This document provides an overview and agenda for an informational webinar on the NYS Health Innovation Challenge. The webinar will feature representatives from the NYS Department of Health and Health 2.0 who will describe the challenge, available data assets including SPARCS, QARR and cardiac reporting system data, and details about the challenge such as evaluation criteria and timeline. The challenge aims to create technology-driven solutions that enable various groups to explore quality, charges and costs data for medical procedures in NYS hospitals in order to increase usage of open health data, reduce healthcare costs, and empower consumers.

1. NYS Health Innovation
Challenge
Informational Webinar
April 24, 2014

2. On the call
• DOH, SPARCS – John Piddock
• DOH, QARR – Joanne Guo
• DOH, Cardiac Reporting System – Kim Cozzens
• DOH, Prevention Agenda - Trang Nguyen
• ITS, Health Data NY – George Javitz
• Health 2.0 – Graeme Ossey
• Health 2.0 – Jen David

3. Agenda
• Challenge Description
• Challenge Data Assets
• Health Data NY and API’s
• Challenge Details
• Evaluation Criteria
• Timeline
• Q & A

4. The Challenge
• Create tech-driven solutions that enable consumers, employers,
public health experts, communities and purchasers to explore
quality, charges and costs data for medical procedures provided by
NYS inpatient hospital facilities.
• Goals
• Increase usage and usability of open health data
• Reduce costs of health care through value based health care decisions
• Turn open data into actionable information that will empower consumers
and others to make informed purchasing decisions

5. Challenge Data Assets
• Statewide Planning and Research Cooperative System (SPARCS)
• Quality Assurance Reporting Requirements (QARR)
• Cardiac Reporting System
• Prevention Agenda 2013 – 2017 Tracking Indicators
• Hospital locations, services, and beds will be posted on Health Data
NY soon.
• Additional data from Health Data NY, Open NY, and other open data
sites.

6. Statewide Planning and Research
Cooperative System
(SPARCS)
John Piddock
Bureau of Health Informatics
Office of Quality and Patient Safety
New York State Department of Health

7. What Is SPARCS?
• Statewide Planning and Research Cooperative System (SPARCS)
• Cooperation between the health care industry and government
• In existence for over 35 years
• Established through statute in 1979
• Enabling legislation and regulations for SPARCS are located under Section 2816 of the Public
Health Law (PHL); and Section 400.18 of Title 10 (Health) of the Official Compilation of Codes,
Rules, and Regulations of the State of New York (NYCRR)
• All payer calendar year-based discharge/visit dataset
• Claim-level detail on patient characteristics, diagnoses, treatments, services, and
charges for hospital discharges, ambulatory surgery, emergency department, and
hospital-based outpatient service visits (or EODC) in New York State

8. Many Uses of SPARCS Data
• Financial, Rate Setting (e.g., APR-DRG SIW)
• Developing and Evaluating Policy
• Epidemiology
• Health Planning/Resource Allocation
• Quality of Care Assessment
• Research
• Surveillance
• Utilization Review
• Geo-coding
• Linkages with other data sets, registries, etc.
• AHRQ Healthcare Cost and Utilization Project
(HCUP)
• Potentially Preventable Readmissions (PPR)
• Potentially Preventable Complications (PPC)
• Patient Safety Indicators (PSI)
• Inpatient Quality Indicators (IQI)
• Prevention Quality Indicators (PQI/PDI)

9. SPARCS Data Collection
• Submissions are by Article 28 facilities or their vendors
• Inpatient Services
• Hospitals
• Outpatient Visits
• Emergency Departments
• Ambulatory Surgery Centers
• Free-Standing Diagnostic & Treatment Center (D&TC)
• Hospital-Based
• Hospital-Based Outpatient (Expanded Outpatient Data Collection)

10. SPARCS File Types
1. Identifying/Deniable: Contains data elements that—if disclosed without any
restrictions on use or re-disclosure—would constitute an unwarranted invasion
of personal privacy
• External applicants for identifying data must be approved by a Data
Protection Review Board (DPRB)
2. Limited: Contains some indirect patient identifiers, such as the month and year
of date fields and some geographic identifiers of the patient
3. De-Identified: As a public use file, it contains basic record-level detail; all public
health information (PHI) has been removed. This has been posted on Health
Data NY (https://health.data.ny.gov) starting with calendar year 2009.

11. SPARCS Data on Health Data NY
(Tabular Format)
Charges and/or Costs Included
Yes No
Discharge
Level
Yes
Hospital Inpatient Discharges
(SPARCS De-Identified):
2009, 2010, 2011, 2012
No
(Aggregate)
Hospital Inpatient Cost
Transparency: Beginning 2009
Hospital Inpatient Discharges by Facility
(SPARCS): Beginning 2009
Hospital Inpatient Discharges by Patient
County of Residence (SPARCS):
Beginning 2009

12. SPARCS Charge and Cost Data
on Health Data NY
• Hospital Inpatient Discharges (SPARCS De-Identified)
• These datasets (2009-2012) contains discharge level detail on patient characteristics,
diagnoses, treatments, services, and charges. This data contains basic record level detail
regarding the discharge; however, the data does not contain protected health information
(PHI) under HIPAA. Costs are available on 2009-2011.
• Hospital Inpatient Cost Transparency: Beginning 2009
• The dataset contains information on the volume of discharges, All Payer Refined Diagnosis
Related Group (APR-DRG), severity of illness level (SOI), medical or surgical classification,
median charge, median cost, average charge and average cost per discharge.

13. Prevention Quality Indicators (PQIs) - Adult
• The Agency for Healthcare Research and Quality (AHRQ) Prevention
Quality Indicators (PQIs) are a set of population based measures that
can be used with inpatient discharge data to identify conditions
where: 1) the need for hospitalization was potentially preventable
with appropriate outpatient care, or 2) conditions that could be less
severe if treated early and appropriately.
• All PQIs apply only to adult populations (over the age of 18 years).

14. Prevention Quality Indicators - Adult
• PQIs can be used as a starting point for evaluating the overall quality of
primary and preventive care in a geographic area (i.e. Zip Code, County).
• PQIs are sometimes characterized as "avoidable hospitalizations," but this
does not mean that the hospitalizations were unnecessary or inappropriate
at the time they occurred. It means that if proper outpatient care had
been given the hospitalization might not have occurred.
• PQIs can provide initial information about potential problems in a
community that may require further, more in-depth analysis from SPARCS
data.
• This analysis can assist in identifying areas where if good outpatient care is
provided it could potentially prevent the need for hospitalization, or for
which early intervention can prevent complications or more severe disease.

15. Prevention Quality Indicators – Adult
• PQI 01: Diabetes Short-Term Complications
• PQI 03: Diabetes Long-Term Complications
• PQI 14: Uncontrolled Diabetes
• PQI 16: Lower-extremity Amputation
among Patients with Diabetes
• Composite S01: Diabetes
• PQI 07: Hypertension
• PQI 08: Heart Failure
• PQI 13: Angina Without Procedure
• Composite S02: Circulatory
• PQI 05: Chronic Obstructive Pulmonary
Disease (COPD) or Asthma in Older Adults
• PQI 15: Asthma in Younger Adults
• Composite S03: Respiratory
• PQI 10: Dehydration
• PQI 11: Bacterial Pneumonia
• PQI 12: Urinary Tract Infection (UTI)
• Composite PQI 91: Acute
• Composite PQI 90: Overall
• Composite PQI 92: Chronic (S01, S02, & S03)

16. PQIs on Health Data NY
• Data files of PQIs, at the Patient County and Zip Code level on Health Data NY.
• Data Elements include : Year, County or Zip, PQI Number and Name, Observed
and Expected Rates per 100,000 people
• Observed (crude) and Expected (adjusted for age group, gender and
race/ethnicity) rates are presented in two distinct datasets (one by Patient
County, one by Patient Zip Code) to allow comparison with the statewide
average, thereby identifying geographical variation.
• Metadata is also posted for the files.
• Lower PQI rates represent better results.

17. Thank You!
SPARCS Operations
Bureau of Health Informatics
Office of Quality and Patient Safety
NYS Department of Health
Corning Tower, Rm. 878
Albany, NY 12237
Phone: (518) 474-3189
E-mail: sparcs@health.state.ny.us

18. Quality Assurance Reporting
Requirements (QARR)
Joanne Guo
Office of Quality and Patient Safety
Bureau of Health Services Evaluation

19. Background-What is QARR
 Standardized national measurement set for the ambulatory health care delivery
system
 Measures are developed to reflect the quality of care being given in a certain
population, condition, or event
 Generally based on recommendations from national organizations or experts in
designated areas
 Required for Commercial HMO, Commercial PPO, Child Health Plus and
Medicaid

20. What is included in the dataset?
Domain Example Measures
Provider Network Board Certification, Satisfaction with Doctors and Specialists
Child & Adolescent Health Childhood Immunization, Lead Testing, Well Care Visits Dental Visits,
Care for Colds and Sore Throats, Medication for Asthma, Preventive
Care and Counseling for Risk Behaviors
Women’s Health Mammography, Cervical Cancer Screening, Chlamydia Testing,
Prenatal and Postpartum Care
Adult Health Preventive Care, Tobacco Cessation, Flu Shots, Management of
Asthma, COPD, Diabetes, Cardiovascular disease and Medications
Behavioral Health Antidepressant Medication Management and Follow Up Care After
Hospitalization for Mental Illness
Satisfaction with Care Getting Care Needed, Getting Care Quickly, Customer Satisfaction,
Care Coordination and Rating of Health Plan

21. How are the data used?
 Annual Publications – Statewide Executive Summary of Managed
Care, Health Plan Comparison, Regional Consumer Guides, Health
Plan Service Use, Health Care Disparities
 Financial Rewards – Quality Incentive for Medicaid plans based on
performance in quality, satisfaction and preventable hospitalization
rates
 Quality Improvement Activities – performance matrix and action
plans, plan-specific reports, improvement projects and focus studies

22. The Challenge
• Allow comparability across all organizations (e.g. health plans, or
health insurance products)
• Provide the public with information about how effective and
satisfying the care and service delivered is across organizations
• Encourage accountability and quality improvement in health care

23. Limitations
• Only validated information is included in the data
• Not all measures are collected every year, some measures are
rotated to control collection burden
• Measures change and health plan mergers limit the ability to trend
over time
• Some measures are reported as inverted rates and caution should
be used when analyzing these measures
• Plans with fewer than 30 eligible members are excluded from the
statistical calculations

24. Questions
Quality Measurement and Evaluation Unit
Bureau of Health Services Evaluation
Office of Quality and Patient Safety
NYS Department of Health
Corning Tower, Rm. 878
Albany, NY 12237
Phone: (518) 486-9012
E-mail: nysqarr@health.state.ny.us

25. Cardiac Reporting
System
Kimberly S. Cozzens
Cardiac Services Program
Office of Quality and Patient Safety
New York State Department of Health

26. Background - NYSDOH Cardiac Data Systems
• Clinical data registries for all Cardiac Surgery and PCI (coronary
angioplasty) performed in NYS.
• Carefully audited for completeness and accuracy.
• Robust statistical analysis to create risk-adjusted mortality rates.
• NYS is a leader in public reporting of cardiac outcomes. More than 20
year history of public reports.

27. Cardiac Surgery and PCI by Hospital
Hospital-level outcome data for patients undergoing cardiac surgery or PCI.
Primary outcome: Risk-adjusted in-hospital /30-day mortality rate (RAMR)
The dataset also contains:
• Number of cases performed at each hospital
• Number of deaths
• Observed and expected mortality rates
• Hospital region
• Indicator for RAMR significantly above or below the NYS rate

28. Additional Data Sets
Cardiac Surgery by Surgeon
and
PCI by Cardiologist
Contain similar information at the physician level.
Data currently available from 2008 - 2010.
Data through 2011 expected in May.

29. How Are the Data Used?
• Providers - monitor their performance relative to others and identify
opportunities for improvement.
• Referring physicians - inform decisions about where to refer patients.
• Consumers - inform selection of a hospital or physician.
• Department of Health – assess quality of care and satisfactory
outcomes across NYS.

30. The Challenge
• Can these data be presented in a way that is more accessible to patients making
decisions about their care? Can they be used to better help patients in selecting a
hospital or physician for these procedures?
• Can these data be used to help inform health system planning with respect to finding the
right balance between regional procedural volume and need?
• Is there a relationship between cost and quality? If so, how can this information be used
to maintain or improve quality of care while increasing efficiency of resource utilization?
• Is there a relationship between regional use-rates of these invasive procedures for
advanced cardiac disease and prevention quality indicators?

31. Limitations
• Provider results should be compared to the NYS result. It is important
to look at the “Comparison Result” data when assessing outcomes.
These data indicate which results are statistically different from the
statewide results.
• Some providers may have made important changes in the time period
since the data were collected. Historical results may not reflect
current performance.

32. Thank You!
Cardiac Services Program
Office of Quality and Patient Safety
NYS Department of Health
1 University Place, Suite 218
Rensselaer, NY 12144
Phone: (518) 402-1016
E-mail:
cardiacdata@health.state.ny.us

33. Prevention Agenda 2013 -2017 Tracking
Indicators
State and County Trend Data
State and County Most Recent Data
Public Health Information Group - Practice

34. Background
The New York State Prevention Agenda 2013-2017 serves as the
blueprint for state and local community action to improve the health of
New Yorkers and address health disparities. One overall and five priority
specific areas are included. The Prevention Agenda establishes goals for
each priority area and defines indicators to measure progress toward
achieving these goals, including reductions in health disparities among
racial, ethnic, and socioeconomic groups and persons with disabilities.
These datasets consist of the 2017 targets and trend data for state
and county level tracking indicators included in the Improve Health Status
and Reduce Health Disparities and five specific priority areas: Prevent
Chronic Diseases, Healthy and Safe Environment, Healthy Women, Infants
and Children, Prevent Mental Health and Substance Abuse and Prevent
HIV, STDs, Vaccine Preventable Diseases and Healthcare Associated
Infections.

35. What is included in the datasets? Prevention Agenda Tracking Indicators – State Trend and Most Recent Year Data
Field
Number
Field Name Field
Size
Format note Description
1 Priority Area Number 1 Integer Prevention Agenda priority area ID number
2 Priority Area 120 Text Full title for the specific Prevention Agenda priority area
3 Focus Area Number 1 Integer Prevention Agenda focus area ID number (focus area within priority area)
4 Focus Area 120 Text Full title for the specific focus area
5 Indicator Number 6 Text Unique indicator identifier
6 Indicator 200 Text Full text description of the health tracking indicator
7 Disparity 3 Text Indicate disparity indicator or not
8 Event Count/Rate 12
Integers with commas or
numeric with decimal
Event counts for rate computations (numerators) or the high-risk group rate for ratio computations
9
Average Number of
Denominator/Rate
12
Integers with commas or
numeric with decimal
Denominator for rate computations or the reference group rate for ratio computations
10 Measure Unit 12 Text Result type, rate or percentage
11 Percentage/Rate/Ratio 12 Numeric with decimal Numerical indicator value estimate
12 Lower Limit of 95% CI 8 Text Lower limit of 95% Confidence Intervals for percentage estimates from survey data
13 Upper Limit of 95% CI 8 Text Upper limit of 95% Confidence Intervals for percentage estimates from survey data
14 2017 Objective 12 Numeric with decimal Target value for the health tracking indicator, as specified by the Prevention Agenda
15 Objective Region 12 Text Region of NYS that the objective pertains to
16 Data Years 100 Text Time period for raw data used in indicator computation
17 Date Source 300 Text Data sources for the raw data used in indicator computation

36. What is included in the datasets? Prevention Agenda Tracking Indicators – County Trend and Most Recent Year Data
Field Number Field Name Field Size Format note Description
1 County Name 35 Text Full county name
2 Priority Area Number 1 Integer Prevention Agenda priority area ID number
3 Priority Area 120 Text Full title for the specific Prevention Agenda priority area
4 Focus Area Number 1 Integer Prevention Agenda focus area ID number (focus area within priority area)
5 Focus Area 120 Text Full title for the specific focus area
6 Indicator Number 6 Text Unique indicator identifier
7 Indicator 200 Text Full text description of the health tracking indicator
8 Disparity 3 Text Indicate disparity indicator or not
9 Event Count/Rate 12 Integers with commas or numeric with decimal Event counts for rate computations (numerators) or the high-risk group rate for ratio computations
10 Average Number of Denominator/Rate 12 Integers with commas or numeric with decimal Denominator for rate computations or the reference group rate for ratio computations
11 Measure Unit 12 Text Result type, rate or percentage
12 Percentage/Rate/Ratio 12 Numeric with decimal Numerical indicator value estimate
13 Lower Limit of 95% CI 8 Text Lower limit of 95% Confidence Intervals for percentage estimates from survey data
14 Upper Limit of 95% CI 8 Text Upper limit of 95% Confidence Intervals for percentage estimates from survey data
15 Data Comments 20 Text Indicate when the county data is unstable or suppressed due to small number of events
16 Quartile 20 Text Quartile(s) that indicator estimate falls within
17 2017 Objective 12 Numeric with decimal Target value for the health tracking indicator, as specified by the Prevention Agenda
18 Objective Region 12 Text Region of NYS that the objective pertains to
19 Data Years 100 Text Time period for raw data used in indicator computation
20 Data Sources 300 Text Data sources for the raw data used in indicator computation
21 Mapping Distribution 1 Integer
Grouping of county rates for color shades in the map (value of "1" indicates the best group and "3"
indicates the worst group)
22 Location 30
Lat/Long coordinates separated by a comma,
within parentheses
Lat/Long decimal degree coordinates for the region covered by the indicator, for use in mapping

40. How are the data used?
• These datasets provide interested parties, including state and local health partners and
the general public information about the most recent data points and trend data for the
2013-2017 Prevention Agenda tracking indicators and the objectives/targets that state
and communities are working toward.
• Interested parties can utilize the local data to assess and identify local priorities, to set
reasonable local level targets, and to monitor progress to collectively contribute toward
the state’s overall progress in the five Prevention Agenda Priority Areas.
• Data can be used in conjunction with other data sources for research, grant applications,
community engagement, educational materials, identifying and communicating local
priorities for interventions.

41. Limitations
This dataset consists of various types of indicators with different units
of measurement such as rates per 10,000 population, percentages,
and ratios. Therefore, comparison of data across indicators might not
be valid.

42. Thank You!
Office of Public Health Practice
prevention@health.state.ny.us
(518) 473-4223
Department of Health
Corning Tower – ESP
Albany, NY 12237

43. Using APIs with
HealthDataNY
and
OpenNY

44. What is an API
• An application programming interface (API) specifies how
some software components should interact with each other.
• In addition to accessing databases or computer hardware, such
as hard disk drives or video cards, an API can be used to ease the
work of programming graphical user interface components
* Wikipedia

45. Socrata’s Open Data APIs
* From Socrata.com/open-data-portal

46. Socrata’s Open Data APIs
* From Socrata.com/open-data-portal

47. Socrata’s Developer Resources
* From dev.socrata.com

48. Socrata Open Data API
* From dev.socrata.com

49. Socrata Open Data API
* From dev.socrata.com

50. Featured NYS APIs

51. HealthDataNY Featured APIs

52. HealthDataNY Featured APIs

53. HealthDataNY Featured APIs

54. HealthDataNY Featured APIs

55. First, get dataset identifier
Example Code

56. Then use identifier in request URL
Use .csv to return CSV file
Example Code

57. Example Code

58. Thank You!
HealthDataNY Team
healthdatany@health.ny.gov

59. Challenge Details
• Pre-registration Form
• Official Submission Requirements
• A text description (500 to 1500 words)
• Power Point (5 to 10 slides)
• Link to working Solution
• Awards
• $15,000 First Prize
• $3,500 Second Prize
• $1,500 Third Prize

60. Evaluation Criteria
• Entries will be judged on the following:
• Decision Making (20%)
• Creativity (30%)
• Feasibility of Implementation (20%)
• Target Audience (15%)
• Utilization of Open Data (15%)

61. Timeline
• Submission phase ends: July 24, 2014
• Judging period: August 2014
• Winners announced: September 2014

62. Thank You!
Q & A
Contact Us
graeme@health2con.com
jenniferd@health2con.com
Visit http://bit.ly/NYSInnov for
more information