california department of health care services newborn hearing screening program hcc semi annual...

California Department of Health Care ServicesNewborn Hearing Screening Program

HCC Semi Annual Meeting

June 14, 2010

Sacramento, CA&

June 15, 2010Walnut Creek, CA

Bay Area/Northern California

Hearing Coordination Center

Regions A & B


Agenda Introductions Overview of the Newborn Hearing

Screening Program (NHSP) Goals of the NHSP/EDHI Tracking and Monitoring Challenges Who is Neometrics? Overview of the Data Management

Service Next Steps


DHCS Joleen Heider-Freeman, RD, Chief, Statewide Programs

Section Hallie Morrow, M.D., M.P.H., NHSP Medical Consultant Katherine Neto, Chief, Hearing & Audiology Services Unit Jennifer Sherwood, M.A., Audiology Consultant, NHSP Ursula Pareja, Contract Manager (Regions A/B) Deborah Hunt, Ph.D., CSUS

HCC Beth Lannon, Director, BA/NC HCC

Neometrics Bill Mince, Vice President Operations Joe Amato, General Manager Gena Curtis, Client Service Manager

Introductions




Service Next Steps


Established in 1998 by California Law as the Newborn and Infant Hearing Screening, Tracking and Intervention Act.

Requirements of the 1998 law: Every CCS-Approved general acute care hospital with

licensed perinatal services shall offer a hearing screening test using protocols approved by the State.

Expansion in 2008: The law was further amended to include: every

general acute care hospital with licensed perinatal services shall administer to every newborn, upon birth admission, a hearing screening test.

Overview of NHSP


Implemented in 2000 NHSP follows the national EHDI

guidelines Requires all hospitals with licensed

perinatal services and/or NICU to report to DHCS or designee

Overview of NHSP (continued)


Hearing Coordination Centers Unique to California Assures families are linked with services,

minimizing the number of babies lost to follow-up Regional support to all hospitals by:

• Providing technical assistance and consultation to hospitals in setting up and maintaining programs

• Certifying inpatient screening providers

• Collecting data


Hearing Coordination Centers (continued) Tracking Infants

• Screening/rescreening

• Diagnostic services

• Notification of PCP

• Early Start referrals Quality assurance activities

• Monitor hospital screening and referral rates

• Provide feedback to hospitals

• Identify training opportunities Education and community outreach






Service Next Steps

Why We Are Here

Why is Data Management Service (DMS) critical to the NHSP? Manual tracking system Expansion of the program HCCs databases Consolidation of requirements

Hospital insight Limited resources Mandatory fields Risk factors


1 – 3 – 6 Goals 1 month of age: hearing screening to all

newborns 3 months of age: diagnostic audiologic

evaluation to all newborns who do not pass the screening

6 months of age: entry into early intervention services, for newborns with hearing loss

Informational materials to families Results to primary care providers

Goals of the Program


DHCS to CDC Mandatory reporting required to the CDC

(Federal Centers for Disease Control and Prevention)

HCCs to DHCS Mandatory reporting to DHCS quarterly on all

activities including data reported by hospitals, as well as ad-hoc reports

Hospitals to HCCs Patient-specific demographic data Results of screens

Reporting Requirements


Hearing loss occurs more frequently than any other congenital condition

Negative consequences of late identification of hearing loss

Early identification and intervention by 6 months of age has shown to result in age-appropriate language development

Why We Screen




Service Next Steps


Difficulties when: Manually tracking and reviewing of records Tracking babies transferring to another

hospital Identifying babies not screened as inpatient Hospital monitoring screen and refer rates Reporting process

Current Reporting Challenges


Current system: In manual form, you are

unable to• Search• Report• Collate• Review

DMS Benefits: Hospitals get real-time

data on screen status Ad-hoc reports can be

generated by hospital users

Hospital users can generate work lists as needed

Hospital can monitor screener performance

Challenge: Manual Review of Data


Current system: Receiving hospital not

always aware of screen status

Receiving hospital not always aware if baby is in non NICU unit

Required to send in status reports for all transferred babies

DMS Benefits: Transfers are recorded as

they occur Hospitals are no longer

required to generate transfer reports

Real-time status is available for State, HCC and hospital users

Audit trail details the history of movement

Automatic action creation helps curb lost to follow-up

Challenge: Managing Transfers


Current system: Hospital birth log is the

only mechanism that can be used to determine whether or not a baby has been missed

Easy to miss babies• No central collection

point for data

DMS Benefits: Reports can be

generated to reconcile birth log to the DMS data

Immediate ID of infants not screened

Challenge: Identifying Missed Babies


Current system: It is not possible to easily

determine screen and refer rates for a hospital.

DMS Benefits: Central data collection

point captures screen and refer rates.

Data can be used for QA for hospital staff to improve screening process

Data can be used for staff education

Challenge: Monitoring of Hospital Screen & Refer Rates


Current system: Hospitals are required to

report information via paper and FAX:• IRF• Weekly reports• Monthly report• Transfer Status Reports

DMS Benefits: Hospitals are no longer

required to report information via paper and FAX:• IRF forms • Weekly reports • Monthly report • Transfer Status Reports

Challenge:Reporting Process




Service Next Steps


Who is Neometrics? Leading provider of data management

software for Newborn Screening market In business since 1978 Acquired by Natus Medical in 2003 Staff has over 100 years experience in

the Newborn Screening market Working with NLM, HRSA and

government agencies to maintain compliance with state and federal initiatives


Neometrics ProductsState MSDS CMS iCMS EDT SRV FIM dCMS VRS Hearing

Alabama X X 2011 2011 2011 X X

Arizona X X X X

California X X

Delaware X X X X X X X

Louisiana X X X

Missouri X X

New Jersey X X X

New York X X X X X X

Oklahoma X X 2011 2011 X X X X

Oregon X X 2011 X

Tennessee X X X X X

Texas X X

Washington X X X X

West Virginia X




Service Next Steps

Overview will cover the following topics: Critical Information on Data Requirements

for Hospitals Help for Hospitals to select Data

Transmission Modes Brief review of DMS Functionality


Overview of the Data Management Service

Infant last name Infant DOB Infant gender Infant birth order Screener name Screen type (right/left) Screen result (right/left)


Required Fields for All Infants


Hospitals will no longer be required to print the Infant Report Form (IRF)

Hospitals will no longer be required to submit the weekly transmittal form to the HCC

Hospitals will be phased-out of the option for faxing information to the HCCs as the system is implemented

The number of reports hospitals are now required to submit will be significantly lower

Reporting Requirements: What YOU Want to Know


Outpatient screening providers will continue to report screening results using the ORF

Diagnostic providers will continue to report diagnostic evaluation results using the DRF

OP and DX providers will continue to receive hard copies of IP screen results from the hospital

Reports will be faxed to the HCC at least weekly At this time, OP and DX providers will not have

access to the DMS

Outpatient and Diagnostic Providers


No new NHSP standards will be issued Policies and procedures will need to be

updated to reflect the new reporting procedures

HCCs will assist with this process

Standards, Policies and Procedures


for Hospitals Help for Hospitals to Select Data



Overview of theData Management Service


Computer Hardware and Software

The hospital is required to provide a PC with access to the DMS website

The hospital is responsible for configuring the interface for data transmission

Technical assistance will be provided

Equipment Requirements


Hospital Staff have access to a PC with Internet access to DMS website?

Screening Device Export capable? What Data Fields are captured?

Hospital HIS Able to send data after admission of newborn? Able to load result data from device? Able to send data after device upload?

Data Transmission Selection

Screening Device Export

• Cart Based Screening Devices

• ALGO 5, ABaer, and IHS screeners are capable of exporting to a local network location

• Contact the tech support group for your device manufacturer for more details

DeviceDevice Export

ModeIntermediary

SoftwareOutput

ALGO 5 Network / media n/a Hi-Track, XML

IHS Network / media n/a Hi-Track

ABaer/HSS Network / media n/a Hi-Track

A2e Media ADAM Hi-Track

A2e color Media ADAM Hi-Track

ALGO 3 Media ADAM Hi-Track


Screening Device Export

• Handheld Screening Devices

• Echoscreen and A3i devices require intermediary software to move data off of the devices.

• Contact the tech support group for your device manufacturer for more details

DeviceDevice Export

ModeIntermediary

SoftwareOutput

EchoScreen Manual Echolink Hi-Track

A3i Manual DUS Hi-Track


Data Transmission SelectionCan your screening device? Is the hospital HIS capable of:

Is there a PC with internet

access in your nursery?

Export data?

Capture required

demographic fields?

Sending admission

data? (ADT)

Loading screening

results from the device

Transmitting screening

data (ORU)

Your Transmission

mode

Yes No No No No No Manual

Yes Yes No No No NoSemi-Automatic

(Upload)

Yes Yes Yes No No NoSemi-Automatic (single, batch)

Yes No No Yes No NoSemi-Automatic

(EDT)

Yes Yes Yes Yes No NoFully Automatic

(batch)

Yes Yes Yes Yes Yes YesFully Automatic

(batch,HL7)


Transmission Mode: Manual

DHCS

Hospital

HearingScreener

INTERNET

Data Entry

DMS

HIS

FaceSheet

BirthLog

RiskFactors

• Demographic Data– Data entered into the DMS in the

manual demographic entry module• Hearing Result Data

– Data entered into the DMS in the manual hearing screening results module

• Risk Factors– Data entered manually

Can your screening device? Is the hospital HIS capable of:



Export data?

Capture required

demographic fields?

Sending admission

data? (ADT)

Loading screening



data (ORU)

Your Transmission

mode

Yes No No No No No Manual


Transmission Mode: Semi-Auto (upload)

DHCS

Hospital

HearingScreener

INTERNET

Data Entry

DMS

HIS

FaceSheet

BirthLog

RiskFactors

Upload




Export data?

Capture required

demographic fields?

Sending admission

data? (ADT)

Loading screening



data (ORU)

Your Transmission

mode

Yes Yes No No No NoSemi-Automatic

(Upload)

• Demographic Data – Data entered into the DMS in the manual

demographic entry module• Hearing Result Data

– Uploaded from the device into the DMS• Risk Factors

– Data entered manually


Transmission Mode: Semi-Auto (single)

DHCS

Hospital

HearingScreener

INTERNET

Data Entry

DMS

HIS

FaceSheet

BirthLog

RiskFactors

Upload




Export data?

Capture required

demographic fields?

Sending admission

data? (ADT)

Loading screening



data (ORU)

Your Transmission

mode


• Demographic Data– Entered into the DMS in the manual


– Uploaded from the device into the DMS


OR



Transmission Mode: Semi-Auto (batch)

DHCS

Hospital

HearingScreener

INTERNET

Data Entry

DMS

HIS

FaceSheet

BirthLog

RiskFactors

Upload




Export data?

Capture required

demographic fields?

Sending admission

data? (ADT)

Loading screening



data (ORU)

Your Transmission

mode


• Demographic Data– Entered into the DMS in the manual




ORFaceSheetFace

SheetFaceSheet


Transmission Mode: Semi-Auto (EDT)

DHCS

Hospital

HearingScreener

INTERNET

Data Entry

DMS

HIS

FaceSheet

BirthLog

RiskFactors

HL7 (ADT)




Export data?

Capture required

demographic fields?

Sending admission

data? (ADT)

Loading screening



data (ORU)

Your Transmission

mode

Yes No No Yes No NoSemi-Automatic

(EDT)

• Demographic Data– Transmitted to the DMS via HL7 ADT

message• Hearing Result Data

– Entered into the DMS Hearing Screening Result module



Transmission Mode: Fully Auto (batch)

DHCS

Hospital

HearingScreener

INTERNET

Data Entry

DMS

HIS

FaceSheet

BirthLog

RiskFactors

Upload

HL7/ADT




Export data?

Capture required

demographic fields?

Sending admission

data? (ADT)

Loading screening



data (ORU)

Your Transmission

mode

Yes Yes Yes Yes No NoFully Automatic

(batch)

FaceSheetFace

SheetFaceSheetFace

Sheet

OR

• Demographic Data– Transmitted to the DMS

via HL7 ADT message• Hearing Result Data




Transmission Mode: Fully Auto (HL7)

DHCS

Hospital

HearingScreener

INTERNET

Data Entry

DMS

HIS

FaceSheet

BirthLog

RiskFactors

HL7




Export data?

Capture required

demographic fields?

Sending admission

data? (ADT)

Loading screening



data (ORU)

Your Transmission

mode

Yes Yes Yes Yes Yes YesFully Automatic

(batch,HL7)

• Demographic Data– Transmitted to the DMS via HL7

ADT message• Hearing Result Data

– Screening Results are transmitted to the HIS

– Screening Results are transmitted to the DMS via HL7 ORU message



for Hospitals Help for Hospitals to select Data



Overview of the Data Management Service


DMS Overview - Functionality

Main DMS Tasks Data Entry Optimization Search Capabilities Daily Worklist Transfers


DMS Overview - Functionality Data Entry Optimization

Mandatory Fields are clearly defined

Data Controls speed entry and promote data integrity


DMS Overview – Functionality

Search Capabilities Search criteria allows users to

use wildcard searches Multiple criteria entry Multiple results are displayed to

refine selection options


DMS Overview – Functionality Search Capabilities

Data Grids support Pivot technology


DMS Overview – Functionality Daily Worklist

Staff uses DMS to view daily work list


DMS Overview – Functionality Transfers

DMS allows users to initiate transfers on-line



1-click functionality to accept transfers



Minimal clicks required to accept transfers



Transfer Status screen replaces weekly status report




Service Next Steps


Hospital data transmission mode Communication within hospital Communication with NHSP (CSUS) Communication from Neometrics

Training Schedule Manuals Help line

Next Steps

Implementation HCC Pilot Statewide HCC roll out Pilot hospitals Statewide hospitals roll out

Implementation

Data collected through the County Vital Statistics cannot be used for the NHSP

That data is not available in the timeframe required by the NHSP to meet the goals of 1-3-6

Collection of NHSP data is time sensitive

HIPAA concerns


Other Questions


Thank you!

[email protected]

california department of health care services newborn hearing screening program hcc semi annual...

Documents

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infant hearing screening

hospital screening

overview of nhsp slide

california law

data overview of nhsp

designee overview of

inpatient screening