May 1999

Grant Results

National Program

Information for State Health Policy

SUMMARY

From 1992 to 1997, South Carolina's Division of Research and Statistical Services developed a data systems improvement plan to link patient and program systems into a full patient-centered database extending across all health care settings over an extended period of time.

Project staff also worked to create a Data Oversight Council to make recommendations concerning health care data issues in the state.

The project was part of the Robert Wood Johnson Foundation (RWJF) Information for State Health Policy national program.

Key Results

  • South Carolina passed legislation in 1993 that created the Data Oversight Council (DOC), composed of representatives from both the public and private sectors. The council makes periodic recommendations to a legislative health care committee concerning:
    • What data systems should be built in the state.
    • What analyses should be performed.
    • What data and information can be disseminated for public use.
  • The DOC gathered information on data release policies from 26 states and numerous professional organizations and constructed its own data release protocol.
  • Project staff linked multiple data sets together — for instance, hospital discharge data with emergency room data, outpatient surgery data, birth and death records, mental health data, and other data sets. The database is intended to enable analyses across health care settings and over time.

Funding
RWJF supported this project through two grants totaling $1,075,000.

 See Grant Detail & Contact Information
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THE PROBLEM

In South Carolina, data were plentiful, but were not organized in a way that informed decision- makers or consumers. The state's challenge has been to develop a formal on-going method for linking health data with health policy development and program management. To this end, one of the project's objectives was to build a virtual data center to bring together all the important data relevant to decision-making on health care.

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THE PROJECT

Data Release. South Carolina passed legislation in 1993 that created the Data Oversight Council (DOC). The DOC is composed of representatives from both the public and private sectors.

The DOC's purpose was to make periodic recommendations to a legislative health care committee concerning what data systems should be built in the state, what analyses should be performed, and what data and information can be disseminated for public use. The DOC's activities focused increasingly over time on the latter — data release issues.

The DOC gathered information on data release policies from 26 states and numerous professional organizations and constructed its own data release protocol. The protocol was used to review each new data request and to determine if data could be released to the requester. The DOC has a policy that favors release of data but protects confidential data on patients and providers. The DOC will continue to make data release decisions.

Data Linkages. With InfoSHP funding, multiple data sets were linked together. Hospital discharge data were linked with emergency room data, outpatient surgery data, birth and death records, mental health data, and other data sets. The database is intended to enable analyses across health care settings and over time. The data have not yet been used extensively but project staff are working toward marketing it to policymakers and researchers.

Institutionalization

The DOC, data linkages project, and Web page development will continue.

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KEY ACCOMPLISHMENTS

The key accomplishments were the establishment of the DOC, the data release policy, and the data linkage project. In addition, the DOC provided an opportunity to bring together key players to discuss data issues and promote the use of valuable health data.

Communications

South Carolina has been very active in publishing and presenting data from the state. Health care researchers, policymakers, and others can directly access public use databases through the Web site (see the Bibliography).

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LESSONS LEARNED FOR OTHER STATES

  1. In states with low demand for data, the process of building a data infrastructure and promoting the use of data in policymaking is an incremental, long-term effort. Activities should focus on building partnerships between public and private organizations, and data producers and users. Also, placing data projects in a neutral location will facilitate these types of efforts.

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GRANT DETAILS & CONTACT INFORMATION

Project

South Carolina Information for State Health Policy Project

Grantee

State of South Carolina State Budget and Control Board Division of Research and Statistical Services (Columbia,  SC)

  • Amount: $ 150,000
    Dates: March 1992 to August 1993
    ID#:  019747

  • Amount: $ 925,000
    Dates: November 1993 to August 1997
    ID#:  022869

Contact

Project Director: Walter Bailey
(803) 734-4022
pete@vapor.drss.state.sc.us

Web Site

http://www2.umdnj.edu/ishppweb/scarolin.htm

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Publications

"Adult Ambulatory Sensitive Conditions in South Carolina" (Research Project). Columbia, SC: Office of Research and Statistics (SC State Budget and Control Board), 1994.

Nursing Subcommittee, Health Professions Functional Work Group, South Carolina Data Oversight Council and Office of Research and Statistics, South Carolina State Budget and Control Board. "Projections of the Demand for Nurses in South Carolina" (Research Project). Columbia, SC: Office of Research and Statistics (SC State Budget and Control Board), 1995.

Office of Research and Statistics, South Carolina State Budget and Control Board, and South Carolina Hospital Association. "Required Reporting: Specialty Hospitals in South Carolina" (Presentation. Workshop on Required Reporting. Columbia, SC: Office of Research and Statistics SC State Budget and Control Board), 1994.

"Pediatric Ambulatory Sensitive Conditions in South Carolina" (Research Project). Alliance for South Carolina's Children. Columbia, SC: Office of Research and Statistics (SC State Budget and Control Board), 1994.

Primary Care Subcommittee, Health Professions Functional Work Group, South Carolina Data Oversight Council and Office of Research and Statistics, South Carolina State Budget and Control Board. "Projections of the Demand for Physicians in South Carolina" (Research Project). Columbia, SC: Office of Research and Statistics (SC State Budget and Control Board), 1995.

"South Carolina Principles and Protocol for the Release of Health Care Data." Columbia, SC: Data Oversight Council and Office of Research and Statistics (SC State Budget and Control Board), 1994.

South Carolina Professional Review Organization and Office of Research and Statistics, South Carolina State Budget and Control Board. "Length of Hospital Stay and Its Related Factors in Transurethral Resection of the Prostate Patients (TURP) in South Carolina" (Research Project). Columbia, SC: Carolina Medical Review, 1994–1995.

Ambulatory Surgery Task Force. South Carolina Hospital Association and Division of Research and Statistical Services, South Carolina Budget and Control Board. "Outpatient Ambulatory Medical Care Data System" (Pilot Research Project). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board), 1992.

Division of Research and Statistical Services, South Carolina Budget and Control Board. "Clinical Decision — Making In the Era of Accountability" (Presentation). South Carolina TAP (Trustee, Administrators, and Physicians) 12th Annual Conference. Hilton Head: Division of Research and Statistical Services (SC Budget and Control Board). 1992.

Division of Research and Statistical Services. South Carolina Budget and Control Board. "How many Physicians are enough for SC? Complex Question, Expensive Implications." SC Lamppost (Newsletter). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board), 1993.

Division of Research and Statistical Services, South Carolina Budget and Control Board. "What's New and Improved" (Presentation). Hospital Planning Workshop. Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board), 1993.

"State of South Carolina Health Data Directory" (Computerized Health Information System Directory). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board). 1993.

"State of South Carolina Health Data Directory" (Hard Copy Health Information System Directory). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board). 1993.

"Evaluating Changes in the Number of Physician Specialists in Urban and Rural Areas of the State" (Maps). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board). 1992.

"Medical Ethics: End of Life" (Presentation). South Carolina Department of Health and Environmental Control Medical Ethics Task Force. Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board), 1992.

"Medical Heroics: Beginning of Life" (Presentation). South Carolina Department of Health and Environmental Control Medical Ethics Task Force. Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board). 1992.

"South Carolina Health Statistics System Infrastructure Survey" (Research Project). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board). 1992.

South Carolina Hospital Association; South Carolina Medical Association; and Division of Research and Statistical Services. South Carolina Budget and Control Board. "Issues to be Considered when Reporting Health Data" (Health Data Reporting Project). Columbia, SC: Division of Research and Statistical Services. 1992.

South Carolina Hospital Association/South Carolina Medical Association Vice Presidents of Medical Affairs Council. South Carolina Hospital Association Task Force on Utilization Management, and Division of Research and Statistical Services. South Carolina Budget and Control Board. "Comparative Inpatient Hospital Charges By Physician Specialty" (Research Project: Educational Seminars). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board), 1992.

South Carolina Hospital Association/South Carolina Medical Association Vice Presidents of Medical Affairs Council; South Carolina Hospital Association Task Force on Utilization Management; and Division of Research and Statistical Services, South Carolina Budget and Control Board. "Quality and Utilization Patterns of Care" (Data Profiles). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board), 1992.

"Survey of Health and Health Care Issues" (Research Project). Columbia, SC: Division of Research and Statistical Services (SC Budget and Control Board). 1992.

Presentations and Testimony

Bailey WP, "Healthy Start and the Integration of Multiple Systems Data," presentation at the American Academy, Oregon, 1995.

Bailey WP, "Capability of the Healthy Start MIS," presentation at the Healthy Start Contractors Meeting, Florence, SC, 1996.

Bailey WP, "HCPR Workshop on Integrated Data Systems," Faculty, St. Louis, MO, 1996.

Bailey WP, "Uses of Integrated Data Systems," presentation at the Association of vital Records and Public Health Statistics, Tucson, AZ, 1996.

Bailey WP, "Update on Data Systems Development and How We Might Collaborate on Future Research," presentation at the Strom Thurmond Institute, Clemson University, Clemson, SC, 1996.

Bailey WP, "Use of Address-matching and Integrated Data Systems in Transportation System Planning," presentation at Transportation Systems Coordinating Committee, Columbia, SC, 1996.

Bailey WP and Corley B, "Benefits of Comparative Inpatient Analysis in a Managed Care Environment," presentation at Richland Memorial Hospital to full medical staff, Columbia, SC, 1996.

Bailey WP and Corley B, "Using Inpatient Data for Improvement," presentation at Newberry Hospital, Newberry, SC, 1996.

Bailey WP and Corley B, "Update on Data Available for Hospital Planning," presentation for Carolina's Hospital Planners Association, Charlotte, NC, 1996.

Bailey WP, "Primary Care Report," presentation to Dean's Committee on Medical Education and Health Professions, Columbia, SC, 1995.

Bailey WP and Corley B, "Group Practice Outcomes Analyses and Comparative Data" (Presentation to a seven member urology practice). Columbia, SC, 1995.

Bailey WP and Corley B, "Comparative Physician and Hospital Utilization Data," presentation to administration of Wallace Thompson Hospital, Union, SC, 1995.

Bailey WP and Corley B, "How Systems being built under RWJ apply to Outcomes Research Centers," presentation to Medical University of South Carolina, Charleston, SC, 1995.

Bailey WP, Corley B and Sasser H, "Required Reporting: Freestanding Ambulatory Facilities in SC," to Columbia, SC: Office of Research and Statistics, Columbia, SC, 1995.

Corley B, "Status of Outpatient Reporting," presentation at the SCHA UB – 92 semi-annual workshop, Columbia, SC, 1996.

Corley B, "Linking Patient Level Databases — Healthy Start," presentation at the Ohio Health Data Exposition, Columbus, OH, 1995.

Corley B, "Ambulatory Care Sensitive Conditions," presentation to the American Public Health Association, San Diego, 1995.

Pease M, "Roundtable — Physician Supply and Demand," presentation to the American Public Health Association, San Diego, 1995.

Pease M, "The SC Healthy Start MIS," presentation at NAHDO Annual Meeting, Washington, 1995.

World Wide Web Sites

The Web site is at www2.umdnj.edu/ishppweb/scarolin.htm.

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Report prepared by: Robert Mahon
Edited by: Karin Gillespie
Edited and reviewed by: Marian Bass
Reviewed by: Molly McKaughan
Program Officer: James Knickman

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