Like Y2K, Oryx is creeping up inexorably on the hospital industry, ready or not.
The brain trust at the Joint Commission on Accreditation of Healthcare Organizations is waiting anxiously for hospitals' contracted performance measurement systems to start transmitting trial data. So far, only a handful have ventured to test their systems.
One of the first was Sisters of Mercy Health System, based in St. Louis.
"The Joint Commission was happy to have someone to work with so early," said John Ward, a senior consultant in Sisters of Mercy's information systems department. "It was a mutual endeavor, where we were helping them and they were helping us."
The electronic transmission of Sisters of Mercy's first submission on March 25 required some tweaking but not as much as Ward had feared. That put the system almost a year ahead of the deadline for submitting real data, which is March 31, 1999, for clinical indicators collected from July, August and September of 1998.
Sisters of Mercy started by submitting data showing its rate of Caesarean-section procedures over time. This longitudinal data set is the first of two parts the Joint Commission requires. The other is a comparison of the hospital and its peers, using the same clinical indicator and the same measurement system.
The Joint Commission said both submissions were successfully completed by mid-May by four groups: Boston Scientific Corp., the Joint Commission's Indicator Measurement System, SMS and Tenet HealthSystem. One of the two parts was completed by MedStat Group, Rehabilitation Foundation and Sisters of Mercy.
Sisters of Mercy Health System has been collecting clinical indicators from 19 hospitals in six states for some time, long predating the Joint Commission's Oryx initiative, unveiled in February 1997.
Like Tenet, Sisters of Mercy developed its own performance measurement system, known as SMHS Comparative Outcomes Analysis of Continuum-Based Healthcare (COACH), for use in its own hospitals, said Sue Sinclair, a quality manager at Sisters of Mercy.
COACH is one of the 344 performance measurement systems accepted for data submission by the Joint Commission (See story below).
Sisters of Mercy hospitals can choose from the following indicators:
Medical readmission rate.
Congestive heart failure readmission rate.
Congestive heart failure readmission rate for CHF and related conditions.
Medicare pneumonia mortality.
One utilization indicator: average length of stay for total hip replacement.
Individual hospitals choose as many as five indicators that cover as much as 20% of their patient population, Sinclair said. The hospitals forward the data to headquarters in St. Louis, which formats them and sends them electronically to the Joint Commission's headquarters in Oakbrook Terrace, Ill.
The format used is X.12, a national standard for transmitting data, which has long been used by the automobile industry and which Congress mandated for future data submission to HCFA.
Jerod Loeb, the Joint Commission's vice president for research and evaluation, congratulated the information management team at Sisters of Mercy for "taking our technical manual and making it real. This is the `eureka' moment."
Loeb said he wishes more healthcare providers would test their transmission programs before the deadline.
"This is not something you can do in the last 10 or 15 days of March 1999," he said. "This is going to take considerable effort."
He advises hospitals not to be shy about leaning on their measurement system vendors to make sure they meet the deadline. Performance measurement systems are required to successfully file test data before the real submission is due.