1. No category

INTRODUCTION TO THE
UNIFORM DATA SYSTEM
Calendar Year 2012
Bureau of Primary
Health Care
Agenda
•
•
•
•
•
•
•
Introducing the UDS
Importance of the UDS
Critical dates in the UDS process
Available Assistance
Overview of UDS Tables and Definitions
Cross Table Consistency in Reporting
Strategies for Successful Reporting
2
What is the Uniform Data
System (UDS)?
• Standardized set of data reported by
federally funded programs:
– Section 330 Grantees – Community Health
Center (CHC), Health Care for the Homeless
(HCH), Migrant Health Care (MHC) and Public
Housing Primary Care Program (PHPC)
– FQHC Look-Alike (LAL) agencies
– Urban Indian Health programs
• “Scope of Project” for the period January
1, 2012 - December 31, 2012
3
12 Tables: Snapshot of
Performance
• Patients you serve
• Types and quantities of services you
provide
• Staffing mix and tenure
• Quality of the care you deliver
• Costs to provide services to patients
• Revenue sources
4
Why is the UDS Important?
• UDS data are used by the BPHC to:
– Ensure compliance with legislative and
regulatory requirements
– Report program achievements
– Monitor performance and identify TA needs
• UDS data are used by programs to monitor
and improve performance
5
Critical Dates in the UDS
Process
• DATA ENTRY: Report through EHB (“Electronic
Handbook”) beginning January 1, 2013
https://grants.hrsa.gov/webexternal/login.asp
• EHB training available through HELP in application and
online training module
• EHB incorporates 100s of edits to alert you to possible
problems that require follow-up.
• REPORT DUE DATE: February 15, 2013
• REPORT FINALIZATION: March 31, 2013
• REPORT FEEDBACK: Trend and Comparison
reports available August
6
Review Process
• 1:1 Technical Assistance: Report is
assigned to a reviewer who works with you
to correct your data from February 15March 31.
• Reviews tables to identify inconsistencies
and possible errors
• Prepares a summary of issues
• Works with you by phone and email to
correct your data
7
Available Assistance
• Regional trainings
• Webinars–LAL, clinical, sampling, changes
• On-line training modules, manual, & fact
sheets available at http://www.bphcdata.net
– Data and reports at
http://bphc.hrsa.gov/healthcenterdatastatistics/r
eporting/index.html
• Telephone and email helpline: 866-UDS-HELP
or [email protected]
• Technical support to review submission
– EHB Support (see handout)
• HRSA Call Center: 877-464-4772
• BPHC Help Desk: 301-443-7356
8
Twelve UDS Reporting Tables
9
Who Reports Which Tables
More than 1 BPHC
Funded program –
Universal + Special Pop.
Grant Reports
Table
1 BPHC Funded
Program –
Universal Report
Look-A-Like Designee
–
Universal Report
ZIP Codes
Yes
3A, 3B, 4
Yes
Yes
No Managed Care or
HCH detail
5
Yes
Visits & Patients, only
Yes
5A
Yes
6A
Yes
6B
Yes
Yes
7
Yes
No Race/Ethnicity
detail
8A
Yes
Yes
9D
Yes
No Managed Care or
retros
9E
Yes
No 330 grants
Yes
Yes
Yes
10
Detailed Tables
• Patient Profile Tables (ZIP Code, T3A, T3B,
and 4)
• Utilization and Staffing (T5 and T5A)
• Clinical Tables (T6A, T6B, and T7)
• Financial Tables (T8A, T9D, and T9E)
11
4 Patient Profile Tables
• Patients by Zip Code
• Table 3A: Patients by Age
and Gender
– Tables 3A, 3B, and 4: Grant
report completed for each
additional funding stream
12
4 Patient Profile Tables—
continued
• Table 3B: Patients by
Race and Ethnicity
• Table 4: Patients by
Income, Insurance, and
Special Populations
13
Data Uses and Accuracy
Checks of Patient Profile
• Uses of Patient Profile Data:
– Describes the patients you serve compared to
target vulnerable populations
– Maps your service area in UDS Mapper
– Calculates indicators such as cost per patient,
visits per patient, etc.
• Data Checks:
– ZIP codes, Table 3A, 3B, and 4 describe the
SAME patients; totals must be equal
– Grant tables are subsets of the universe
14
2 Staffing and Utilization
Profile Tables
• Table 5: Types and
quantities of services
provided and staff who
provide these services
– Columns b and c
completed for each
additional funding
stream (include all
activity for patients
reported on grant Tables
3A,3B, and 4)
– Report FTEs, visits, and
patients
15
2 Staffing and Utilization
Profile Tables—continued
• Table 5A: Tenure of
Health Center Staff
– From personnel records
– Head count of persons
– Months of service for
selected staff categories
and positions
16
Data Uses and Accuracy
Checks of Staffing and
Utilization Profile
• Uses of Staffing and Utilization Data:
– Calculate indicators such as cost per visit,
continuity of care, staffing levels, etc.
– Continuity of staffing
• Data Checks:
– Total patients on Tables 3A, 3B, and 4 cannot
exceed patients on Table 5, nor can Table 5
patients be less than the total on those tables
– Staffing relates to costs on Table 8A
– Visits relate to revenues reported on Table 9D
– Grant tables are subsets of the universe.
17
3 Clinical Profile Tables and
EHR Info
• Table 6A: Selected
Diagnoses and Services
– Completed for each
additional funding
stream
– Not reported by LALs
18
3 Clinical Profile Tables and
EHR Info
• Table 6B: Quality of
Care Indicators
– “Process measures”: If
patients receive
timely routine and
preventive care, then
we can expect
improved health.











Early entry into prenatal care
Childhood immunizations
Pap tests
Weight assessment & counseling
on nutrition and activities for
children
Adult weight screening & followup
Tobacco use assessment
Tobacco cessation intervention
Asthma drug therapy
Lipid lowering therapy for those
with coronary artery disease
(CAD)
Aspirin or other anti-thrombotic
therapy for those with ischemic
vascular disease (IVD)
Colorectal cancer screening
19
3 Clinical Profile Tables and
EHR Info—continued
• Table 7: Health
Outcomes and
Disparities
 Normal birthweight (≥2500 grams)
 Controlled hypertension (BP<140/90)
 Controlled diabetes (Hba1c ≤ 9)
– “Intermediate outcome
measures”: If this
measurable
intermediate outcome is
improved, then later
negative health
outcomes will be less
likely.
20
3 Clinical Profile Tables and
EHR Info Reporting
• Column a: Universe – All patients who meet the
reporting criteria.
• Column b: Universe or sample of 70 patients
– Must report universe when universe is less than 70
patients and for prenatal care and delivery outcome
measures.
• Column c: Compliance – Report number of charts
whose clinical record indicates that the
measurement rules and criteria have been met.
Universe
Sample or
Universe
Records in
Compliance
21
Electronic Health Record
(EHR) Addendum
• Series of questions on the adoption of
EHRs, certification of systems, and how
widely adopted the system is throughout
the health center’s providers
22
Data Uses and Accuracy
Checks of Clinical Profile
• Uses of Clinical Data:
– Evaluate quality of care provided to patients
– Monitoring for health improvement activities
• Data Checks:
– Patients reported by health condition relates
to patients by age and gender (T3A) and race
and ethnicity (T3B)
– Birth outcomes related to prenatal patients
23
3 Financial Profile Tables
• Table 8A – Financial
Costs
– Column a = Accrued
costs of delivering
services
– Coloumn b = total
facility and nonclinical support costs
(Line 16 col a)
24
3 Financial Profile Tables–
continued
• Table 9D – Patient Related
Revenue
– Cash income received during
the year for charged services
– Revenues reported by payor:
Medicaid, Medicare, Other
Public, Private, Self Pay
25
3 Financial Tables—continued
• Table 9E – Other
Revenues
– Cash income received
during the year from
grants, contracts, and
other non-patient
related sources
– Do not duplicate
revenues reported on
Table 9D
26
Data Uses and Accuracy
Checks of Financial Profile
• Uses of Financial Data:
– Evaluate financial viability (e.g., costs vs.
revenues; fee structure, payor mix)
• Data Checks:
– Revenues by payor are related to insurance
enrollment on Table 4, including managed care
– Charges on 9D relate to visits on T5
– Costs on 8A relate to revenues on 9D and 9E
27
Key Definitions
28
Patient Defined: Who Counts?
• Patient = “Head Count” – total number of
individuals who receive at least one visit
during reporting year
– Patients count once and only once regardless
of the number or scope of visits.
– Not all contacts count as a visit.
– Must have at least one visit that is reported on
Table 5 to count as a patient.
29
Visits Defined: What Counts?
• Visit (column b)
– Not all staff report visits
• Physicians, NP, PAs, CNM,
Nurses, Dentists,
Hygienists, BH, vision,
case managers, and
health educators
• No visits: ancillary,
medical assistants,
transportation, eligibility
assistance, non-health
related services, nonclinical support staff
30
Visit Defined: What Counts?
• Face to face, one to one between patient and
provider
– Exception: behavioral health (group and telemedicine)
– No group health education, diabetes, etc.
• Licensed provider for medical, dental, vision, etc.
– Include volunteer and contracted provider
• The service must be documented in a chart.
• Providers act independently.
• Use professional judgment unique to their training
and education
– Note: Not all contacts are “visits”
31
Visit Defined—continued
• Only 1 visit/patient/provider type/day
– Unless 2 different providers at 2 different sites
• Only 1 visit/provider/patient/day regardless
of the number of services provided
• Count paid referral, nursing home, hospital
visits
• Do not count immunization only, lab only,
dental varnishing, mass screenings, health
fairs, outreach, or pharmacy visits
• Count visits provided by both paid and
volunteer staff
32
Full-time Equivalent (FTE)
Defined
• Who is counted? All personnel who contribute
to the operations of the health center at
approved locations
– Employees, contracted staff, residents, and
volunteers
– Do not count paid referral provider FTEs
• How is FTE calculated?
– 1.0 FTE is equivalent to one person working fulltime for one year; prorate part-time and part-year
• CANNOT USE STAFF LIST AS OF DECEMBER 31
– Report FTE based on work performed; FTEs can be
allocated across multiple categories
33
Tenure for Health Center
Staff Defined
• Reporting FTEs and Tenure –
are NOT the same thing.
– Selected staff employed by
the health center
• Full- and part-time, part-year,
contract, NHSC
• Locums, on-call, residents, and
volunteers
– Combined tenure
• In consecutive months (not FTE)
• As of last work day of year
• By job title
34
Strategies for Successful
Reporting
• Work as a team
– Tables are interrelated
• Adhere to definitions and instructions
– Read manual and apply definitions
• Check your data before submitting
– Relationships exist across tables.
– Address edits in EHB by correcting or providing
explanations that demonstrate your
understanding.
• “Data “says so” does not cut it!”
– Report timely, accurate data.
• Work with your reviewer.
35
Thank you for attending this webinar
and for all of your hard work to provide
comprehensive and accurate data to BPHC!
Ongoing questions can be addressed to
[email protected]
866-UDS-HELP
36