Roles of State Agencies
The New York Department of Health manages several initiatives under the aegis of the Center for Consumer Health Care Information, which went live in August 2001. In December 2001, the NY State Health Department was awarded a four-year federal grant from AHRQ totaling $5.4 million to support its ongoing hospital patient safety improvement efforts, known as the New York State Safety Improvement Demonstration Project (Grant Number: U18 HS11880). Support extended from September 30, 2001 through August 31, 2005.
- • New York Patient Occurence And Tracking System (NYPORTS)
NYPORTS is an adverse event reporting system implemented pursuant to New York State Public Health Law (Article 28) Section 2805-l, Incident Reporting. As detailed in the Annual Report 1999, the NYPORTS system was developed by a statewide workgroup of industry experts and multiple actively-practicing health care professionals and quality assurance and risk management professionals. The Department participated on the group and provided the necessary support to carry out development and implementation activities. The statewide hospital association and its regional affiliates also participated in development and implementation in support of the group's activities. A statewide roll-out of the system occurred in April 1998.
- • Licensing Agency investigations – Department of Health
The New York State Department of Health (DOH) is the regulatory agency with licensure and regulatory control over medical facilities, and it plays a significant supportive role in support of the NYPORTS and Cardiac Surgery Reporting System (CSRS) programs, which publish annual risk-adjusted outcomes for cardiac surgery and percutaneous coronary interventions (PCIs).
The regulatory tenor of the New York program is established by DOH Commissioner Antonia C. Novello, who on occasion has issued threats of severe sanctions to healthcare facilities for failure to report to NYPORTS. Examples include a February 13, 2001 directive to Hospital administrators and an excerpt appearing in peer review [Health Affairs, p. 287, May/June 2001] in which she indicated that
"For those hospitals that have ignored these critical reporting requirements, we will identify you, single you out and sanction you in a public forum."
The DOH has a history of active intervention in response to reports of perceived poor performance in healthcare. [Chassin MR, "Achieving And Sustaining Improved Quality: Lessons From New York State And Cardiac Surgery," (July/August 2002) 21 (2): 40-51. [PDF]
- • Statewide Planning and Research Cooperative System (SPARCS)
SPARCS is a comprehensive patient data system established in 1979 as a result of cooperation between the health care industry and government. In April 1983 and June 1985, the State Hospital Review and Planning Council adopted additional regulations regarding the reporting of ambulatory surgery data to the New York State Department of Health. The authority for SPARCS is provided in Section 400.18 of Title 10 (Health) of the Official Compilation of Codes, Rules, and Regulations of the State of New York (NYCRR), with additional specifications for Outpatient Ambulatory Surgery in Section 755.10 and Ambulatory Surgery Definition in Section 755.1. The regulations require that inpatient data be submitted by all Article 28 facilities certified for inpatient and that outpatient data be submitted by all hospital-based ambulatory surgery services and all other facilities providing ambulatory surgery services. All data has to be submitted according to a designated format and schedule. In April 1993, a Universal Data Set task force released a new UDS specification which included reporting codes for use with the UB-92 paper form and a new electronic format. The resulting system streamlined multiple data submission formats into a single format, removing redundant reporting requirements for hospitals and other health care facilities
The SPARCS data is currently used by the Niagara Health Quality Coalition (NHQC) for the outcomes of the AHRQ Inpatient Quality Indicators that provides hospital comparisons in a report-card format for 25 of the 34 identified Inpatient Quality Indicators. These IQIs are published on the website for the Alliance for Quality Health Care (AQHC).