THCIC's Public Use Data File What the release means to physicians

by Shellie Pruden, DCMS director of medical practice relations and Denise Remus, PhD, RN

What would happen if, after the Texas Health Care Information Council releases its public use data file containing patient-level data, you find that the hospital to which you admit most of your patients is publicized as the highest risk for death in the city? Where did this data come from and what does it mean?

The Texas Health Care Information Council is directed by the Legislature to develop a statewide healthcare data collection system to collect healthcare charges, utilization data, provider quality data, and outcome data to promote cost-effective, quality health care. To accomplish this, the THCIC established its hospital discharge data program, which will release its first public data on Dec 15. The specific legislation and rules can be found on the THCIC Web site at www.thcic.state.tx.us.

This program requires some 450 Texas hospitals to submit quarterly data on all inpatient discharges, regardless of status or dispositions. This includes all medical/surgical, intensive care, nursery, subacute, skilled nursing, long-term, psychiatric, substance abuse, and rehabilitation patients. In addition to the traditional billing data, hospitals must collect and submit information about patient race, ethnicity, Social Security number, and payer.

THCIC must not release data that could be used to identify a patient or physician, and data can be released to the public only if it has been edited by THCIC and verified by the hospitals for accuracy and consistency. The data also must include severity and risk modifiers. Based on this criteria, only a small subset of the data submitted actually becomes public.

But when it does, and if the news isn't good, you do have recourse. Remember that the original source, for the majority of the data, is the documentation in the medical record. It is critical for physicians to provide complete and timely documentation. There is no chart review or audit before submission of the data. After submission to THCIC, the hospital staff and physicians have only a brief period to review and request correction of data. If data errors are found during the certification phase, the hospital must pay THCIC's vendor to be able to correct the data. While hospitals, by statute, must provide physicians the opportunity to review, request correction, and comment on the data, the process by which this is done may be unique to each facility. Each hospital has appointed a certification officer who will be responsible for THCIC data certification and will be familiar with the process.

For more information contact THCIC Physician Board Members Lewis Foxhall, MD; Amanullah Khan, MD; Ruben Martinez, MD; and Karl Swann, MD. Also, the people listed below can answer questions about THCIC's public use data file:
Denise Remus, PhD, RN, vice president of data initiative at Dallas-Fort Worth Hospital Council, 972-717-4279 or dremus@dfwhc.org.
Anne Gallagher, policy analyst at Texas Medical Association, 800-880-1300 or anne.gallagher@texmed.org.
Shellie Pruden, director of medical practice relations at Dallas County Medical Society, 214-948-3622 or shellie@dallas-cms.org.
Jim Loyd, THCIC executive director, 512-482-3317 or jim.loyd@thcic.state.tx.us.

THCIC Preparation Seminar The DFWHC and DCMS will sponsor an educational session on Wednesday, Nov 8, to assist hospitals and physicians in preparation for the public release of discharge data. CME will be available. The morning session will provide an overview of the data elements and anticipated uses; the afternoon program will focus on training hospital staff and physicians in responding to inquiries by the media, patients, and other public members. Each attendee will receive a comprehensive packet of background materials on THCIC and hospital discharge data. A registration form and additional information about the program can be found at the DFWHC Web site (www.dfwhc.org) under the heading "Data Initiative" or by calling 972-717-4279, or send an e-mail request to eleonard@dfwhc.org.