@article{Crossen_2017, title={Importance of Continued Data Quality Assessment of Syndromic Production Data}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7619}, DOI={10.5210/ojphi.v9i1.7619}, abstractNote={<div style="left: 89.1818px; top: 317.842px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.08186);" data-canvas-width="63.1985303030303">Objective</div><div style="left: 104.045px; top: 332.657px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03044);" data-canvas-width="375.92175984848467">To explore the quality of data submitted once a facility is moved</div><div style="left: 89.1818px; top: 349.172px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.979535);" data-canvas-width="391.99372727272754">into an ongoing submission status and address the importance of</div><div style="left: 89.1818px; top: 365.688px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00223);" data-canvas-width="204.32132575757578">continuing data quality assessments.</div><div style="left: 89.1818px; top: 397.115px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.11811);" data-canvas-width="81.88294696969696">Introduction</div><div style="left: 104.045px; top: 411.93px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.04492);" data-canvas-width="376.13513560606015">Once a facility meets data quality standards and is approved for</div><div style="left: 89.1818px; top: 428.445px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03167);" data-canvas-width="390.98440378787865">production, an assumption is made that the quality of data received</div><div style="left: 89.1818px; top: 444.96px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03166);" data-canvas-width="390.9633469696967">remains at the same level. When looking at production data quality</div><div style="left: 89.1818px; top: 461.475px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01299);" data-canvas-width="392.8219621212121">reports from various states generated using a SAS data quality</div><div style="left: 89.1818px; top: 477.991px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.977761);" data-canvas-width="389.6213257575757">program, a need for production data quality assessment was identified.</div><div style="left: 89.1818px; top: 494.506px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.967128);" data-canvas-width="391.57399469696963">By implementing a periodic data quality update on all production</div><div style="left: 89.1818px; top: 511.021px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.970454);" data-canvas-width="389.3461833333332">facilities, data quality has improved for production data as a whole and</div><div style="left: 89.1818px; top: 527.536px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01718);" data-canvas-width="390.54501818181825">for individual facility data. Through this activity several root causes</div><div style="left: 89.1818px; top: 544.051px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01797);" data-canvas-width="390.5787090909091">of data quality degradation have been identified, allowing processes</div><div style="left: 89.1818px; top: 560.566px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00475);" data-canvas-width="348.1955454545453">to be implemented in order to mitigate impact on data quality.</div><div style="left: 89.1818px; top: 591.994px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.07334);" data-canvas-width="57.70971969696969">Methods</div><div style="left: 104.045px; top: 606.809px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.999506);" data-canvas-width="377.3802954545454">Many jurisdictions work with facilities during the onboarding</div><div style="left: 89.1818px; top: 623.324px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02344);" data-canvas-width="390.59555454545443">process to improve data quality. Once a certain level of data quality</div><div style="left: 89.1818px; top: 639.839px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.04265);" data-canvas-width="391.02932499999986">is achieved, the facility is moved into production. At this point the</div><div style="left: 89.1818px; top: 656.354px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.998553);" data-canvas-width="392.53137803030285">jurisdiction generally assumes that the quality of the data being</div><div style="left: 89.1818px; top: 672.869px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.04711);" data-canvas-width="391.3058712121212">submitted will remain fairly constant. To check this assumption in</div><div style="left: 89.1818px; top: 689.385px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.979211);" data-canvas-width="389.53007954545444">Kansas, a SAS Production Report program was developed specifically</div><div style="left: 89.1818px; top: 705.9px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00706);" data-canvas-width="190.28344696969702">to look at production data quality.</div><div style="left: 104.045px; top: 722.415px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.988309);" data-canvas-width="374.6021992424242">A legacy data set is downloaded from BioSense production servers</div><div style="left: 89.1818px; top: 738.93px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.959092);" data-canvas-width="389.2633598484848">by Earliest Date in order to capture all records for visits which occurred</div><div style="left: 89.1818px; top: 755.445px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.990094);" data-canvas-width="389.61851818181816">within a specified time frame. This data set is then run through a SAS</div><div style="left: 89.1818px; top: 771.96px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03179);" data-canvas-width="390.7036462121213">data quality program which checks specific fields for completeness</div><div style="left: 89.1818px; top: 788.476px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.996551);" data-canvas-width="389.8010106060606">and validity and prints a report on counts and percentages of null and</div><div style="left: 89.1818px; top: 804.991px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.989502);" data-canvas-width="389.5834234848483">invalid values, outdated records, and timeliness of record submission,</div><div style="left: 89.1818px; top: 821.506px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.950282);" data-canvas-width="391.0251136363634">as well as examples of records from visits containing these errors.</div><div style="left: 89.1818px; top: 838.021px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.986039);" data-canvas-width="389.5511363636362">A report is created for the state as a whole, each facility, EHR vendor,</div><div style="left: 89.1818px; top: 854.536px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00556);" data-canvas-width="392.65631515151506">and HIE sending data to the production servers, with examples</div><div style="left: 89.1818px; top: 871.051px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00687);" data-canvas-width="392.36011590909135">provided only by facility. The facility, vendor, and HIE reports</div><div style="left: 89.1818px; top: 887.566px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00188);" data-canvas-width="284.18281818181816">include state percentages of errors for comparison.</div><div style="left: 104.045px; top: 904.082px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.954835);" data-canvas-width="376.26849545454564">The Production Report was initially run on Kansas data for the</div><div style="left: 89.1818px; top: 920.597px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02306);" data-canvas-width="390.6545136363636">first quarter of 2016 followed by consultations with facilities on the</div><div style="left: 89.1818px; top: 937.112px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00851);" data-canvas-width="390.1407272727271">findings. Monthly checks were made of data quality before and after</div><div style="left: 89.1818px; top: 953.627px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0345);" data-canvas-width="390.79910378787883">facilities implemented changes. An examination of Kansas’ results</div><div style="left: 89.1818px; top: 970.142px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01792);" data-canvas-width="390.54080681818186">showed a marked decrease in data quality for many facilities. Every</div><div style="left: 89.1818px; top: 986.657px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00199);" data-canvas-width="298.62779545454543">facility had at least one area in need of improvement.</div><div style="left: 104.045px; top: 1003.17px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02662);" data-canvas-width="375.94843181818186">The data quality reports and examples were sent to every facility</div><div style="left: 89.1818px; top: 1019.69px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01881);" data-canvas-width="390.5085196969696">sending production data during the first quarter attached to an email</div><div style="left: 89.1818px; top: 1036.2px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02432);" data-canvas-width="390.64328333333344">requesting a 30-60 minute call with each to go over the report. This</div><div style="left: 89.1818px; top: 1052.72px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01569);" data-canvas-width="390.3302386363637">call was deemed crucial to the process since it had been over a year,</div><div style="left: 89.1818px; top: 1069.23px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0522);" data-canvas-width="391.084072727272">and in a few cases over two years, since some of the facilities had</div><div style="left: 89.1818px; top: 1085.75px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03871);" data-canvas-width="390.95492424242434">looked at data quality and would need a review of the findings and</div><div style="left: 89.1818px; top: 1102.26px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00016);" data-canvas-width="389.84733560606065">all requirements, new and old. Ultimately, over half of all production</div><div style="left: 89.1818px; top: 1118.78px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00238);" data-canvas-width="203.90018939393943">facilities scheduled a follow-up call.</div><div style="left: 104.045px; top: 1135.29px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01887);" data-canvas-width="375.775765909091">While some facilities expressed some degree of trepidation, most</div><div style="left: 89.1818px; top: 1151.81px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.988235);" data-canvas-width="389.49638863636363">facilities were open to revisiting data quality and to making requested</div><div style="left: 89.1818px; top: 1168.32px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.988242);" data-canvas-width="389.5651742424241">improvements. Reasons for data quality degradation included updates</div><div style="left: 89.1818px; top: 1184.84px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01956);" data-canvas-width="390.5604598484848">to EHR products, change of EHR product, work flow issues, engine</div><div style="left: 89.1818px; top: 1201.35px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0045);" data-canvas-width="290.0506515151514">updates, new requirements, and personnel turnover.</div><div style="left: 520.227px; top: 316.142px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.988258);" data-canvas-width="377.36625757575746">A request was made of other jurisdictions (including Arizona,</div><div style="left: 505.364px; top: 332.657px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01453);" data-canvas-width="390.37375606060596">Nevada, and Illinois) to look at their production data using the same</div><div style="left: 505.364px; top: 349.172px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01431);" data-canvas-width="390.3218159090909">program and compare quality. Data was pulled for at least one week</div><div style="left: 505.364px; top: 365.688px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00152);" data-canvas-width="167.6543863636364">of July 2016 by Earliest Date.</div><div style="left: 505.364px; top: 397.115px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.08498);" data-canvas-width="50.70481818181818">Results</div><div style="left: 520.227px; top: 411.93px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.957386);" data-canvas-width="376.523984848485">Monthly reports have been run on Kansas Production data both</div><div style="left: 505.364px; top: 428.445px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0299);" data-canvas-width="391.05318939393953">before and after the consultation meetings which indicate a marked</div><div style="left: 505.364px; top: 444.96px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.975909);" data-canvas-width="391.25814242424235">improvement in both completeness of required fields and validity</div><div style="left: 505.364px; top: 461.475px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.04685);" data-canvas-width="390.68539696969697">of values in those fields. Data for these monthly reports was again</div><div style="left: 505.364px; top: 477.991px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00209);" data-canvas-width="142.68100000000004">selected by Earliest Date.</div><div style="left: 505.364px; top: 509.418px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.10288);" data-canvas-width="84.24131060606061">Conclusions</div><div style="left: 520.227px; top: 524.233px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.957182);" data-canvas-width="376.41168181818176">In order to ensure production data continues to be of value for</div><div style="left: 505.364px; top: 540.748px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02783);" data-canvas-width="391.1051295454546">syndromic surveillance purposes, periodic data quality assessments</div><div style="left: 505.364px; top: 557.263px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.961705);" data-canvas-width="391.1093409090909">should continue after a facility reaches ongoing submission status.</div><div style="left: 505.364px; top: 573.779px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.955884);" data-canvas-width="391.4027325757578">Alterations in process include a review of production data at least</div><div style="left: 505.364px; top: 590.294px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.97305);" data-canvas-width="389.36583636363616">twice per year with a follow up data review one month later to confirm</div><div style="left: 505.364px; top: 606.809px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00227);" data-canvas-width="260.82378787878787">adjustments have been correctly implemented.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={Crossen, Sophia}, year={2017}, month={May} }