The Robert Wood Johnson Foundation
Information for State Health Policy Program
mkassis@hw1.cahwnet.gov
World Wide Web: http://www.chipp.cahwnet.gov/
California's component of the Robert Wood Johnson funded InfoSHP program focuses its resources on transforming the state from one which is rich in health data to one which is rich in health information, particularly in the area of primary care.
Phase II will accomplish a number of objectives including finalizing and implementing several draft policies developed during Phase I and completing five specific projects aimed at improving the usefulness of statewide health data either by linking data from different sources or creating new methods of displaying and analyzing existing multi-variable data sets. Work on these activities will be accomplished by an expanded CHIPP staff and by staff located in a number of Agency departments including the Office of Statewide Health Planning and Development (OSHPD), the Department of Health Services (DHS), and the Health and Welfare Data Center.
In recognition of the increased policy responsibilities and organizational complexities of Phase II, a new career Executive position was created to manage the project. Michael Kassis, the current head of the Department of Health Services Medically Indigent Services Section, has been recruited to fill the position and will begin with CHIPP in early February. The remainder of the staff should be in place by the end of March.
Progress toward completion of Phase II objectives has been made on a number of fronts. The health data base inventory developed in Phase I has been formatted for distribution on diskette and has been distributed to a small sample of users to critique its usefulness and provide suggestions for improvements. At the same time, work is being done on an electronic version which will be completed by the end of Year 1. In the area of confidentiality policies and procedures, OSHPD and DHS have entered into a Memorandum of Understanding as a first step toward developing a process for fulfilling requests for confidential elements from OSHPD's hospital discharge data base. When completed, these procedures will be reviewed by the CHIPP confidentiality/privacy focus group which will determine their applicability to other confidential health data bases.
Several steps have been taken toward the objective of developing linked data sets for public use. OSHPD has increased its capacity to edit Social Security Numbers and other data elements critical to the linkage process by hiring four additional staff in its discharge data section. Data linkages - between multiple hospital discharge records for the same person and between hospital discharge data and death records - have been successfully rested in two different contexts. In the first case, linkages for the purpose of determining the quality of information have been undertaken by OSHPD and have proven to be a feasible way to identify and correct erroneous data. In the second case, the capability to achieve linkages between multiple hospital discharges for the same patient became a critical element in the success of OSHPD's recent report on hospital outcomes. By linking records, researchers were able to include information on the outcome of hospital stays for patients treated for myocardial infarction whose care involved transfers between hospitals. this situation is particularly common in rural areas of California where tertiary care is not available at local hospitals. Later phases of this study will include linkages to death records to determine post- discharge mortality. As Phase II progresses, linkages between five statewide data sets will be undertaken. Each in intended to both increase the quality of the data contained in the individual data sets and to enhance the useability of these data for policy development.
Project Title: California Health Information for Policy Project
Proposed Director: Mike Kassis, Project Director
Project Structure: Governor Wilson has designated the Health and Welfare Agency (HWA) as the lead agency for the California Health Information for Policy Project (CHIPP). The HWA is the Cabinet level entity responsible for administration of health and health data programs in the State. The HWA has delegated responsibility for staffing and implementation of CHIPP to the Office of Statewide Health Planning and Development (OSHPD). David Werdegar, MD, MPH, Director of OSHPD, will chair the CHIPP Steering Committee; a representative of HWA will be a member of this group. Other members include the directors of all key HWA departments, legislators, and representatives of local government, minority communities, and academia. The interagency work group (IWG), which is reflective of the wide diversity of the state, comprises 45 individuals representing: State and local government agencies, the California Legislature, health care providers, private sector users of health data, researchers, consumer advocates and minority health organizations. This group is chaired by the Project Director and functions under the broad direction of the CHIPP Steering Committee. Specific products and recommendations of the IWG are transmitted to the Steering Committee for approval and then to the HWA for implementation.
Health Policy Issues: At the outset of Phase 1, the CHIPP Steering Committee clearly agreed that California's overriding health policy concern is "access to and management of primary health care services." In terms of health information, this concern can be best addressed if the state works to: establish statewide access to a rational, client/family oriented, needs based, integrated, statewide capacity to provide coordinated primary health care services which focus on prevention and early intervention; and, identify and establish logical policy, program, and information linkages among primary care service programs.
In the short-term, significant progress can be made toward these objectives by enhancing the useability of existing data systems, facilitating data access, linking data sets across programs, and improving output formats. In the long-term, the state must plan for an integrated primary care data system with uniform core data sets and coding, and model communication and architectural standards.
CHIPP will accomplish its short- and long-term objectives by activities to
Specific projects proposed for Phase II will include:
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Revised: September 29, 1996
Home Page URL: http://www2.umdnj.edu/shpp/homepage.htm