Missouri Hospital Association Data Reporting Mandate

03 Apr

Since 1993 all Missouri hospitals have been required to report personal data on all hospital patients receiving care.  Data has been collected beginning in 1986 and Kansas and Missouri are jointly collecting data since 2000.   Reporting data is sent on CD’s (Compact Discs) monthly to member hospitals.  (I would guess without any security or encryption.)  That is a lot of CD’s.  I wonder if all of them are accounted for?  Have any been “thrown away”?

In a recent meeting in February 18, 2010 they have started to enforce rules about a 1% error threshold with the quality of data.  Here is a summary of the February 18 meeting.  I wonder if they have provided any historical data of provider error rates?

HIDI will provide an overview of the guidelines for data submission, including the collection, editing and correction of discharge data.

HIDI recently conduct regional meetings at MHA-member hospitals to review HIDI’s inpatient and outpatient discharge collection process. Staff provided an overview of the guidelines for data submission, including the collection, editing and correction of discharge data. Staff also provided an update on the required discharge data submission to the state.

In November, the Missouri Department of Health and Senior Services notified hospitals and ambulatory surgical centers of its intent to enforce the 1 percent field level error threshold for reporting patient abstract data included in 19 CSR 10-33.010. The rule, effective since Dec. 31, 1992, established procedures for state reporting of patient abstract data for inpatients and outpatients by hospitals and ASCs. HIDI processes and reports discharge data for most MHA-member hospitals and for HIDI-contracted ASCs. According to DHSS, enforcement of the 1 percent error threshold will begin with federal fiscal year 2010’s first quarter data submission — discharges between Oct. 1 and Dec. 31, 2009. Reporting organizations not able to meet the 1 percent error threshold must submit a corrective plan of action to DHSS.

The full report can be found here.  http://www.sos.mo.gov/adrules/csr/current/19csr/19c10-33.pdf

(click on this image to enlarge)

In addition to the personal data required the medical diagnosis, condition, procedure codes, charges, patient disposition, physicians and medical record number were provided.

This information is kept in it’s original form and can be used for other purposes if approved by the HIDI Data Release Advisory Committee appointed by the director.  Unique patient data can be used for detailed studies though subsequent release of data cannot identify patient, physician or provider.

In a letter dated November 18, 1992 from Kenneth L.  Kuebler, Executive Vice President of HIDI,  he provided a concern about this data collection process.

“7.              In addition, legal counsel has brought to our attention the fact that compliance with certain of your reporting requirements will place hospitals in violation of a federal patient confidentiality statute (I will provide the precise citation later when it is provided to me) that precludes the release of the identity of patients treated for drug or alcohol abuse.  The rules will need to reflect this restriction and exempt from the reporting requirements the name or social security number of patients discharged for these types of treament.”

I wonder if compliance to this Federal Patient confidentiality statute was monitored or enforced.  It would have fallen to the reporting hospitals and ambulatory surgery facilities.

HIDI provides many reports to…

The following data are available to MHA-member hospitals.

Hospital Inpatient Reports

These reports contain comprehensive information concerning hospital utilization patterns and patient characteristics and are valuable tools for hospital planning and evaluation. Available since 1986, the reports are mailed to member hospitals that provide inpatient discharge data. Beginning with the 2000 Hospital Inpatient Reports, inpatient discharge data for Missouri and Kansas are combined and reported at the hospital level. Participating Missouri hospitals may purchase reports for Kansas, and participating Kansas hospitals may purchase reports for Missouri. In 2003, the utilization rate tables for Missouri were added to the CD as a convenience to members. The tables report the 500 most frequent principal diagnoses, the 500 most frequent principal procedures and all diagnosis-related groups (DRG).

Interim Hospital Inpatient Reports

Hospital Outpatient Reports

Census Data

Management and Productivity Reports

Monthly Utilization Report

Do all states collect this type of data?

I searched through the 19 CSR 10-33.010. (The rule, effective since Dec. 31, 1992, established procedures for state reporting of patient abstract data for inpatients and outpatients by hospitals and ASCs.)  I did not find the word privacy.  I don’t know what privacy laws protect this data.