Question

Identify a regulatory agency, quality oversight group/agency, or another entity that is capturing and reporting on quality data at the local, state, or national level. You may also take a look at the entities that report quality data on an organizational level. Utilizing the entity you choose, discuss the following:

1. Analyze and discuss the entity’s role in the changes a health facility and health care administrator must make in order to meet or exceed quality standards.
2. How does the quality being measured associate with the current changes in the health care environment?

Answer 1

Health Database Organization
Health database organisation (HDO) to refer to organisations that have access to (and likely power over) databases and have as their chief mission the public release of data and the results of analyses conducted on the databases under their supervision.
Analyze and discuss the entity’s role in the changes a health facility and health care administrator must make in order to meet or exceed quality standards.

Assessing access to treatment and efficiency of resources
Assessing access to or lack of access to care is important for assessing the effectiveness of health care delivery systems and for effective planning of such systems. Understanding the economic, geographical and transportation barriers to health care, disparities in health care and access to health services is important for evaluating the ongoing effects of o

Assessing expenses and finding savings opportunities
Curbing healthcare expenditure involves setting global budget caps and relating charges to shifts in service duration.

Assessing the quality and results of treatment
Information on quality of care is important to everyone — for selecting a care source, developing a treatment plan, creating a case of malpractice, or seeking to improve care — and this committee has given particular attention to issues of quality assurance and enhancement throughout its deliberations.
Studies of mortality rates unique to hospitals
Research of hospital-specific mortality rates were an early subject in quality of care research using broad databases.

Effectiveness and Performance
But another important field of study concerns health care efficacy and outcomes — the clinical evaluative sciences, as some call it. Effectiveness awareness includes determining the efficacy and appropriateness of health care in daily settings for so-called typical patients and normal providers

Compliance assurance and quality assurance services

Providers can find information for QA / QI services in HDO databases of clear importance. Competition based on pricing in a healthcare system that stresses competition — one that can heavily control costs and other economic factors and disallow pre-existing condition provisions, selective risk selection by insurers and similar cost-shifting strategies —

Patient care monitoring and follow-up
Health care professionals with certain patient care roles may be able to access the knowledge in the HDO databases. Examples of such applications include: testing the allergies of patients to medication, collecting patient history at the time of patient-practitioner interactions, organising complex case management and encouraging improved contact among all

Improving Operational Quality
A major purpose of the health care reform is to make processing of claims for health insurance and financial transactions more effective. Both health insurers have databases obtained from various sources. These databases have historically acted as tools for checking qualifications, reporting by suppliers (for tax purposes), and adjudication of claims.

Functioning managed care systems
Providers or others may find HDO databases helpful in recognising patients who are likely to benefit from case management and streamlining precertification tasks.

Strategic Planning and Contracting

HDO data can promote a variety of long-term planning, business , and financial management activities facing insurers, employers, and providers. Such information can also be applied in the increasingly common selective contracting activities

Tracking of injury and illness, preventive treatment and wellness
It can be expected that those researching and having responsibility for public health activities will use HDO databases for a wide variety of applications. These include study of accident and disease occurrence, and reports of trauma-related health conditions and chronic disease prevalence. Today the records of diseases and accidents include infections

Promoting municipal and Community health planning, education and development

2. How does the quality being measured associate with the current changes in the health care environment?

While the comprehensiveness attribute is obviously of vital importance in assessing the usefulness of a database, HDOs need to avoid the trap of collecting whatever it is possible to collect, regardless of its reliability and completeness, and therefore end up with data elements that will only be used occasionally and, worse, of uncertain value when used.

Second, the knowledge needs to be reliable and analyzable. These points are often couched on in terms of data reliability and validity. More importantly, if they are to be useful, the accuracy and completeness of data elements that will be used extensively must be ensured. Among the issues to be avoided are: incomplete data; out-of-range quantitative data values (e.g., patient age; fees; even laboratory standards in the most sophisticated databases of the future); arbitrary shifts in measurements over time ( e.g. doubling the patient's weight during office visits); obviously incorrect information ( e.g., wrong sex); and miscoded information on diagnostic tests, actual treatments, surgical procedures, drugs, and the like.

Third, the committee is also of the opinion that systemic aspects of health systems should be emphasised as conducive to data and information of high quality. Databases should be constructed around a core of uniformly recorded (or translatable) data that is appropriate and can be demonstrated to be reliable and true for the intended study of the HDO (in line with the comments just above).

Fourthly, the Committee takes the view that the basic structure and content of these databases should be carefully designed from the outset, but they must have sufficient capacity for expansion and change as health care reform, research into quality and outcomes, and other diverse facets of the health care sector develop in the coming years.

Recommendation :
ACCURACY AND COMPLETENESS
Health database organisations are responsible for ensuring continuous data consistency and, in particular, take proactive action to ensure: (1) the completeness and integrity of the data in the databases for which they are responsible, and (2) the validity of the data for the analytical purposes for which it is used.

COMPUTER BASED PATIENT RECORD
The Committee therefore recommends that organizations from the health network endorse and contribute to regional and national efforts to establish computer-based patient records.