Meeting of the
Comprehensive Health Information System (CHIS) Advisory Council
Health Care Facility Website / Ambulatory Surgery Data Technical Workgroup
MINUTES
Date: January 25, 2006
Beginning Time: 10:00 a.m.
Venue: Face-to-face and by teleconference, Florida Hospital Association, Orlando, FL
Members Present: Kim Streit, Chair; James Bracher; Betsy Miller, proxy for Steve Horner
Members Present by Teleconference: Chuck Bombard, R.N.; Tom Granatir; Mark Michelman, M.D.;
Cindy Righter; Lisa Simpson, M.D.; Alan Smith, M.D.; Bruce Platt, proxy for Bob Wychulis
Members Absent: Martin Cone; Leslie Dughi; Paul Duncan, Ph.D.; Peter Lohrengal; Charles Milsted;
Phil Rond, Ph.D.
AHCA Staff Present: Cheryl Barfield; Penny Bos; Beth Eastman; Beth Register
AHCA Staff Present by Teleconference: Cruz Conrad; Adrienne Henderson; Gloria Barker; Bill
Dahlem, Ph.D.; Christopher Sullivan, Ph.D.; Carolyn Turner; Judith Salpeter, R.N.; James Coste, AHCA
IT
Other Participants Present: Brian Klepper, The Center for Practical Health Reform; Leah Jaffe, Jackson
Health System; Diane Cosgrove, Orlando Regional Healthcare; Bill Kelly, TREO; Mark Alexander, I.S.
Consulting; James Williams, All Children’s Hospital; Kimberly Jenkins, Blue Cross, Blue Shield;
Other Participants by Teleconference: Steve Mindlin, Rose, Sundstrom & Bentley
Materials Provided in Binder: Agenda, Draft Minutes (December 1, 2005); Website Survey Results;
Website Statistics; Recommendations for Display of Charge, Length of Stay and Readmission Data;
Methodology for Risk Adjustment; Resource Article on Hospital Pricing; Proposed Pediatric Procedures
and Conditions; APR-DRG Tables; Project Timeline; Post Meeting Critique (face to face); Post Meeting
Critique (by teleconference), Proposed 2006 Meeting Dates
Meeting Handouts: Website Technical Workgroup Guiding Principles for Website Design;
Status of Tasks Assigned to AHCA Staff by Website Workgroup
Welcome, Introductions and Roll Call: Kim Streit, Chair, opened the meeting at 10:00 a.m. The
meeting began with the workgroup members and interested parties introducing themselves. Kim Streit
welcomed new member, Lisa Simpson, M.D., to the CHIS Health Care Facility Website/ Ambulatory
Surgery Data Technical Workgroup.
Review and Approval of Minutes of December 1, 2005 Meeting in Tallahassee. James Bracher
moved to approve the minutes and Betsy Miller seconded the motion. The motion passed.
Agency Update: Penny Bos, AHCA, provided the members with a status report of the Agency’s actions
since the last meeting. She states that SCHS released the first Emergency Departments report and the
SCHS Annual Report on January 23, and both were posted on the Florida Health Stat website. She then
gave an update on Lisa Rawlins, indicating that it was Ms. Rawlins’ intention to return to the office
around the middle of March. Beth Eastman updated the workgroup on the status of the tasks, actions and
motions from the past meeting.
AHCA TASK: Staff will, at the beginning of each meeting, provide a review and update of the tasks
assigned at previous meetings.
Update of Health Plan Workgroup: Penny Bos, AHCA, relayed to the members that the Health Plan
workgroup plans to meet February 1, and that the plan for the Health Plan website was to go live on
October 1. The website will be designed by the Agency’s IT Department. Health Plan members were
asked for a wish list on what they want to see on the Health Plan interactive website.
Update of Hospital Acquired Infections Workgroup: Kim Streit, Chair, gave a brief summary of the
Hospital Acquired Infections workgroup meeting that occurred the day before. She further stated that a
long range planning meeting was set for some time in late May to review consumer input and review
federal actions. The Chair then briefed the members on the HAI workgroup’s recommendation that there
be a joint teleconference with the consumer website workgroup to look at the definitions, infection data
display and how to incorporate and trend data for SIP. The suggested date for this joint teleconference
was February 22, 2006 from 10 a.m. until 12 p.m.
AHCA TASK: Beth Eastman was requested to provide a review of other states’ websites, at each
meeting, when available, to gain perspective and gain ideas for Florida’s websites.
Update of Public Relations Workgroup: Penny Bos, AHCA, reported that the Public Relations
workgroup will have their first meeting February 13, 2006 in Tallahassee. The workgroup currently has 8
members and are looking forward to getting things off the ground to facilitate the marketing plans of the
websites.
RECOMMENDATION: The members recommended to challenge the Public Relations Workgroup to
make it clear what’s on the website, where information is located, how to find information, how items are
linked, and focus on the sort options of the services list in particular. Further, it was recommended that
the group push the website’s survey in marketing efforts.
Update of Physician’s Workgroup: It was reported that the Physician’s workgroup now has 10
members and will meet sometime late February.
Summary of Website Survey Results and Statistics: Beth Eastman reviewed the web survey results –
there were 163 responses. Jim Bracher stated that it looked good, and that it seems to be reaching the
targeted audiences. The Chair recommended that the members take a look at improving the ease of the
navigation of the site and provide any suggestions or recommendations for improvement.
AHCA TASK: AHCA staff to check with Jeff Greg, of AHCA’s Facility Regulation Bureau, to provide
members with a clearer understanding of how hospitals are linked by services, and determine if it’s
possible for enhancements.
WORKGROUP TASK: Members were asked to compare the survey questions on
FloridaCompareCare.com with the national AHRQ health survey, and provide suggestions or
recommendations to Beth Eastman, AHCA, via email.
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AGENDA ITEM: It was suggested by the Chair that the members take a look at the survey, and email
ideas to Beth Eastman. She will work with the vendor based on the feedback from the workgroup and
provide an update to the members at the next meeting.
Vendor Presentation: Bill Kelly, Treo Solutions, gave a demonstration to members on the display of
charges, indirect vs. direct standardization and risk adjusted. He then provided the following summary of
new presentation/display recommendations by the CHIS Website Workgroup:
1) Change the current methodology on inpatient conditions/procedures from DRGs and ICD9 codes
to be APR-DRG specific
2) Show volume for ALL conditions and procedures – currently we X out those less than 30
however according to the inpatient rule, we need to X out those less than 5
3) For charges and length of stay, display stars (or some other type of wingding as determined by the
group) whether it is 3 or 5 groupings (also to be determined) and then have a drilldown on the
wingding where you will see the volume, observed (actual) value, and the expected value for that
facility for both charges and length of stay
4) The wingding ranking will be determined based on observed/expected ratio or based on percent
difference (also to be determined)
5) Thus we will no longer be displaying the risk adjusted number which is what we are currently
displaying on the website for charges and length of stay (observed/expected * statewide average =
risk adjusted)
6) We will continue to display the risk adjusted number for readmissions by facility only (this
however is an item that the workgroup wants on the agenda in the future to relook at the
methodology because it is readmissions for any reason, not necessarily for the initial hospital
admission) – 3M is currently working on a methodology for this so we are following their
progress
RECOMMENDATION: It was recommended that the vendor attend future meetings to help
members stay on task and to ensure that time is not wasted on something that is not possible or practical
from the vendor’s point of view. The Chair invited the vendor to attend the February 22, 2006 joint
teleconference meeting.
MOTION: Jim Bracher made a motion that the website show cases and summary rankings for both
length of stay and charges with statewide average at the top, and with the ability to drill down and click
on ranking for specific details. Betsy Miller, proxy for Steve Horner, seconded the motion.
MOTION AMENDED: After discussion of the motion, it was recommended that it also be separated by
age, and that the format will be age defined at the top. The motion was approved unanimously.
RECOMMENDATION: It was suggested that the readmission data be left the way it is until 3M changes
are complete within the next year or so.
AGENDA ITEM: The Chair asked that readmissions be added to the project list and timeline and to ask
3M to discuss their methodology at a future meeting.
Consumer Website Workgroup Update: Kim Streit, Chair, gave a review of the project listing to the
Consumer Website group for their consideration in the coming year. The group reviewed the listed
projects and opened the discussion on relevancy and timing of each item, and discussed what AHCA
should do sooner than later with regards to recommendations.
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AHCA TASK: Beth Eastman will look at all suggestions of project timelines, and report back to the
Workgroup.
Website Enhancements / Modifications: Beth Eastman, AHCA, provided a review of the Pediatric
Conditions/Procedures APR DRG Descriptions. The workgroup members discussed the distinction
between Quality Indicators from AHRQ and indicators for pediatrics. Lisa Simpson, M.D., will provide
Phase II Pediatric Quality Indicators overview at the next meeting. Dr. Simpson then requested a
navigational tool on the front page of the website for adult and pediatrics and that there would be 2 sets of
expecteds – adult and pediatrics
WORKGROUP TASK: Lisa Simpson, M.D., will review the list of pediatric procedures and conditions
and provide to AHCA for discussion at the next meeting.
Review of Other States’ Websites: The members reviewed the New Hampshire and Utah websites. The
Chair suggested that the members review other states’ websites and submit comments on features and
items of interest to AHCA. The Chair urged members to review as many sites as possible.
WORKGROUP TASK: The members are to review the other states’ websites before the next meeting
and provide the Chair, and Beth Eastman, AHCA, with comments and suggestions for features and other
items of interest.
AHCA TASK: AHCA Staff will send the link to Norton Health Care to all of the members so they can
review the site.
Other Business: Bill Kelly, Treo Solutions, asked the members if they were interested in coming up
with an extended search option to help link information pages to someplace like healthline.com to help
consumers understand what they were reading. The Chair suggested that the members come up with a list
of possible sites to link to that would provide additional information to the consumers. The site might
provide definitions, explanations of conditions and procedures, or a search option link to health line.com
to help educate consumers. It was agreed that the Chair would work with AHCA to update the projects
list for the upcoming year, and include the issues that were brought up and would provide an updated
project list for everyone.
WORKGROUP TASK: Members are to provide a list of possible sites for links on the website that
would provide consumers with additional information.
AHCA TASK: AHCA Staff to work with vendor to provide physician’s data to hospitals.
Meeting Evaluation. The workgroup members and the interested parties were encouraged to complete
and return the meeting evaluation forms.
Next Meeting. The next CHIS Health Care Facility Website/Ambulatory Surgery Data Technical
Workgroup meeting will be a joint teleconference with the Hospital Acquired Infections Technical
Workgroup, and was scheduled for February 22, 2006.
Adjournment. The meeting adjourned at 2:10 p.m.
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