Use of a National
Standard Dataset to
Accelerate Development
& Reporting
May 28th, 2013
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Faculty/Presenter Disclosure
• Faculty:
– Patricia Chung, Vancouver Coastal Health
– Isabel Tsui, Canadian Institute for Health Information
• Relationships with commercial interests:
– Nothing to declare.
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.
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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
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Standardization Benefits
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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
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Data Warehouse Project
NACRS
Standards
Secure Data Warehouse
Automated Reports
ED
ADTC
Standardize
Data
VCH
Information
PARIS
Clinical Support
Other
Facility’s
Information
Finance
Other Dataset
Pixalere
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Patient Continuum
OR
Cubes
BSC/ Dashboard
Ad hoc reports
Ministry/CIHI
Submission
Portals
DAD
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.
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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
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Warehouse & NACRS
Quick
&
Easy
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CIHI
NACRS
ED
Mandated
in B.C.
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.
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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
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VCH – BC NACRS Implementation
Implementation Milestone
BC Project Target Dates VCH Achieved Dates
Sign Service Agreement with
Vendor
May 31, 2011
N/A
Complete Technical Implementation
Schedule
Jun 30, 2011
Oct 15, 2010
Complete NACRS Abstracting
Software Installation
Sep 2, 2011
N/A
Complete Required Interfaces
Nov 11, 2011
Dec 2010
Complete Internal System Testing
Dec 16, 2011
Feb 2011
Confirm Vendor Testing
Mar 16, 2012
N/A
Complete Facility Testing
Apr 20, 2012
May 2011
Submit Data to NACRS
May 3, 2012
June 2011
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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
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NACRS ED Coverage 2013-14*
Canada: estimated
64% participation
YT
100%
BC
65%
AB
MB
SK
100%
45%
46%
ON
100%
QC†
PE
27%
NS
77%
*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
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eNACRS – National Reports
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CIHI - ED Wait Times at a Glance
(Dashboard)
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CIHI - ED Wait Times at a Glance
(Quick View)
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CIHI - ED Wait Times Targets
(Dashboard)
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CIHI - ED Wait Times Comparison
(Dashboard)
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CIHI - Ambulatory Activity
(Quick View)
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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.
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Thank You!!
Patricia Chung
Isabel Tsui
Director of Data Management &
Reporting, Decision Support
Manager, CAD Database
Development and Expansion
Vancouver Coastal Health
Canadian Institute for Health
Information
 604 714 3771 x 2322
 416.549.5527
 Patricia.Chung@vch.ca
 itsui@cihi.ca
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Questions
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