1. Minnesota Direct Clinical Data Collection Methods and Results
Jim Chase
Pay for Performance
Concurrent Session 4.07
February 28, 2008
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2. 2007 Health Care Quality Report
Reports on 14 quality measures
Reports results on 128 medical systems
73 multi-specialty groups
34 single-specialty groups
21 urgent/convenience care
Over 90% of Minnesotans get their care from these providers
Quality ratings posted on Web site Nov. 1
Full report will be available on Nov. 15
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3. Impacts of Public Reporting and P4P
Measures are being imbedded in clinical practice
Results are being used for clinic promotion and marketing
Call for alignment
Improve the measures
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5. Why Composite Measures?
Types of composite measures
All or none
Continuous or discrete
Keep it simple
Focus for improvement
Provides summary of information for consumers
Intermediate outcomes/risk reduction
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6. Direct Data Submission Advantages
All patients represented
Faster results
Site level reporting
Increased provider confidence in data
Submitted through a secure portal
Used with electronic or paper records
Collects clinical and patient experience data not available in claims
A non-profit organization formed by all of Minnesota’s health plans and the Minnesota Medical Association
MN Community Measurement’s mission is to improve the quality of care provided to patients by Minnesota’s provider groups. MN Community Measurement does this by monitoring and reporting the provider groups’ performance on a variety of measures that our medical community has agreed are important.
MN Community Measurement was recognized as a leader in health care quality improvement through measurement and reporting in recent visits to Minnesota by U.S. President Bush and U.S. Secretary of Health and Human Services Michael Leavitt, and in a recent speech by Minnesota Governor Tim Pawlenty, and through a major grant from the Robert Wood Johnson Foundation.

8. DDS uses all populations – more patients eligible for the measure
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DDS samples more of the eligible population (data from all groups reporting)
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MNCM Data Portal
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Portal Features
Central repository for data submission
Efficient method for medical groups to maintain their own data
Provides training and support/user guide
Immediate validation checks
HIPPA compliant electronic submission
Immediate feedback to group on rates
Can be used for multiple measures
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12. Direct Data Results Wider range of results by site
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Rewards Threshold
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16. How do DDS results compare to the health plan method?
There are slightly different measurement specifications
Only data from that group
All population not just managed care population
DDS results slightly higher, but explained by self selection of the groups
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17. Comparison of Results by Method
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18. Audit Process for Direct Data
Audited all submission in the first year
Random 8 charts reviewed, additional 30 if errors found
If single EMR system used, did not audit all sites
Of 28 groups were audited
1 dropped out rather than be audited
3 sites had significant incorrect values
Several resubmitted after understanding process errors
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19. Lessons learned from the audit
Auditing helped both sides improve process
Denominator, denominator, denominator
EMR collection = less human error
Build in training and support for groups – help desk during data submission
Keep sample rules simple
Direct submission is a viable method to collect clinical data
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20. Are We Where We Want to Be in Diabetes Care?
Optimal Diabetes Care: all cardiovascular measures at target
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Future
Redesign payment
Redesign care
More support for clinical data collection
Participate with other regions
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22. Questions or Comments chase@mnhealthcare.org Jim Chase
Executive Director, MN Community Measurement
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