U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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NPIRS CLINICAL DATA MART

Public Health Nursing (PHN) Case Study

Background

How many "home visits" has the PHN program made this year? How timely is my PHN program information? In what clinical setting are the majority of my patients being seen? How can I show the PHN program’s contribution to agency-wide Government Performance Results Act (GPRA) measures? How can we help standardize and improve documentation and coding practices for the PHN program? Such were the questions the PHN program struggled with.

Public Health Nursing data is entered into the local Resource Patient Management Systems (RPMS) clinical repository. The local RPMS system is ideal for obtaining access to local data and information. However, local RPMS systems do not easily support the need to track and manage national level information, identify trends and provide a basis for performance improvement.

Solution

The Public Health Nursing program partnered with the National Patient Information Reporting System (NPIRS) program to develop a "Public Health Nursing/Community Health Nursing" (PHN/CHN) web-based data mart. Working closely with nursing leadership, key reporting requirements were identified and logic developed for building "canned" reports. Public Health Nurses now have access to a variety of reports including workload, program management and performance measurement information. The application makes full use of the National Data Warehouse (NDW) database to provide information by clinical setting, ICD9 diagnostic categories and health education related data. The site also contains information specific to the timeliness of data exported to the NDW. This information is used to improve the timeliness of documentation of PHN encounters and export to the NDW database.

Results

The PHN/CHN data mart continues to be the primary tool nursing leadership uses to monitor, track and manage data related to Public Health Nursing activities. Additionally, the application is used to assist PHN programs across the agency to improve and standardize documentation and coding practices so information can be more consistent across programs. The site also contains a number of national GPRA measures and demonstrates through data, how the Public Health Nursing Program contributes to these measures. Planned upgrades for the application include adding newly developed reporting tools for the recent agency initiative "Partnership for Patients" (P4P). The site will be the principal method used by the PHN program to support new and emerging initiatives.