What is NACRS?

What is NACRS? - e

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Transcript What is NACRS? - e

Use of a National Standard Dataset to Accelerate Development & Reporting

May 28

, 2013

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.

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 4

Standardization Benefits

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 6

Data Warehouse Project

DAD

OR ADTC PARIS Clinical Support Finance Other Dataset Pixalere NACRS Standards

Secure Data Warehouse Standardize Data

VCH Information Other Facility’s Information Automated Reports Cubes BSC/ Dashboard Ad hoc reports Ministry/CIHI Submission 7

• 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.

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 9

Warehouse & NACRS

Quick & Easy

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.

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 12

VCH – BC NACRS Implementation

Implementation Milestone

Sign Service Agreement with Vendor

BC Project Target Dates

May 31, 2011 Complete Technical Implementation Schedule Jun 30, 2011

VCH Achieved Dates

N/A Oct 15, 2010 Complete NACRS Abstracting Software Installation Complete Required Interfaces Sep 2, 2011 Nov 11, 2011 N/A Dec 2010 Complete Internal System Testing Confirm Vendor Testing Complete Facility Testing Submit Data to NACRS Dec 16, 2011 Mar 16, 2012 Apr 20, 2012 May 3, 2012 Feb 2011 N/A May 2011 June 2011 13

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 14

NACRS ED Coverage 2013-14*

Canada: estimated 64% participation

YT 100% BC 65% AB 100% SK 46% MB 45% ON 100% QC † NS 77% PE 27%

*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 15

eNACRS – National Reports

CIHI - ED Wait Times at a Glance (Dashboard)

CIHI - ED Wait Times at a Glance (Quick View)

CIHI - ED Wait Times Targets (Dashboard)

CIHI - ED Wait Times Comparison (Dashboard)

CIHI - Ambulatory Activity (Quick View)

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.

Thank You!!

Patricia Chung Director of Data Management & Reporting, Decision Support Vancouver Coastal Health  604 714 3771 x 2322  [email protected]

Isabel Tsui Manager, CAD Database Development and Expansion Canadian Institute for Health Information  416.549.5527

 [email protected]