About Health Transparency

Interesting commentary by Dr. Cosgrove, President and CEO of the Cleveland Clinic, on transparency and a patient’s right to information as part of the Learning Health System Commentary Series of the IOM Roundtable on Value & Science-Driven Health Care.

Home Health quality data on CMS Home Health Compare has been updated as follows:

Reporting data for January 2012 through December 2012:

1. How often patients got better at walking or moving around.
2. How often patients got better at getting in and out of bed.
3. How often patients got better at bathing.
4. How often the home health team checked patients for pain.
5. How often the home health team treated their patients’ pain.
6. How often the home health team treated heart failure (weakening of the heart) patients’ symptoms.
7. How often patients had less pain when moving around.
8. How often patients’ breathing improved.
9. How often the home health team took doctor-ordered action to prevent pressure sores (bed sores).
10. How often the home health team included treatments to prevent pressure sores (bed sores) in the plan of care.
11. How often the home health team checked patients for the risk of developing pressure sores (bed sores).
12. How often patients’ wounds improved or healed after an operation.
13. How often the home health team began their patients’ care in a timely manner.
14. How often the home health team taught patients (or their family caregivers) about their drugs.    October 2011     September 2012
15. How often the home health team checked patients’ risk of falling.
16. How often the home health team checked patients for depression.
17. How often the home health team determined whether patients received a flu shot for the current flu season.
18. How often the home health team determined whether their patients received a pneumococcal vaccine (pneumonia shot).
19. For patients with diabetes, how often the home health team got doctor’s orders, gave foot care, and taught patients about foot care.
20. How often patients got better at taking their drugs correctly by mouth.

Reporting data for October 2011 through September 2012:

1. How often patients receiving home health care needed any urgent, unplanned care in the hospital emergency room – without being admitted to the hospital.
2. How often home health patients had to be admitted to the hospital.

Patient Survey Results data updated to report for October 1, 2011 through September 30, 2012

Data has been updated on CMS Hospital Compare as follows:

• HCAHPS measures: updated to 11Q3_12Q2
• HQA measures: HA, HF, PN and SCI updated to11Q3_12Q2
• Emergency department care measures updated to 12Q1_12Q2
• Preventive care measures updated to: 12Q1_12Q2
• HAI Measures updated as follows:
  • Central Line Bloodstream Infections: 11Q3_12Q2
  • Catheter Associated Urinary Tract Infections 12Q1_12Q2
  • Surgical Site Infections from colon surgery (SSI: Colon) 12Q1_12Q2
  • Surgical Site Infections from abdominal hysterectomy (SSI: Hysterectomy) 12Q1_12Q2

• HIT measures updated to 12Q1_12Q2
• Structural measures updated to report 12Q1_12Q2 except for one measure (Multispecialty surgical registry) reporting 11Q3_12Q2

Measuresets not updated:

• Readmission & mortality measures are still reporting 08Q3_11Q2
• IQI & PSI measures (Serious Complications & deaths) still reporting 09Q3_11Q2
• HAC measures still reporting 09Q3_11Q2
• Medicare payment measures still reporting same time periods as follows:
  • Number of medicare patients treated: 10/1/2010-9/30/2011
  • Spending per Hospital Patient with Medicare: 5/1/2011-12/31/2011

In a first for Canada, CBC’s the fifth estate has launched an interactive tool that allows patients to rate the quality of care in their own hospitals. It’s part of Rate My Hospital, an in-depth look at hospital performance across the country.

CBC’s online patient ratings tool allows users to evaluate their hospital stay using a five-star rating scale on five measures:Overall recommendation; Cleanliness of the hospital; Communication with the staff; Courteous and respectful treatment and Timely care.

The California Office of the Patient Advocate released its annual Healthcare Quality Report Card. The 2013 report card (http://www.opa.ca.gov/report_card/) provides California consumers with side-by-side comparisons of the largest health plans in the state (10 HMOs and six PPOs), ranking them on national standard-of-care measures that involve treatment and prevention of a range of acute and chronic conditions with significant implications for personal health.

The 2013 report card is available at http://reportcard.opa.ca.gov/rc2013/

The latest data update to the Illinois Hospital Report Card and consumer guide to health care Web site (healthcarereportcard.illinois.gov), which included updates to quality, infection, nurse staffing and infection data, was published today. Hospital quality measures reported are for time-period April 1, 2011 to March 31, 2012.

Also included in this data update were:

• Updated health care-associated infection data on surgical site infections associated with coronary artery bypass surgeries, based on data from July 1, 2011 through June 30, 2012. Included data in statewide aggregate report.
• Updated composite “Process of Care Measures” from the Center for Medicare and Medicaid Services Hospital Compare performance measure data from April 1, 2011 to March 31, 2012. Adjusted composite scores to account for recently retired sub-measures.

Quality is a central component of any discussion around health care and one of the key dimensions and measurements of quality care is the patient experience.  However, many healthcare organizations struggle to become ‘patient focused’ and fail to score well on patient satisfaction surveys.  New research from Brigham and Women’s Hospital, published in the March edition of British Medical Journal Quality and Safety, offers a potential explanation — insufficient support from hospital management to improve the patient experience by engaging physicians and nurses in the process.

Read full study: The patient satisfaction chasm: the gap between hospital management and frontline clinicians, BMJ Qual Saf 2013;22:242-250 doi:10.1136/bmjqs-2012-001045

New and updated performance data comparing access to care, health care quality, and outcomes in hospitals and regions are now available on WhyNotTheBest.org.

The new performance data measure:

• median wait times for emergency care;
• pneumonia and influenza immunization rates;
• use of health information technology (whether hospitals receive lab results electronically and track clinical results between patient visits); and
• average spending per hospitalized Medicare beneficiary.

In addition, the following data sets have been updated with the most recently available data from CMS Hospital Compare:

• process-of-care measures for recommended heart attack care, heart failure care, pneumonia care, and surgery;
• Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures of patients’ experiences; and
• incidence of health care–associated infections (CLABSIs).

To get started, explore these featured reports:

• Health System Hospitals vs. Non-Health System Hospitals: Immunization Rates (Group Comparison)
• North Carolina and South Carolina Hospitals: CLABSIs (Hospital Comparison)
• Use of Health Information Technology: Colorado Hospitals (Hospital Comparison)
• Emergency Department Wait Times: California HRRs (Regional Comparison)
• Spending per Beneficiary: Manhattan Hospitals (Hospital Comparison)

AHA News writes: The Centers for Medicare & Medicaid Services seeks input through March 26 on potential survey instruments, measures and topics for two experience-of-care surveys it is developing – one for patients at hospital outpatient surgery departments and ambulatory surgery centers, and the other for family members and friends of patients who die in hospice care. The agency plans to develop and submit the surveys to the Agency for Healthcare Research and Quality for recognition as Consumer Assessment of Healthcare Providers and Systems surveys.

Data has been updated on CMS Hospital Compare as follows:

• HCAHPS  data updated to report data for 11Q2_12Q1
• HQA data: all measures updated to 11Q2_12Q1 (see note on retired measures below).
• Readmission & mortality measures not updated. Update period is in July
• IQI & PSI Measures: not updated. Update period is in July.

• HAC Measures: not updated.  Update period is in July.

• New Emergency Care Measures (7)  reporting data for 1/1/2012-3/31/2012
  ED-1b Average (median) time patients spent in the emergency department, before they were admitted to the hospital as an inpatient
  ED-2b Average (median) time patients spent in the emergency department, after the doctor decided to admit them as an inpatient before leaving the emergency department for their inpatient room
  OP-20 Average time patients spent in the emergency department before they were seen by a healthcare professional
  OP-21 Average time patients who came to the emergency department with broken bones had to wait before receiving pain medication
  OP-22 Percentage of patients who left the emergency department before being seen
  OP-23 Percentage of patients who came to the emergency department with stroke symptoms who received brain scan results within 45 minutes of arrival

• New Preventive Care Measures (2) reporting data for 1/1/2012-3/31/2012
  IMM-1a Patients assessed and given influenza vaccination
  IMM-2 Patients assessed and given pneumonia vaccination

• HAI Measures: Central Line Associated Bloodstream Infections (CLABSI)  data updated to 11Q2_12Q1
• 3 new HAI measures added reporting data for 1/1/2012-3/31/2012
  Catheter Associated Urinary Tract Infections (CAUTI)
  Surgical Site Infections from colon surgery (SSI: Colon)
  Surgical Site Infections from abdominal hysterectomy (SSI: Hysterectomy)

• New HIT measures (2) added reporting data for 11Q1_11Q4
  OP-12 Able to receive lab results electronically (11Q1_11Q4)
  OP-17 Able to track patients’ lab results, tests, and referrals electronically between visits (11Q1_11Q4)

HQA Measures retired for this update as follows:

• AMI-1    Heart Attack Patients Given Aspirin at Arrival
• AMI-3    Heart Attack Patients Given ACE Inhibitor or ARB for Left Ventricular Systolic Dysfunction (LVSD)
• AMI-4    Heart Attack Patients Given Smoking Cessation Advice/Counseling
• AMI-5    Heart Attack Patients Given Beta Blocker at Discharge
• HF-4    Heart Failure Patients Given Smoking Cessation Advice/Counseling
• PN-2    Pneumonia Patients Assessed and Given Pneumococcal Vaccination
• PN-4    Pneumonia Patients Given Smoking Cessation Advice/Counseling
• PN-5c    “Pneumonia Patients Given Initial Antibiotic(s) within 6 Hours After Arrival’ – Timing of Receipt of Initial Antibiotic Following Hospital Arrival
• PN-7    Pneumonia Patients Assessed and Given Influenza Vaccination
• SCIP-Inf -6        Surgery Patients with Appropriate Hair Removal

For more information on data updated:  http://www.medicare.gov/HospitalCompare/Data/AboutData/Data-Updated.aspx