State Consumer Health Information and Policy Advisory Council Meeting How the Florida Department of Health Uses Data from the Agency for Health Care Administration Division of Public Health Statistics and Performance Management Florida Department of Health State Consumer Health Information and Policy Advisory Council Meeting September 26, 2019

Memorandum of Understanding (MOU) MOU between the Agency for Health Care Administration(AHCA) and Department of Health (DOH) Since 2009 and renewed every three years Inter-agency data use agreements required Linkage of data sets, release and presentation of data consistent with Florida Administrative Code rules 59E-7.029 and 59B-9.039.

Data Exchanged Between AHCA and DOH Quarterly, AHCA sends data to DOH: Hospital Discharge Emergency Department Ambulatory Surgery Annually, DOH sends data to AHCA: Births Deaths Fetal Deaths

DOH Uses of AHCA Data for Public Health Projects Project or Study Title Council of State and Territorial Epidemiologists Surveillance Indicators for Substance Use and Mental Health Injury Data Surveillance Disease Surveillance System Data Validation and Decision Making Maternal and Infant Health Care Quality Improvement Duval County Health Department Outcomes Surveillance Project Multi-State Analysis of Ambient Health, Air Quality, and Occupational Emergency Department Visits Environmental Public Health Tracking (EPHT) Ongoing Chronic Disease Epidemiology and Surveillance Fetal and Infant Mortality Review (Orange County) Opioid Misuse and the Typology of Behavioral Health Service in Orange County, FL Florida Birth Defects Registry (FBDR) Prescription Drug Monitoring Program Annual Report Heroin-related Morbidity and Mortality Prescription and Illicit Drug Misuse and Abuse Illicit Drug Use and Prescription Drug Misuse in Polk County, Florida Trends in C. Difficile Infection

Maternal and Infant Health Care Quality Improvement Project Study title: Maternal and Infant Health Care Quality Improvement Purpose: To improve the maternal and infant health care quality in Florida Also known as the Florida Perinatal Quality Collaborative (FPQC) Partnership between DOH and University of South Florida (USF) Participating hospitals receive timely reports that measure specific health care quality and data quality indicators. Data required: Previously linked hospital and Vital Statistics birth data

Standardized Data Linking Methodology In 2010, DOH and USF collaborated on data linking methodology Deterministic: Exact or partial agreement on specific patient identifiers. Minimizes false positives. Stepwise: Series of steps where specific patient identifiers are matched. Hierarchical: Linking steps ordered; higher confidence steps precede steps of lesser confidence. Unique feature: Mothers and infants first linked within hospital data, then linked to Vital Statistics birth data.

Importance of Patient Identifiers Identifiers such as social security numbers (SSN) help reduce risk of false positives (linking records that should not be linked) From 2018 hospital discharge data: Infants Total: 241,190 Valid INFANTLINK: 195,000 (80.1%) Female patients over 8 years old Total: 2,575,720 Valid SSN: 2,388,756 (92.7%) While patients might be reticent to provide SSN, most still do.

FLHealth CHARTS Deidentified, aggregated AHCA data are provided publicly through FLHealth CHARTS Data from a variety of sources are also provided, including data from sister agencies such as the Departments of Children and Families, Corrections, and Education. Karen Freeman, CHARTS Manager, will provide a live demonstration: http://www.flhealthcharts.com/charts/Default.aspx