Utah Health Data Committee (HDC) Meeting
Minutes
Tuesday, January 10th, 2017
3:05 pm – Meeting started by Chair Jim VanDerslice after establishing a quorum in person and via phone.
The meeting took place between 3:05 and 5:00 pm in Room 125 at the Utah Department of Health 288 N 1460 W Salt Lake City.
Attendees:
Mark Bair (phone)Lynette Hansen
Vaughn Holbrook (until about 4p)
Lynda Jeppesen
Jim Murray
Steve Neeleman
Tanji Northrup (phone)
Alan Ormsby
Kevin Potts (until about 4p)
David Purinton
Hinkley Jones Sanpei
James VanDerslice
Sharon Donnelly
1. Approval of November 2016 Meeting Minutes
Chair VanDerslice noted the change in the meeting minutes requested by Sharon Donnelly; Sharon suggested to include more detail on the prior research into the legal authority held by DOH and HDC to release data to Molina for its data request leading to the discussion at the HDC meeting and proposed ad hoc committee.
These edits were made prior to meeting and reviewed by members.
Motion to adopt meeting minutes: Alan Ormsby
Second: Jim Murry
None opposed
Updates from and reviews of each HDC associated subcommittee were the next 4 agenda items.
2. Data Use Subcommittee (DUS) Update and Review
Jim VanDerslice is the chair of the DUS. Chair VanDerslice reviewed a handout with brief bullet points and information on the DUS.
Key Points from the discussion:
● Focus and role of the DUS: Develops recommended policies related to data use approvals; implements committee procedures for handling data use requests; reviews data use requests, including those that involve research data sets or identifiable data; can approve data use requests on behalf of the HDC; also makes recommendations that require consideration by full committee.
● Norm Thurston shared an update on the University of Utah institutional license and the data request and approval process.
o The request first goes to Jahn Barlow with the Utah Resource for Genetic and Epidemiologic Research (RGE) for initial review. The request is then passed on to Mike Martin with the Office of Health Care Statistics, where the request undergoes the standard data approval process depending on the type and nature of the data requested.
● Chair VanDerslice reviewed the list of the data uses, releases, and analyzes performed with the data.
● Agenda item 2a. Molina data request update:
o Lynette Hansen reviewed the basics of the data request by Molina; the request is to obtain information about the health status of marketplace clients; this information would be used to offer wrap around care and services to clients based on health conditions and needs. Risk adjustment on the clients would be applied.
o This request has now been classified as a research proposal (a test use case) and has been submitted to an IRB for review.
o Discussion about this data request included: how will the data and resulting information be used/applied? Answer: Information will be used to connect members to healthcare services where the data indicates a need, such as a primary healthcare provider.
o What results or measures from the research project can be expected? What are the intended outcomes? Answer: An example may be decreased emergency department visits by members connected to a primary physician. Decreases in overall utilization or an influence on risk scores.
o The intent is to see if making connections like this with and for members actually works.
o This is classified as research because it is determined that data, as requested by Molina, cannot be used for operational functions; the law does not currently allow for this use.
● Agenda item 2b. Possible new uses for data:
o There was discussion and questions about using data for operation purposes; these are policy questions.
§ Basic question is: can the APCD and/or healthcare facilities ever be used to support healthcare operations?
· A more specific question would be: Would it be acceptable for data suppliers (such as hospitals or health insurance providers/payers) to get more data (through the APCD or facilities data) about their current patients or enrollees for the specific purpose of providing/supporting better (or cheaper) care?
o Concerns regarding use of data for operations were expressed by several members. Specifically considering the uncertain future of the Affordable Care Act and some of the safeguards (e.g. pre-existing conditions) included in therein.
o It was also expressed that there is potential for good use of the data for operational purposes, but only with the appropriate and strong safeguards in place.
o The requirements of HIPAA covered entities and how these requirements may or may not be involved was also discussed. OHCS would use data sharing agreements, as it is not a HIPAA covered entity, if data of this nature would be shared/given.
o Only data uses defined in the statutory authority may be used or applied, which limits operations. If OHCS was a [HIPAA] covered entity, there actually could be additional uses or applications of the data.
o A change in the state statute that to allow such operational uses would need to be made with strong safeguards and potential penalties to ensure compliance and that use does not go outside of the approved bounds.
● Other agenda items for 2 were covered in the handout and not discussed.
3. Facilities Task Force Update and Review
Charles Hawley with the Office of Health Care Statistics gave an update on the Facilities Task Force.
Key Points from the discussion:
● Focus and role of the Facilities Task Force: to reach out to the healthcare facilities that submit data to OHCS and include those facilities in discussions related to the data submissions, data uses, and other relevant items.
● An update on the facilities data processing vendor contract was offered.
o Mercer received the contract after the competitive RFP process.
o The contract has not been executed yet, as it is still under the State review and approval process.
● Work is being done now to normalize/standardize the historical facilities data as well as provide a longitudinal compilation of the data.
● This year, there will be updates to the data submission guide (DSG) for facilities.
The next item was addressed out of the original agenda order due to its relevance to the Facilities Task Force agenda item.
4. Update on Healthcare Facilities Database RFP (agenda item 6)
Charles Hawley with the Office of Health Care Statistics gave additional updates on the healthcare facilities data process.
Key Points from the discussion:
· The healthcare facilities data processing and management vendor will facilitate more timely data processing and produce data products more quickly than in the past.
· Starting with the 2017 data, quarterly data sets will be available in addition to the final annual data set.
· 2016 data will be available sooner than previous years.
5. Payer Task Force Update and Review (agenda item 4)
Lynette Hansen, chair of the Payer Task Force (PTF), gave an update on the work and discussions of the Payer Task Force over the past year. Members of the PTF include any and all payers that submit data to the All Payer Claims Database.
Key highlights from the discussion:
● The updates and revisions to the data submission guide (DSG) were reviewed at several PTF meetings throughout the year. Contributions from payers are welcome.
● Specific items discussed at the PTF throughout the year include: the U.S. Supreme Court decision regarding self-funded employer plans exclusion from APCDs, payer specific data flow tracking sheets, SharePoint sites, and data uses of the APCD.
● For 2017, some topics for discussion at PTF will be on how APCD data can and will be used and how can data benefit payers and data submitters.
● The HDC members also discussed cost and ‘discounted care’ for procedures at healthcare facilities.
6. Transparency Advisory Group Update and Review (agenda item 5)
Alan Ormsby, chair of the Transparency Advisory Group (TAG), gave an update on the work and discussions of the TAG over the past year. The vision and focus of this subcommittee is that high-value information on health care cost and quality is displayed to the Utah general public, so that consumers can use it to make the best health care decisions.
Key highlights from the discussion:
● In 2016, the TAG focused on the maternity cost project and opioid use, which was put on hold for a period of time due to staffing changes.
● In 2017, the focus of TAG will include dental data and consumer info to make these services shoppable and opioid use, which will look at prescribing and the spectrum of response from the medical community. There is a need to work with stakeholders to get feedback.
● Discussion also involved cautions for releases of information and the need to involve medical communities, small medical groups and clinics. There may be unintended consequences making checks and balances on information and its review important.
7. Cost Tools
Norm Thurston gave an update on why the cost tool remains a point of continued discussion; OHCS feels pressure to answer the question of ‘what does this [healthcare service] cost’ in a manner consumable by the public. In November 2016, there was a discussion of partnering with a media company and/or a technology company to accomplish the goal of publishing data in a manner that the public can use combining cost, quality, and location.
Key highlights from the discussion:
· The idea of using a (completely de-identified) dataset for coder/coding experts to use and potentially come up with a way to present or analyze the data was discussed.
o The three basic pieces of data would be needed: procedure code, price (what the patient ended up paying), provider (who provided the service).
o These data have been debated on whether it is too much to release given the sensitive, nuanced, and complex nature of these.
· This discussion would continue in more detail at another time.
· Caution would be that statisticians can make the data tell whatever story they want. There needs to be a balance between innovation, accuracy, and utility.
· Price transparency website would take lots of time; OHCS could probably produce one or two services a year.
· If HDC/OHCS built a website on cost transparency, would anyone use it? Having this website or tool is an expectation placed on the existence of the data, but it may not be realistic to meet.
8. State Health Data Plan.
Norm Thurston
Key highlights from the discussion:
· Some sections of the Plan that were highlighted in green to show the sections for feedback and information from the HDC members were particularly needed.
· State Health Data Plan Section 3, which is ‘key questions, issues or problems that health data could help address,’ was one of the main sections discussed. This section is essentially asking why the data is being collected.
· The uses identified from previous meetings and this meeting are:
- Addressing rising costs
- Consumer-driven health plans/care
- Identifying and driving value
- Improving population health
- Poverty policy
- Integration and coordination of care
- Efforts to improve access to care
- Health care quality and how it can be measured
· One item discussed is how can these uses be operationalized and what are the priorities.
· From a legal perspective, the State Health Data Plan has been adopted and the legal requirement has been met.
· This Plan can now be a living document that is revisited throughout the year(s) and used as a guide for the work of the HDC and OHCS.
· OHCS is looking for guidance from HDC on what should the data be used for.
· Preventative medicine, quality, and medical home are additional aspects for data uses.
Norm Thurston also mentioned that the March meeting date may be moved due to its close proximity to the end of the State Legislative session. Members were told to watch for their emails for more information.