Dear Title X Health IT Family,
I’m writing with many mixed emotions to let everyone know that after 6 years of service, today is my last day at the HHS Office of Population Affairs. I have accepted an exciting new position as a Senior Advisor to the Director of the Office of Women’s Health at the Health Resources and Services Administration (HRSA) within HHS. I’m looking forward to helping HRSA OWH grow the office’s mission into its next phase of excellence.
OPA is in the process of identifying new staff to take over my duties on the FPAR 2.0 and Family Planning Profile initiatives. Until a more permanent replacement is identified, my colleague, Emily Jones, has graciously volunteered to monitor the FPAR2.email@example.com inbox and respond to your requests for information. I’m also happy to report that Emily will be participating on the IHE De-identification for Family Planning Committee to resolve the public comments submitted on the DeID guidance. Thank you, Emily!
It has been my true pleasure and honor to work with all of you on this important effort over the years. I’m extremely proud of everything that my fantastic team accomplished in such a short time! In case you haven’t yet heard, OPA has pushed back the implementation of FPAR 2.0 to 2019 at the earliest. So there is still plenty of time to work out all of the kinks with this ambitious transition for the Title X network.
Thank you for the work you do to provide essential family planning services to women and men in need! I wish each of you the best success in your current and future endeavors! Feel free to keep in touch with me via LinkedIn. I do hope that our paths cross again in the very near future.
My very best regards,
We have created a number of resources to assist Title X and other stakeholders in understanding both the content of the De-Identification guidance documents and the process for submitting public comments. The Guide explains everything you need to know.
|1) Guide and Glossary||A guide that contains links to the official De-Identification Supplement and White Paper, prompting questions, submission directions, resources and an accompanying glossary of the technical terms.
Download here: DeID Public Comment Guide and Glossary 2015-12-16
|2) Annotated White Paper||Annotated version of the official White Paper that defines terms and jargon and points out areas where OPA is especially seeking comments
Download here: Annotated_IHE_ITI_WP_Analysis-of-DeID-Algorithms-for-FP
You’ll need to save a copy and view it electronically to see the annotations (highlighted in yellow).
|3) Public Comment Form||1. Download the tailored Excel workbook here: ITI_Public_Comment_Form_De-ID-FP_tailored_1.4.16
2. Enter line-by-line or general comments and email the completed form to firstname.lastname@example.org by February 5th
You can also submit more general comments using the IHE web form at http://ihe.net/ITI_Public_Comments/.
|4) Webinar on De-Identification Public Comment Submission||If you missed the webinar on January 13th, you can download the slides here:|
|5) Family Planning Profile||The Trial Implementation version of the Profile (for reference)|
What To Do Next:
- Download and read the Guide, noting the areas for focus.
- Download and read the Annotated De-Identification for Family Planning White Paper (best to view this electronically, if you print it out you won’t be able to see the annotations).
- Check out the FAQs below.
- Complete and email the Public Comment Form to email@example.com by February 5, 2016
Below are some of the questions we’ve already received about the DeID guidance:
Q1. White Paper – page 8, line 250 – Regarding adding days to your performance measure reporting, I’m a little confused about what you mean by the sentence “Should we be concerned if data are fuzzed at the agency level and then aggregated and “re-fuzzed” at higher levels.” Can you explain this fuzzing and re-fuzzing concept?
Holiday Greetings, Title X Universe!
Apologies for the long spell between posts – I’ve been a bit buried since the departure of my esteemed team members earlier this year (I’m sure many of you can relate).
I am reaching out now to let you know about another important opportunity to influence the future of FPAR 2.0 and the Family Planning Profile. OPA has been working with IHE’s ITI committee over the past year to develop guidance to help OPA best protect the future FPAR 2.0 encounter-level data set. A number of Title X grantees and other family planning stakeholders have been involved in the subcommittee discussions since Spring 2015. Now it’s time for the rest of Title X to have a chance to weigh in!
Public comments are due February 5, 2016.
What To Do Next:
- Click on Resources above.
- Download and read the Guide, noting the areas for focus.
- Download and read the Annotated De-Identification for Family Planning White Paper (best to view this electronically, if you print it out you won’t be able to see the annotations)..
- Attend the webinar on January 13, 2016 (click on Resources above for the information).
- Complete and email the Public Comment Form to firstname.lastname@example.org by February 5, 2016
- Forward this blog post to your vendors and ask them to participate in the public comment period.
If you have limited time…
Don’t worry! In the Guide, we point you to the most important areas for your review and consideration.
Christina Lachance along with consultants, Gila Pyke and Laura Bright, are happy to answer any questions regarding the De-Identification documents. Please email questions to FPAR2.email@example.com and we will respond ASAP or set up a time to speak by teleconference.
You can also participate in the webinar on January 13th (see Resources above) and ask us questions then.
For more background, see our previous blog post on this topic.
Thank you in advance for helping us make FPAR 2.0 as secure as possible to protect Title X clients while also serving OPA’s data collection and analysis needs. Remember, at the end of the day, we want to make this data available for YOU to use for performance measurement and quality improvement efforts.
Wishing everyone a great holiday! See you next year.
I am writing to let you know that as of September 20th I will be moving on from my temporary post at OPA to a permanent position within HHS at HRSA in the HIV/AIDS Bureau. I am very excited to join the team at the Ryan White Part F Special Projects of National Significance (SPNS), especially to help advance their workforce capacity building project and a health & housing IT project. I have already noticed some overlap of sites with Title X and SPNS! Past SPNS projects have resulted in some excellent resources to implement proven interventions for special populations.
It has been very exciting to work with all of you on the FPAR 2.0 project. In a very short period of time our small but energetic team has made tremendous progress to advance the needs of Family Planning providers in Health IT. We bridged communication gaps between vendors and Title X sites, raised the visibility of Title X, and brought to light a more concrete vision for FPAR 2.0. I hope I have served you well and thank you for sharing your experiences with me.
My departure does leave Christina as a one-woman team, at least for the time being, so please be understanding as she continues the FPAR 2.0 work! Our project is now much more interconnected with other federal, industry, and standards resources so she is not completely alone. However, it will take some time for her to respond to inquiries, especially the more technical ones. Please do your best to spread the word about this effort to your colleagues and to participate in the upcoming public review of the IHE de-identification guidance for FPAR 2.0.
I wish all of you in the Title X community the best of luck as you work so hard every day to deliver much-needed services to clients. I also want to thank our vendor community often highlighted on this blog for being excellent partners as we figure out this journey together.
Please feel free to reach out to me at my HRSA address once that is established. You can also stay in touch through LinkedIn. Hope to work with you again soon!
Using Maps to Give Your Clinic a Competitive Edge
More and more Title X administrators and service sites are talking about how to buy software that supports their clinical and administrative needs beyond billing and diagnostic coding. Figuring out your needs and embarking on any information technology project can be daunting. To help health professionals navigate this process, the Office of the National Coordinator for Health IT (ONC) has long provided a general guide for health providers when they want to buy EHR systems or change to a new system.
This post is about one feature in some EHR systems that can help you better understand your patient population and service area – maps! Creating maps with health data has gone from the realm of being used only by highly trained analysts with specialized software to being much more accessible to everyone. For example, HRSA’s UDS Mapper is commonly used by health centers to discover unmet need in their service area and to use this information in funding applications.[i] The CDC has long supported the Community Health Status Indicators which compares all US counties on a range of health-related measures and has some mapping features.
Closer to home, the Family Planning National Training Centers unveiled their Title X mapping tool at the recent Title X grantee meeting. This online mapping tool shows the location of Title X clinics as points and then counties are color-coded according to the estimate of women in need of Title X services. Use this tool today to help plan future clinic locations and outreach efforts!
Family planning professionals face unique challenges every day. Between providing clinical services, complying with state and federal regulations, and simply keeping a site operational, some days, the EHR system is not a top priority. Maps, however, are a relatively untapped resource within some EHR systems that can help service sites mitigate these obstacles and contribute to a clinic’s overall success.
EHR systems can go beyond just digitizing real-time patient health data. When combined with mapping technology–known as Geographic Information Systems (GIS)–EHR systems can deliver rich insights into otherwise static data. GIS technology works by linking information about an area to the physical location associated with that information, and then displaying the information on a map. For example, while you could simply list all the counties in the US and each county’s teen pregnancy rate in a table it might be more powerful to display this information on a map of US counties where each county has a color code for the teen pregnancy rate. On a map you can also better discern geographic patterns of the data, for instance, one county may have a high teen pregnancy rate and be surrounded by counties with low rates potentially indicating that there may be geographic isolation of the resources best able to address that high rate. Many Healthy People goals can be examined at the county level through the mapping feature of the Health Indicators Warehouse by the National Center for Health Statistics. Other examples of mapping general health risks are available from the University of Washington. GIS displays can help target a family planning center’s limited resources, secure grant funding, deliver personalized care, and help drive real change in the community.
A common application of GIS in population health management is to map where clients live and work. By analyzing how long it takes these patients to drive, bicycle, walk, or use public transportation to get to your service site, you can more accurately schedule appointment times. This example featuring South Carolina demonstrates how operations data can be placed on map to understand staff workload and patient wait times. Maps can also help you understand administrative data, like funding levels that federal programs provide to states, or the availability of non-physician providers in a county.
The most robust GIS platforms allow clinics to obtain and analyze statistics about your clinic catchment area (down to a census block); access thousands of demographic, census, health, crime, and business variables; and quickly identify high need areas to determine where to allocate funding and outreach. A new way of presenting information is called a StoryMap. StoryMaps are great tools for showing stakeholders the impact you’re having. They don’t necessarily have to have a map, but can have images, video, text, etc. The scenario used in this example is looking at where an additional OB/GYN provider may be needed based on the prevalence of low birth weight babies.
Which institutions have successfully implemented a GIS platform within their EHR?
Recognized as a leader in innovation, Children’s National Health System in Washington, DC has championed the use of a GIS platform alongside their EHR technology since 2007. Children’s EHR system operates across inpatient departments, ambulatory clinics, and a regional data exchange that encompasses 240 independent physicians. Chief Information Officer and Chief Medical Information Officer Brian Jacobs, M.D., leads the health system’s GIS and EHR efforts.
Over the last eight years, Children’s information technology team has discovered geographic patterns in patient data and produced actionable information that would not be possible without GIS. Jacobs used GIS to combine EHR data on pediatric burn injuries with patients’ residential addresses. The map revealed that the majority of burn cases originated in just a few neighborhoods. Armed with this intelligence, Children’s partnered with leaders in those specific communities to target burn-prevention outreach. The outcome? The emergency department at Children’s saw a significantly decreased number of thermal burn cases.
So, how do you determine which EHR system pairs well with GIS to set you up for success?
Typically, mapping technology is integrated with EHR systems through a data warehouse or data mart. This enables access to maps and other analytical features related to revenue management or quality improvement. Many EHR systems do not have the ability to integrate GIS with their technology so the most common solutions are linked to EHR data, but do not operate inside the EHR systems.
Get started by downloading our Assessing EHR Systems for Mapping Capabilities brochure which contains questions that you can ask EHR vendors to assess their system’s ability to support geographic or spatial analysis. You may also be interested in this free resource of detailed demographic and lifestyle information about people living in your clinic’s zip code. Non-profit clinics can apply to join the Esri Non-Profit Program to receive the most advanced GIS software for their EHR here. All clinics can join the largest GIS and mapping community with thousands of health records and millions of health datasets, ArcGIS Online, which gives you access to StoryMaps and Open Data sharing tools. ArcGIS Online, as well as the Community Commons and Health Landscape sites allow clinics make maps on the fly and start experimenting with creating maps for their clinic. In the end, all clinics have geographic data. Using our brochure to understand the questions to ask the EHR vendors will help to guarantee the ability to leverage this data. Mapping even a small percentage of a clinic’s data for internal or external use can help clinics turn their EHR data into actionable information. Through gaining insight into the spatial patterns that are part of their everyday operations clinics become more effective and better serve their communities.
Finally, here is fall reading list for those who want to explore how spatial analysis can help in public health and health care.
Brown DR, Hernández A, Saint-Jean G, Evans S, Tafari I, Brewster LG, Celestin MJ, Gómez-Estefan C, Regalado F, Akal S, Nierenberg B, Kauschinger ED, Schwartz R, Page JB. A participatory action research pilot study of urban health disparities using rapid assessment response and evaluation. Am J Public Health. 2008 Jan;98(1):28-38. Epub 2007 Nov 29. PubMed PMID: 18048802; PubMed Central PMCID: PMC2156052. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2156052/
Booza JC, Bridge PD, Neale AV, Schenk M. Incorporating Geographic Information Systems (GIS) into program evaluation: lessons from a rural medicine initiative. J Am Board Fam Med. 2010 Jan-Feb;23(1):59-66. doi: 10.3122/jabfm.2010.01.090167. PubMed PMID: 20051543. http://www.jabfm.org/content/23/1/59.short
Angier H, Likumahuwa S, Finnegan S, Vakarcs T, Nelson C, Bazemore A, Carrozza M, DeVoe JE. Using geographic information systems (GIS) to identify communitiesin need of health insurance outreach: An OCHIN practice-based research network(PBRN) report. J Am Board Fam Med. 2014 Nov-Dec;27(6):804-10. doi: 10.3122/jabfm.2014.06.140029. PubMed PMID: 25381078. http://www.jabfm.org/content/27/6/804.short
Barrow RY, Berkel C, Brooks LC, Groseclose SL, Johnson DB, Valentine JA. Traditional sexually transmitted disease prevention and control strategies: tailoring for African American communities. Sex Transm Dis. 2008 Dec;35(12 Suppl):S30-9. doi: 10.1097/OLQ.0b013e31818eb923. Review. PubMed PMID: 18955915; PubMed Central PMCID: PMC2754735. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754735/
Fisher RP, Myers BA. Free and simple GIS as appropriate for health mapping in a low resource setting: a case study in eastern Indonesia. Int J Health Geogr. 2011 Feb 25;10:15. doi: 10.1186/1476-072X-10-15. PubMed PMID: 21352553; PubMed Central PMCID: PMC3051879. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051879/
Beasley M, Coffey K, Haldeman A. A Cost-Benefit Analysis of a New Safety Net Clinic in Petersburg, Virginia. 14 Dec 2009. The Thomas Jefferson Program in Public Policy, The College of William and Mary. https://www.wm.edu/as/publicpolicy/documents/prs/petersburg.pdf
Go forth and map!
[i] Bazemore A, Phillips RL, Miyoshi T. Harnessing Geographic Information Systems (GIS) to enable community-oriented primary care. J Am Board Fam Med. 2010Jan-Feb;23(1):22-31. doi: 10.3122/jabfm.2010.01.090097. PubMed PMID: 20051539. http://www.jabfm.org/content/23/1/22.long
Note: This blog post was written as a collaborative effort between the OPA Health IT Team and the Esri Health and Human Services Team.
Hope everyone is having a great summer! We here at OPA are busily preparing for the Title X National Grantee Meeting, which is only a couple of weeks away now.
We wanted to let the grantees who will be attending this year’s meeting know about 3 important health IT-related items:
#1 Stop…Demo time!
We are really excited to have the opportunity to present a live demo of the future of FPAR 2.0 during Tuesday morning’s plenary session!
We were able to convince the partners who presented with us in the Mother Vignette at HIMSS to get the team back together for a demo specially tailored for the Grantee Meeting.
Our fabulous colleagues Adam Meloan (Netsmart) and Jon Reid (Utah Department of Health) will be sending data to the mock FPAR 2.0 platform (built by our contractor, AEGIS) front and center at the meeting. During the demo, we will show you a real-world example of how the IHE Family Planning Profile can be operationalized within an EHR system and a public health system to facilitate FPAR 2.0 reporting and to give you back clinically-relevant performance measures.
Here’s a teaser of what you will see during the demo…don’t worry, we’ll walk you through every step!
#2 And the survey said…
Also during the plenary session, we will describe the results of the FPAR 2.0 Data Element Survey that we administered earlier this Spring. We know that everyone has been eagerly awaiting these results. Thank you again to those who participated!
We will post some of the key findings here on the blog after the meeting, so that folks who aren’t able to attend can stay in the loop and see what your peers said about their FPAR 2.0 readiness.
(Thank you in advance for your patience – keeping up with the blog has been more challenging now that we are a smaller team!)
#3 FREE Consulting! FREE Consulting!
Last, but certainly not least, we are super pumped that the amazing Gila Pyke – an expert we’ve been working with to create a robust privacy and security plan for the future FPAR 2.0 system – will also be presenting during the Grantee Meeting.
During Gila’s break out session “Keeping it Confidential – Insight on Privacy and Security Practices for Patient Data” on Tuesday from 2-3:30pm, you will learn how to assess your current privacy and security practices along with how to champion this same assessment for your subrecipients. Don’t miss it!
—————– BONUS: One-on-One Consulting! —————–
As a special treat, Gila will also be holding office hours on Tuesday and Wednesday for any grantees who are interested in learning more about overcoming your unique privacy and security challenges and supporting HIPAA compliance. So if you’re in the mood for some FREE EXPERT ADVICE, please sign up at the meeting registration desk to reserve a time to speak with her one-on-one.
Additionally, the Family Planning National Training Centers will be hosting 3 of the health IT experts from the HIT Community of Practice in the HIT Learning Lab. These experts will also be available for grantees to consult with one-on-one on a variety of health IT topics. Sign up at the registration desk to take advantage of these fabulous resources!
That’s it for now. We look forward to giving everyone an update on all things FPAR 2.0 at the meeting. See you in DC!
It is very bittersweet to announce that I will be moving on from my position as an ORISE Fellow here within the Office of Population Affairs. I have absolutely loved my time here working in reproductive health and health IT, but I have decided to take a leap of faith and embark on a new career path that I’ve been interested in for a number years now. I will be joining the staff of a D.C. charter school as a Pre-K Teacher. I will be spending my time with 3-year olds all day, every day, and y’all may think I’m nuts, but I could NOT be more excited!
I have learned such an unbelievable amount over the past year and a half, from my INCREDIBLE team, from the rest of the OPA staff, and from all of you. I so strongly believe in the importance of sexual education, reproductive freedom, and access to reproductive health services for EVERYONE, and literally every single day I am amazed by and grateful to those of you who have so selflessly devoted yourself to the cause. I hope to one day make an impact on the field again as a sex-ed teacher, and this is my first step in achieving that goal. It has been fascinating to be immersed in the health IT world, and I’m so grateful to have learned so much about it. In between cleaning up juice-box spills and wiping runny noses, I will absolutely be keeping up with the twists and turns that I’m sure are to come!
Beginning in July, please forgive the rest of the Health IT Team if they are a bit slower than normal to respond, particularly to emails sent to the FPAR 2.0 inbox. They will still get back to you, but it may take just a bit longer than it has in the past. Thanks in advance for your understanding!
Thank you for all of your help, guidance, and hard work. This was an amazing experience, and I am grateful to all of you for helping make it so. I wish you all the best of luck in everything you do!
Please be aware that the response options for the proposed Pregnancy Intention data element in the FPAR 2.0 Data Inventory Checklist have been updated.
One of our stakeholders found a mistake in the version we had posted and circulated with the FPAR 2.0 Data Element Survey. It is our intention to follow the guidelines as outlined by One Key Question, so we have altered the response option categories accordingly.
You can find a copy of the updated FPAR 2.0 Data Inventory Checklist DRAFT here. Please keep in mind that it is STILL A DRAFT.
Apologies for the oversight! Please email us at FPAR2.firstname.lastname@example.org if you have questions about this change.
Attention family planning administrators and clinicians!
Do you have questions about using your EHR? Do you want to learn about how your colleagues are using health information technology in their practices? Then we have good news! OPA’s Family Planning National Training Centers have launched a new Health Information Technology Community of Practice (HIT CoP for short)!
The HIT CoP is a closed community designed to give folks who are working in or running clinics a space to ask questions, give advice, and learn more about EHRs and health information technology in general. Sure, you can always ask us for tips, and you can (and should!) call your vendor. But nothing is more valuable than learning from your peers, who are experiencing similar challenges and working in similar environments. For a preview of the kind of topics are covered in the CoP, check out the screenshot below of some of the current discussion threads…
The HIT CoP is a resource that will ultimately be guided by YOU: the network, the people in the field who are working with EHRs every day. The more active participants the CoP has, the more robust a resource it will become, and the more you will benefit from it…so everyone make sure to sign up today!
First of all, a big THANK YOU to everyone who completed the FPAR 2.0 Data Element Survey! We are pleased to report that JSI received a total of 1,711 completed surveys! This translates to a 39% response rate with, approximately, half of the Title X grantees completing a survey and a quarter of the subrecipients and service sites completing one (out of the folks who used the traceable survey links). The state with highest rate of completion was UTAH, with 93% of their subs and sites participating! TENNESSEE came in second at 74%. A huge round of applause to these two outstanding states for their enthusiastic participation!
The data we received from everyone who completed a survey will be absolutely invaluable in helping us determine the course of action in the building of FPAR 2.0. We are still working on cleaning and analyzing the full survey results, and we will share a more complete analysis with you just as soon as we can.
Now that survey has closed, we wanted to give everyone a chance to save a copy of the draft of the FPAR 2.0 Data Inventory. Please keep in mind that this inventory is NOT FINAL. It is entirely possible that we will make changes to it in the coming months/years. However, it is a solid blueprint that should give you a better idea of what to expect when we roll out FPAR 2.0.
Feel free to show it to EHR vendors and other health IT stakeholders as you move forward with any purchasing decisions, upgrades, or other changes you might be making to your health IT-related workflows. If you have any questions about the document, please don’t hesitate to reach out to us directly (FPAR2.email@example.com), or to pose questions to your colleagues in the Health IT Community of Practice recently introduced by the National Training Centers!
Check out the Data Inventory below!