Patient-Level Data. February 4, Webinar Series Goals. First Fridays Webinar Series: Medical Education Group (MEG)
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1 First Fridays Webinar Series: Medical Education Group (MEG) Patient-Level Data February 4, 2011 Provide Insights into MEG Operations Share Up-To-Date Information Webinar Series Goals Share Best Practices How Can Pfizer Improve Processes? Respond to Outstanding Questions From Providers 1
2 Agenda: Patient-Level Data Welcome and Review of MEG Operations Planning is Everything in the Collection of Patient-Level Data Sean Hayes, PsyD, Vice President, AXDEV Group, Inc. and Suzanne Murray President & Founder AXDEV Group, Inc. Q and A Closing Remarks The Pfizer Grants Portal 2
3 Inside the Resource Center Archived Webinars Mouse-over goal statements The MEG 2-Step Requestor MEG Evaluate Register Submit Review Decide Notification Single Event Pay Reconcile / Close Quarterly Review Multistep Program Monitor 3
4 Quarterly Review Schedule 2011 Application Period Date Decision To Be Signed LOA Start Date of Communicated Deadline Program/Activity By Sept 1, 2010 Oct 15, 2010 Dec 5, 2010 Jan 1, 2011 or later Dec 1, 2010 Jan 15, 2011 Mar 1, 2011 April 15, 2011 June 1, 2011 July 15, 2011 Mar 4, 2011 June 3, 2011 Sept 2, 2011 Minimum of 2 weeks before start date or the decision will reverse to denied April 1, 2011 or later July 1, 2011 or later Oct 1, 2011 or later Sept 1, 2011 Oct 15, 2011 Dec 2, 2011 Jan 1, 2012 or later It s All About the Patient P A T I E N T Patients are in the forefront of our operation Addressing performance improvement Totally-engaged learners Interdisciplinary care for a holistic approach Education is an intermediate step to improved patient care Needs assessment Tools to get there 4
5 Planning is Everything in the Collection of Patient-Level Data Presenters: Suzanne Murray Sean Hayes February 4th, 2011 Agenda Objectives 5 minutes Context for patient-level data Patient-level data in the educational cycle Planning of patient-level data collection Linking the impact to the education What is done and what could be done Potential obstacles for patient-level data Q & A 5 minutes 5 minutes 10 minutes 5 minutes 10 minutes Copyright 2011 AXDEV Group Inc. 10 5
6 Objectives At the end of this presentation, participants should recognize: 1.The importance of planning for patient-level assessment 2.The value of patient-level data in assessing health care providers competence and performance 3.The broad variety of patient-level data sources available 4.Different ways of collecting patient-level data while respecting patients privacy, confidentiality and anonymity Copyright 2011 AXDEV Group Inc. 11 Disclosure Suzanne Murray President & Founder AXDEV Group International Sean Hayes, PsyD Vice-President AXDEV Group The presenters do conduct patient-level research in multiple countries. 6
7 Who we are AXDEV Group is an international Performance Improvement organization that specializes in assisting healthcare organizations and stakeholders improve professional competencies, interdisciplinary team practices, organizational functioning, and clinical practice efficiency. Copyright 2011 AXDEV Group Inc. 13 Agenda Objectives Context for patient-level data Patient-level data in the educational cycle Planning of patient-level data collection Linking the impact to the education What is done and what could be done Potential obstacles for patient-level data Q & A Copyright 2011 AXDEV Group Inc. 14 7
8 ACCME Criteria for Evaluation of CME Essential Area 3: Evaluation and Improvement Element 2.4: Evaluate the effectiveness of its CME activities in meeting identified educational needs. Element 2.5: Evaluate the effectiveness of its overall CME program and make improvements to the program. Criteria for Compliance C 11. The provider analyzes changes in learners (competence, performance, or patient outcomes) achieved as a result of the overall program s activities/educational interventions C 12. The provider gathers data or information and conducts a program-based analysis on the degree to which the CME mission of the provider has been met through the conduct of CME activities/educational interventions. 15 Performance Improvement in What? Health System Models / Structurest Functions Family Medicine / Pathology / Clinical practice / Finance / Human resources Teams Interdisciplinary / Homogenous CME Professionals Administrators / Clinicians / Researchers / Support / Technical staff Patients/Caregivers Compliance / Concordance / Experience of care / Satisfaction 8
9 Agenda Objectives Context for patient-level data Patient-level data in the educational cycle Planning of patient-level data collection Linking the impact to the education What is done and what could be done Potential obstacles for patient-level data Q & A Copyright 2011 AXDEV Group Inc. 17 Patient-Level Data in CME Why do we need patient-level data? Patients are the ultimate benefactors of Health Education and Performance Improvement in health care Patients are a source of data regarding health care providers competence and performance Patient-centric model: Patients are a critical part of the health care team Copyright 2011 AXDEV Group Inc. 18 9
10 Patient-Level Data in the Educational Cycle EVALUATION NEEDS ASSESSMENT Educational Design Process BEHAVIOURAL OBJECTIVES Offer critical source of information regarding gaps and barriers of health care providers Triangulation and cross-validation Identify unperceived needs Program impact on patient outcomes Offer additional critical source of performance and competence EDUCATIONAL DESIGN Knowledge / Skills / Attitudes Aligned with patient profiles Copyright 2011 AXDEV Group Inc. 19 Patient-Level Data in Needs Assessment Copyright 2011 AXDEV Group Inc
11 Patient-Level Data in Needs Assessment Presented at Alliance 2008 Copyright 2011 AXDEV Group Inc. 21 Patient-Level Data in Evaluation Don Moore, Vanderbilt University. Planning for and Assessing the Impact of Learning Activities. First Fridays Webinar Series: Medical Education Group (MEG), August 6th,
12 Patient-Level Data in Evaluation Patients are a valuable source of data regarding participants competence and performance Don Moore, Vanderbilt University. Planning for and Assessing the Impact of Learning Activities. First Fridays Webinar Series: Medical Education Group (MEG), August 6th, 2010 Agenda Objectives Context for patient-level data Patient-level data in the educational cycle Planning of patient-level data collection Linking the impact to the education What is done and what could be done Potential obstacles for patient-level data Q & A Copyright 2011 AXDEV Group Inc
13 Linking Impact to Education CME Impact on patient outcomes clinical endpoints: e.g., A1c, BP, CD4 count Copyright 2011 AXDEV Group Inc. 25 Linking Impact to Education CME Impact on program participants Knowledge, Skill, Competence, Attitude Impact on patient outcomes clinical endpoints: e.g., A1C, blood pressure Copyright 2011 AXDEV Group Inc
14 Linking Impact to Education CME Impact on program participants Performance Impact on patient outcomes Competence Patient-provider relation Adherence Copyright 2011 AXDEV Group Inc. 27 What is Generally Done Satisfaction questionnaires Self-assessments Surveys Interviews Focus groups Observations Performance tests Diaries Chart audits Is a more satisfied patient a validation of receiving better care? "Does (electronic) medical records reflect care being given or does it reflect care being documented?" (NIQIE Annual Meeting meeting, Gabrielle Gaspar, Sutter Physician Services, 2010) Copyright 2011 AXDEV Group Inc
15 What Could Be Done Patient Journey (experience) Mapping Satisfaction questionnaires i Self-assessments Surveys Quantitative Interviews X Focus groups Qualitative Observations Diaries Performance tests Chart audits Patient data registries Combinations Copyright 2011 AXDEV Group Inc. 29 Patient-Level Data Collection Areas to be evaluated Patient data collection methods Objective assessment Chart audits (e.g. laboratory measures) Patient data registries Communication Interviews Focus groups Concordant goal development Observations Diaries Subjective assessment (e.g. pain) Self-assessments Surveys Patient education Interviews Focus groups Observations Copyright 2011 AXDEV Group Inc
16 Patient-Level Data Collection Essential questions Why do I need patient data? How will it demonstrate the impact of the program? What data collection method best fits? Do I need protected health information? Is the data I will be collecting individually identifiable? Do I need the patient s written permission (Informed Consent Form)? Do I need IRB approval to protect the patients anonymity, confidentiality and privacy? Copyright 2011 AXDEV Group Inc. 31 Agenda Objectives Context for patient-level data Patient-level data in the educational cycle Planning of patient-level data collection Linking the impact to the education What is done and what could be done Potential obstacles for patient-level data Q & A Copyright 2011 AXDEV Group Inc
17 Privacy (HIPPA) HIPAA Privacy Rule defines protected health information or PHI as individually identifiable health information that is transmitted or maintained in any form or medium (electronic, oral, or paper) by a covered entity or its business associates, excluding certain educational and employment records. HHS Protection of Human Subjects Regulations Title 45 CFR Part 46: Private information must be individually identifiable in order for obtaining the information to constitute research involving human subjects. Individually identifiable means the identity of the subject is or may readily be ascertained by the investigator or associated with the information. 33 Privacy (HIPPA) The Privacy Rule allows a covered entity to de-identify data by removing all 18 elements that could be used to identify the individual or the individual's relatives, employers, or household members De-identified health information, as described in the Privacy Rule, is not PHI, and thus is not protected by the Privacy Rule. PHI may be used and disclosed for research with an individual's written permission in the form of an Authorization Informed Consent Institutional Review Boards (IRB) 34 17
18 Privacy (HIPPA) 1. Names 2. All geographic subdivisions smaller than a state, t except under certain condition for the initial three digits of a ZIP Code 3. All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death 4. Telephone numbers 5. Fax numbers 6. Electronic mail addresses 7. Social security numbers 8. Medical record numbers 9. Health plan beneficiary numbers 10. Account numbers 11. Certificate/license numbers 12. Vehicle identifiers, serial numbers, license plate numbers 13. Device identifiers/serial numbers 14. Web universal resource locators (URLs) 15. Internet protocol (IP) address numbers 16. Biometric identifiers, including fingerprints and voiceprints 17. Full-face photographic images and any comparable images. 18. Any other unique identifying number, characteristic, or code, unless otherwise permitted by the Privacy Rule for re-identification. 35 Confidentiality & Anonymity Definitions Confidentiality: (International Organization for Standardization (ISO), ISO/IEC 17799, Jan 4, 2009) "ensuring that information is accessible only to those authorized to have access" Anonymity: (adapted from anonymous, HIPPA glossary) ensuring that information is collected without identifiers, and that is never linked to an individual Informed consent (FDA s guide to informed consent): a process of information exchange that may include, in addition to reading and signing the informed consent document, subject recruitment materials, verbal instructions, questions/answers sessions and measures of subject understanding Copyright 2011 AXDEV Group Inc
19 Key Messages Plan Plan Plan Identify when you need patient level data Identify when you do not Map out link between program and patient data collected Select appropriate collection method Respect of patients privacy, confidentiality and anonymity Copyright 2011 AXDEV Group Inc. 37 Copyright 2011 AXDEV Group Inc
20 Conclusion Patients are a valuable source of data regarding health care providers competence and performance Good planning of the patient-level data collection process will : Ensure data is collected respecting patients privacy, confidentiality and anonymity Guide you in selecting appropriate data collection methods Ensure alignment of data and assessment objectives Increase validity of findings by accessing multiple data sources Copyright 2011 AXDEV Group Inc. 39 Thank you! 20
21 Until Next Time Please join us for our next webinar Block Grants Guest Speakers: Bob Addleton, Ed.D. and David Pieper, PhD Friday, March 4 th, am ET Next grant window opens March 1, 2011 for activities to occur July 1, 2011 or later See what providers are doing to move education forward PfizerMedEdGrants Resource Center Publications 21
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