1. Use of a National Standard Dataset to Accelerate Development & Reporting May 28 th, 2013 1

2. Faculty/Presenter Disclosure Faculty: –Patricia Chung, Vancouver Coastal Health –Isabel Tsui, Canadian Institute for Health Information Relationships with commercial interests: –Nothing to declare.

3. Key Takeaway Points 1.NACRS is a rich standardized dataset which provides you with operational information to improve efficiency as well as national benchmark information that can be used for a variety of purposes 2.Use of a national standard dataset, NACRS, to standardize ED information had profound positive effects at Vancouver Coastal Health. 3. Many jurisdictions and hospitals with data warehouses can reap immense benefits from the adoption of NACRS and other CIHI data standards. 3

4. Objectives Describe the use of CIHI’s National Ambulatory Care Reporting System (NACRS) dataset as the foundation of data warehouse development at Vancouver Coastal Health. Highlight far reaching positive effects and outcomes 4

5. Standardization Benefits 5

6. Vancouver Coastal Health 13 Acute Hospitals 15 CHC ~ 500 direct/contracted services Staff ~ 20,000 Volunteers ~ 5,000 Budget ~$3 Billion Many disparate IT systems 6

7. Data Warehouse Project Standardize Data Other Facility’s Information VCH Information Secure Data Warehouse Automated Reports Cubes Ad hoc reports DAD ED OR PARIS ADTC Other Dataset Pixalere Clinical Support Finance BSC/ Dashboard Patient Continuum Ministry/CIHI Submission Portals NACRS Standards 7

8. What is NACRS? NACRS – CIHI’s National Ambulatory Care Reporting System – supports data collection and reporting on Emergency Department (ED) and ambulatory care (day surgery and ambulatory clinics). CIHI (Canadian Institute for Health Information) is an independent not-for-profit organization providing essential data and analysis on Canada’s health system and the health of Canadians. CIHI provides information for pan-Canadian analyses from databases supported by national standards. 8

9. NACRS in B.C. In September 2010, the BC Ministry of Health mandated NACRS reporting for 15 high-volume ED sites by April 2012 including 4 sites in VCH. NACRS ED Level 2 reporting was mandated: submission of wait times data elements plus 2 “pick-list” data elements ED Discharge Diagnosis (CED-DxS) Presenting Complaint List 9

10. Warehouse & NACRS CIHI NACRS ED Mandated in B.C. Quick & Easy 10

11. VCH: BC NACRS Mandate VCH’s standardized ED data in warehouse No Vendor - Reduced Costs & Saved Time Minor modifications required Submitted Level 1 data 9 months after mandate opposed to 20 months More time to work with CIHI to improve COT descriptors & discharge diagnosis to be ready for Level 2 in May 2012. 11

12. Results Low Stress Implementation with few errors Submit data on more than 4 mandated sites Ability to spend funds more innovatively to help end users Project on time and under budget 12

13. VCH – BC NACRS Implementation Implementation MilestoneBC Project Target DatesVCH Achieved Dates Sign Service Agreement with Vendor May 31, 2011N/A Complete Technical Implementation Schedule Jun 30, 2011Oct 15, 2010 Complete NACRS Abstracting Software Installation Sep 2, 2011N/A Complete Required InterfacesNov 11, 2011Dec 2010 Complete Internal System TestingDec 16, 2011Feb 2011 Confirm Vendor TestingMar 16, 2012N/A Complete Facility TestingApr 20, 2012May 2011 Submit Data to NACRSMay 3, 2012June 2011 13

14. Benefits of NACRS Data Compliance = Badge of Quality Regional reporting sites faster and more efficient. Locally, information to improve ED operations: Improve patient flow Pay for Performance Reporting – Improve Revenue Physician Shadow Billing National Benchmarking to measure & improve performance 14

15. NACRS ED Coverage 2013-14* Canada: estimated 64% participation YT 100% BC 65% AB 100% SK 46% MB 45% ON 100% QC † NS 77% PE 27% 15 *Includes current and planned NACRS implementations † CIHI and Québec Ministry of Health and Social Services initiative to include ED data from all Québec facilities in NACRS on hold

16. eNACRS – National Reports 16

17. CIHI - ED Wait Times at a Glance (Dashboard) 17

18. CIHI - ED Wait Times at a Glance (Quick View) 18

19. CIHI - ED Wait Times Targets (Dashboard) 19

20. CIHI - ED Wait Times Comparison (Dashboard) 20

21. CIHI - Ambulatory Activity (Quick View) 21

22. Summary/Conclusions Standardizing ED information in data warehouse to NACRS standard definitions had profound effects at VCH. NACRS is a rich standardized dataset which provides immediate and immense benefits. Many other jurisdictions and hospitals have data warehouses. If already not using NACRS and/or other CIHI data standards, we recommend you investigate them and update your systems accordingly. 22

23. Thank You!! Patricia Chung Director of Data Management & Reporting, Decision Support Vancouver Coastal Health  604 714 3771 x 2322  Patricia.Chung@vch.ca Isabel Tsui Manager, CAD Database Development and Expansion Canadian Institute for Health Information  416.549.5527  itsui@cihi.ca 23

24. Questions 24