Design of a Toolkit to Add Electronic Clinical Data to Statewide Hospital Administrative Claims Data

This project designed the Adding Clinical Data Toolkit to help statewide data organizations enhance the clinical content of their administrative data. The work was based on pilot projects sponsored by the Agency for Healthcare Research and Quality in four Healthcare Cost and Utilization Project (HCUP) partner states (Florida, Minnesota, Virginia, and Washington). The addition of clinical data to administrative data—especially present-on-admission (POA) codes and laboratory results—is a practical, cost-effective method to improve the quality of data being used in quality improvement efforts and hospital assessments.

The main objectives of the project were to:

• Catalog tools that help data organizations increase effectiveness and efficiency when adding laboratory values or POA codes to administrative discharge records.
• Solicit input from partner organizations and statewide data organizations on ways an electronic toolkit can enhance the clinical content of statewide electronic hospital discharge abstracts.
• Develop content recommendations for an Adding Clinical Data toolkit.
• Develop a toolkit dissemination strategy.

Materials from the pilot projects, a partner survey, and Webinar discussions formed the basis of the team's recommendations for the toolkit's content and dissemination strategy. Specific recommendations included developing new benchmarking tools to evaluate the quality of POA results, and designing the toolkit with materials developed by the pilot States and other HCUP partners. In addition, the team recommended addressing all facets of data collection and adding the toolkit to the HCUP User Support (HCUP-US) Webpage Enhancing the Clinical Content of Administrative Data. Dissemination recommendations included using the HCUP-US Web site, providing educational Webinars with HCUP partners and others, conducting presentations at professional conferences, and writing a journal article to document the purpose, process, and results of working with data organizations to expand clinical data collection.

The toolkit is expected to help groups enhance the clinical content of their statewide electronic hospital discharge abstracts, add laboratory results, and improve efforts to enhance the quality of POA coding and analysis of results.