Understanding and Using HIVQUAL Data

1. Understanding and Using HIVQUAL Data Johanna Buck Senior Quality Consultant NYSDOH AIDS Institute July 18th, 2008

2. First, a little background • The HIVQUAL software was developed by the National HIVQUAL Project. • The National HIVQUAL Project is sponsored by HRSA/HAB Division of Community Based Services. The NYSDOH AIDS Institute is the recipient of the funding. • The goal of the HIVQUAL Project is to coach RW grantees (Part C and D) in using a QI model developed by the AI to improve the quality of care delivered to persons with HIV.

3. HIVQUAL Software -overview • Designed to facilitate the monitoring of clinical care by capturing key quality elements • Microsoft Access runtime application • Indicators are based on clinical practice guidelines developed by NYSDOH AI • Provides a simple vehicle for the rapid generation of reports that monitor clinical care of the patients entered into the database • Will also analyze data for different subgroups, including age,gender,VL, race/ethnicity..

4. HIVQUAL Software – limitations • It is not a clinical tracking system • Provides a retrospective look at care • Does not interface easily with other software • Cannot be customized by users

5. NYS HIVQUAL • As of 2007, all NYS HIV providers were required to submit performance data via the HIVQUAL software (approx. 160 providers) • Replaced the IPRO on-site external reviews • Validation of data still conducted by IPRO on a subsample • Technical assistance and support provided by the AI • Interfaces with AIRS • Required indicators based on program funding and services

6. NYS HIVQUAL continued • Move to self review across the state moved quality monitoring from “QA” to “QI” • Contributes to a statewide performance database to be used for benchmarking, etc. • Opportunity for all staff delivering care to be aware of clinical guidelines and their program’s performance

7. What can HIVQUAL data be used for (besides sending it to the AI?) • Establishing a baseline • Identifying and addressing variation in performance • Setting priorities • Determining whether changes lead to improvements • Comparing performance with others (benchmarking) • Demonstrating success(improvement) to others (patients, board, leadership, community..)

8. Information Into Action

9. Putting Data into Action “While deciding what to measure and how to measure it are important challenges, an equally important challenge lies in determining the appropriate reaction to the measurement once we have it.” - Paul E. Plsek Using Measure to Support Improvement

10. Barriers To Putting Data Into Action • Don’t even know where to get data/info • Paralysis by analysis • No one is interested in it • Defensiveness • Too complex to understand • Incorrect data collection and/or interpretation of data results Information Action Analyzing Data

11. Stages of Coping with Data (Don Berwick) The data are…… Stage II Right, not a problem Stage I wrong Stage III Right, not my problem Stage IV Right, it's my problem

12. So how about the HIVQUAL data reports? • Types of reports available: • Data Quality and Control Reports • Visit Frequency Reports • HIV Monitoring Reports • ARV Management Reports • Specific Clinical Indicator Reports

13. Data Quality and Control

16. Visit Frequency Reports

19. HIV Monitoring Reports

22. ARV Management Reports

26. Specific Indicator Reports

30. Time for a break and then we will work with our reports.