer path on Quality Indicators

A screen shot of MONAHRQ is displayed. The screen shot shows an example of what the final output could look like (walk through the output).

Arrays information on up to four hospitals for the indicators selected.
Click on any indicator and get detailed information in graphic form.

Slide 9

Details in graphic form

A screen shot of MONAHRQ is displayed.

Get details for each hospital in rank order, compared to the state average.

Slide 10

Detailed path on Quality Indicators

A screen shot of MONAHRQ is displayed.

The detailed path provides more information for each indicator.

Slide 11

Overall results for the state

A screen shot of MONAHRQ is displayed.

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.

Slide 12

Results by individual hospital

A screen shot of MONAHRQ (State Healthcare Information Portal) is shown on the screen.

Information on:

• Numerators.
• Denominators.
• Observed, expected and risk-adjusted rates.
• Confidence intervals.

Slide 13

Potentially Avoidable Hospitalizations

A screen shot of MONAHRQ is displayed.

Potentially Avoidable Hospitalizations - based on AHRQ's Prevention Quality Indicators (PQIs - ambulatory care sensitive conditions)

Slide 14

Potentially Avoidable Hospitalization Path

A screen shot of MONAHRQ is displayed.

Rates for avoidable admissions by county- Highest rates in dark blue, lowest rates in light blue.

Click on Summary Table for more details.

Slide 15

Potential cost savings associated with reducing preventable admissions

A screen shot of MONAHRQ is displayed.

Details on avoidable admissions by county, including cost savings.

Can download to Excel.

Slide 16

Rates of Conditions and Procedures Path

A screen shot of MONAHRQ is displayed.

Rates of health conditions and procedures- Use county populations as the denominator in prevalence rates.

Slide 17

Groupings of diagnoses and procedures

A screen shot of MONAHRQ is displayed.

Can get information on prevalence of conditions or procedures by DRG, MDC, or CCS.

Slide 18

Search function

A screen shot of MONAHRQ (State Healthcare Information Portal) is shown on the screen.

Slide 19

Tabular results by county

A screen shot of MONAHRQ is displayed.

For all counties in the state: numbers of discharges and rate per 1,000 population.

Click on Map to view graphic display.

Slide 20

Map of rates by county

A screen shot of MONAHRQ is displayed.

Rates for specific conditions and procedures by county - Highest rates in dark blue, lowest rates in light blue.

Slide 21

Utilization path

A screen shot of MONAHRQ is displayed.

Utilization statistics (similar to information from HCUPnet).

Slide 22

Utilization across all conditions, entire state

A screen shot of MONAHRQ is displayed.

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.

Slide 23

Utilization on individual conditions.

A screen shot of MONAHRQ (State Healthcare Information Portal) is shown on the screen.

Can also search for utilization information on individual conditions.

Slide 24

... for individual hospitals

A screen shot of MONAHRQ is displayed.

Slide 25

Detailed utilization for all hospitals

A screen shot of MONAHRQ is displayed.

Information on:

• Numbers of discharges.
• Charges.
• Costs.
• Length of stay.
• Percent died.

For all hospitals individually.

National, regional, and state benchmarks included.

Slide 26

More details for individual hospitals

A screen shot of MONAHRQ is displayed.

The same information is available for individual hospitals, by

• Age group.
• Gender.
• Payer.
• Race.

Slide 27

How do you get there?

A screen shot of MONAHRQ (Import Data Wizard) is shown on the screen.

Slide 28

Import Data Wizard

A screen shot of MONAHRQ (Import Data Wizard) is shown on the screen.

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.

Slide 29

Select your data file

A screen shot of MONAHRQ (Import Data Wizard) is shown on the screen.

Slide 30

Map data elements

A screen shot of MONAHRQ (Import Data Wizard) is shown on the screen.

You map your data to the format required by MONAHRQ by clicking and dragging data elements.

Slide 31

Map input values

A screen shot of MONAHRQ (Import Data Wizard) is shown on the screen.

You then define your data elements to values understood by MONAHRQ (based on UB04 standard).

Slide 32

Load your data

A screen shot of MONAHRQ (Import Data Wizard) is shown on the screen.

Slide 33

Run analysis

A screen shot of MONAHRQ (Import Data Wizard) is shown on the screen.

Slide 34

Build your website

A screen shot of MONAHRQ (Website Builder Wizard) is shown on the screen.

Slide 35

MONAHRQ Website Wizard

A screen shot of MONAHRQ (Website Builder Wizard) is shown on the screen.

The Website Wizard takes you through a step-by-step process of processing your data and building your website.

Slide 36

Cell suppression and other parameters

A screen shot of MONAHRQ (Website Builder Wizard) is shown on the screen.

Set thresholds for cell suppression (to protect confidentiality) and other parameters.

Slide 37

Select which measures to include in website

A screen shot of MONAHRQ (Website Builder Wizard) is shown on the screen.

Can specify which QIs to include.

Measures endorsed by the National Quality Forum are identified.

Slide 38

Customize your website

A screen shot of MONAHRQ (Website Builder Wizard) is shown on the screen.

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.

Slide 39

The final product

A screen shot of MONAHRQ's final product is shown on the screen.

Slide 40

What makes MONAHRQ unique?

Empowers organizations and consumers to use data to make informed decisions

• Organizations create and host their own website and upload their own data.
• Local organizations do quality reporting using a standard, validated method.
• End users draw together multiple data sources providing information at the local level.