Unit 2

 To be able to discuss the relationship between

health care data and health care information.
 To be able to identify problems associated with
poor quality health care data.
 To be able to define the characteristics of data
quality.
 To be able to discuss the challenges associated
with measuring and ensuring health care data
quality.
 Data is raw unprocessed facts and figures that
have no context or purposeful meaning and
information is processed data that has meaning
and is presented in a context.
 Information is processed data
 Health care information is processed
health care data

 Health care data are raw health care facts,

generally stored as characters, words,
symbols, measurements, or statistics.

 One thing apparent about health care

data is that they are generally not
very useful for decision making.

 Health care data may describe a

particular event, but alone and
unprocessed they are not particularly
helpful
 Take for example this figure: 79 percent. By itself, what
does it mean? If we process this datum further by
indicating that it represents the average bed
occupancy for a hospital for the month of January, it
takes on more meaning. With the additional facts
attached, is this figure now information?

 Knowledge is a “combination or
rules, relationships, ideas, and
experience” (Johns, 1997)
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser
  Health care data are the source of health
care information, so it stands to reason that a
health care organization cannot have high-
quality health care information without first
establishing that it has high-quality health care
data
 Data quality must be established at the most
granular level.
 Much health care information is gathered
through patient care documentation by clinical
providers and administrative staff

 Poor-quality data collection and reporting can

affect each of the purposes for which we
maintain patient records .At the organizational
level a health care organization may find

 diminished quality in patient care

 poor communication among providers and patients
 problems with documentation
 reduced revenue generation due to problems with
reimbursement, and
 a diminished capacity to effectively evaluate
outcomes or participate in research activities
  What are some of the problems associated
with having poor-quality data?
The Medical Record Institute identified five
major functions that are negatively affected
by poor-quality documentation
 Patient Safety
 Public Safety
 Continuity of Patient Care
 Health Care Economics
 Clinical Research and Outcomes

 The importance of having quality health care

information available to providers and heath care
executives cannot be overstated.
 Health care decision makers rely on high-quality
information.
 The issue is not whether quality information is
important but rather how it can be achieved.
 Health care organizations must establish data
quality standards specific to the intended use of the
data or resulting information
the Medical Records Institute (MRI) has published a set of
“essential principles of healthcare documentation
and the American Health Information Management
Association (AHIMA) has published a data quality
management tool.
 The MRI argues that there are many steps that must be taken to create
systems that ensure quality health care documentation. It has
developed the following key principles that should be adhered to as
these systems (and their accompanying policies) are established:

 Unique patient identification must be assured within and

across healthcare documentation systems
 Health care documentation must be
 Accurate and consistent
 Complete
 Timely
 Interoperable across types of documentation systems.
 Accessible at any time and at any place where patient care is
needed.
 Auditable
 Confidential and secure authentication and
accountability must be provided

Medical Records Institute (MRI) takes the

position that when practitioners interact
with electronic resources they have an
increased ability to meet the these
guidelines. (MRI, 2004)
 American Health Information Management Association (AHIMA)

AHIMA Data Quality Management Model:

Data Characteristics
 Accessibility  Accuracy
 Consistency  Comprehensiveness
 Currency  Definition
 Granularity  Relevancy
 Precision  Timeliness
 Data accuracy: Data are the correct
values and are valid.
 Data Accessibility: Data items should be
easily obtainable and legal to collect.
 Data comprehensiveness: All of the data
required for a particular use must be
present and available to the user.
 Data Consistency: The value of the data
should be reliable and the same across
applications

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

 Data Currency: The extent to which data are

up-to-date; a datum value is up-to-date if it is
current for a specific point in time, and it is
outdated if it was current at a preceding time
but incorrect at a later time
 Data Definition: Clear definitions should be
provided so that current and future data users
will know what the data mean. Each data
element should have clear meaning and
acceptable values
 Data granularity The attributes and values of
data should be defined at the correct level of
detail.
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser
 Data precision : Data values should be just
large enough to support the application or
process.
 Data relevancy: The data are meaningful to
the performance of the process or application
for which they are collected
 Data timeliness: Timeliness is determined by
how the data are being used and their context.

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Systematic
Random
 Systematic errors are errors that can be
attributed to a flaw or discrepancy in adherence
to standard operating procedures or systems.
 If the diagnosis coding errors were the result
of poor handwriting or transcription errors, they
would be considered random errors.
 Systematic errors Random errors
• Unclear data definitions • Illegible handwriting in data
• Unclear data collection guidelines source
• Poor interface design • Typing errors
• Programming errors • Lack of motivation
• Incomplete data source • Frequent personnel turnover
• Unsuitable data format in the • Calculation errors (not built into
source the system)
• Data dictionary is lacking or not
available
• Data dictionary is not adhered to
• Guidelines or protocols are not
adhered to Lack of insufficient
data checks
• No system for correcting detected
data errors
• No control over adherence to
guidelines and data definitions

 Information technology has tremendous

potential as a tool for improving health
care data quality.
 Clearly, electronic medical records (EMRs)
improve legibility and accessibility of
health care data and information
 Structured data input improves data
comprehensiveness, relevance and
consistency

Activities for Improving Data Quality

 Data Error Prevention
 Compose a minimum set of necessary data
items
 Define data and data characteristics in a data
dictionary
 Develop a data collection protocol
 Create user friendly data entry forms or
interface
 Compose data checks
 Create a quality assurance plan
 Train and motivate users

 Data Error Detection

 Perform automatic data checks
 Perform data quality audits
 Review data collection protocols and
procedures
 Check inter- and intraobserver variability
(if appropriate)
 Visually inspect completed forms (online or
otherwise)
 Routinely check completeness of data entry
 Actions for Data Quality Improvement
 Provided data quality reports to users
 Correct inaccurate data and fill in incomplete
data detected
 Control user correction of data errors
 Give feedback of data quality results and
recommendations
 Resolve identified causes of data errors
 Implement identified system changes
 Communicate with users

 After all, the most sophisticated of information

systems cannot overcome the inherent problems
associated with poor-quality source data and
data collection or entry errors.
 The data characteristics and frameworks
presented here can be useful tools in the
establishment of mechanisms for ensuring the
quality of health care data.
 The challenge of health care organizations
today is to implement information technology
solutions that work to improve the quality of
their health care data.
 Data vs. Information
 Problems of Poor Quality Data
 Ensuring Data/Information Quality
 MRI Guidelines
 AHIMA Characteristics
 Types Data Errors
 Causes of Poor Quality Data
 Activities for Improving Data Quality

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