Improving Data for Decision Making:
HHS Data Collection Strategies for a Transformed Health System
IMPLEMENTATION UPDATE AND ACCOMPLISHMENTS
December 2011
This report is available on the Internet at:
http://aspe.hhs.gov/datacncl/DataStrategy/imp-accomp11.shtml
The data collection systems sponsored by HHS are critical to the HHS mission,
and they also provide most of the national statistical capacity to monitor
the health of the population and the functioning of the health care, public
health and human services systems. Many HHS data systems represent the state
of the art in their class, but new challenges are placing increasing demands
on these resources. New data needs are arising, significant gaps exist,
pressures for improved timeliness are mounting, and costs are increasing.
At the same time, new administrative data systems needed to support health
reform, and the widespread adoption of EHR systems and electronic information
exchange can provide a wealth of new data sources. In sum, there is
a need to improve survey efficiencies, to address gaps in data for vulnerable
populations and to improve the timeliness of data collection and
dissemination. All of these improvements must be accomplished in a
manner that protects confidentiality.
The HHS Data Council has completed an assessment of the HHS survey and data
collection portfolio and developed a number of strategies and action
steps. The actions are designed to strengthen the capacity of HHS data
collection resources; promote synergy and reduce duplication; assure
efficiencies, quality, utility and timeliness; enhance HHS capacity for quick
response data, improve State and local data and data on vulnerable populations,
and address departmental data priorities. The Council’s report
also outlines a framework for coordination and integration in current data
systems as well as opportunities for future integration and alignment of
data from surveys, administrative data systems and EHR systems. As
indicated below, many of the strategies and actions are already underway
and others are planned in the months ahead. The Council also emphasizes
that the success of all the strategies and improvements will depend upon
HHS’ ability to maintain the core surveys and administrative data systems
that comprise the foundation of our data capacity.
In its review, the Council identified a number of critical data priorities
of department wide interest that agencies are endeavoring to address, including
data on:
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The impact of the Affordable Care Act (ACA) and other forces affecting health
system change on health status outcomes, insurance coverage rates, access
and quality indicators, health care expenditures and population health measures.
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The impact of ACA on the behavior of States, health plans, employers, providers,
and consumers.
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Health status and health care disparities of vulnerable populations, such
as racial and ethnic populations, persons with disabilities, rural populations
and LGBT populations.
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State and community level policy and public health data.
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Changes in the adequacy of health care institutions and workforce to meet
needs.
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Social determinants of health and the changing nature of population health
beyond the health care delivery system.
In order to meet high priority data needs, the Council identified several
goals that would assist the agency in this effort.
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Goal 1: Improve the speed and efficiency of data collection and release.
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Goal 2: Improve access to HHS data.
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Goal 3: Assure the privacy and confidentiality of HHS data.
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Goal 4: Enhance methodology to address policy and population data needs.
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Goal 5: Ensure that survey integration efforts are preserved and expanded.
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Goal 6: Maximize data linkages between HHS data systems to increase
analytic capacity and survey efficiency.
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Goal 7: Promote opportunities for integration, standards, and alignment
of surveys, administrative data systems and EHRs to meet data needs in a
coordinated manner.
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HHS is taking a number of steps to improve the speed of data collection
by maximizing the appropriate use of web surveys, quick turnaround phone
surveys, and automating data collection for provider surveys. Examples
include:
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ASPE has initiated a new project with NCHS to test the feasibility of developing
a web panel for the National Health Interview Survey. NHANES is also
exploring the feasibility and utility of a web capability.
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AHRQ and ASPE are testing a quick response telephone survey for faster data
collection on special topics using a limited sample in MEPS. AHRQ is
conducting a special survey on a small MEPS sample to explore the potential
for a web component.
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NCHS has re-designed and integrated its family of hospital, emergency department
and outpatient departments into a new National Hospital Care Survey, and
is developing plans for a family of long term care surveys and a core survey
of long-term care facilities.
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SAMHSA’s emergency room survey is being combined and integrated into
the larger family of NCHS provider/facility surveys with interagency
collaboration, increasing sample size and response rates, and providing
additional data and linkage capability.
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SAMHSA is merging its two national facility surveys, combining sample frames
and instruments to streamline data collection, reduce burden, and expand
online options.
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ASPE and NCHS are pilot testing the feasibility of extracting clinical data
from EHRs for the surveys of health care facilities and providers.
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ASPE has initiated a project with CDC to assess the feasibility of acquiring
standardized structured EHR data for public health surveillance reporting
programs.
HHS agencies are developing and expanding a number of early data release
programs, including NCHS, AHRQ, SAMHSA and CMS initiatives, and working with
the Chief Technology Officer.
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Current initiatives include preliminary and advance data release projects
such as the NCHS NHIS quarterly early release program and the early release
from the MEPS Insurance Component. Other agencies are exploring early
release options.
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CMS is creating claims-level public use files (PUFs) that can be made available
to users free of charge on the CMS website. CMS is also testing new
techniques of data acquisition from States that could reduce administrative
costs and level of effort for both federal and State governments, and improve
timeliness and reliability of Medicaid data.
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CMS is currently pursuing methods to collect encounter data collected for
Medicare beneficiaries in managed care plans.
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NCHS has re-engineered internal processing for birth and death records and
is developing a quarterly report for a select group of health indicators
to be published within six months of the birth/death event.
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SAMHSA is working on a remote data analysis system for analysts to access
variables not available on public use files (State codes) without accessing
the restricted-use file.
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All HHS agencies will continue to expand their efforts to provide access
to their extensive data resources through outlets such as Data.Gov,
HealthData.Gov, and the Health Indicators Warehouse.
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HHS has developed data collection standards for race, ethnicity, primary
language and other demographic data as outlined in Section 4302 of the Affordable
Care Act. The Secretary adopted final data standards on October 28,
2011 and implementation is underway.
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HHS agencies are developing and assessing the potential of model based estimates
to provide data for small areas and special populations. Specifically,
NCHS is developing and assessing the potential of small area estimation
procedures for the NHIS and other NCHS surveys. HHS is working with
external groups to improve State and local data.
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LGBT population: NCHS is currently field testing new questions and
survey procedures to add measures of sexual orientation on the adult NHIS.
HHS is convening listening sessions with the external community on transgender
health data needs.
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HHS will promote opportunities for integration, standards and alignment of
surveys, administrative data systems and EHRs to meet emerging data needs
in a coordinated manner.
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The Data Council has established a Work Group to coordinate plans and activities
for adding new questions to HHS and Census surveys to monitor the impact
of health reform.
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The Data Council has established a workgroup to review the new administrative
data systems associated with ACA implementation to determine where greater
alignment in terms of data standards can enhance the potential for ACA
monitoring, policy analysis, and evaluation, and will describe how survey
data can complement administrative data.
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The Data Council will assess the utility of commercial data sources and
nontraditional data sources to answer policy questions and increase HHS analytic
capability.
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The Data Council will coordinate a review of agency Research Data Centers
with a view toward improvements in access to data while ensuring strict
confidentiality protections.
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The HHS Data Council will examine all current data linkage capacities and
linked data sets. Plans for new linked data sets will be highlighted.
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HHS has begun a multi-agency effort to assess the current state of monitoring
the workforce with existing data and the potential of new standardized data
from States, professional groups, and other federal agencies to augment present
efforts.
Where to?
Top of Page | Contents
HHS Data Strategy
Home Pages:
HHS Data Council
Assistant Secretary for Planning and Evaluation
(ASPE)
U.S. Department of Health and Human Services
(HHS)
Last updated: 12/20/11
