Upcycling: Bringing new life to existing health data

From the Health Affairs Blog:

By now, most of us are familiar with recycling. Items with reclaimable value are collected; then base materials are salvaged to create new products—often of lesser quality.

Fewer people are familiar with the term upcycling, a form of recycling that involves reconceiving, and sometimes adding to, existing items with the goal of giving them a different purpose and higher value. Though the term may be unfamiliar, the concept is old. A hundred years ago, farm families upcycled feed sacks into dresses, and old doors into furniture. The fleece jackets we now see everywhere, often made from reclaimed plastic bottles, are a modern example of upcycling.

In the world of health care data, too, opportunities exist to upcycle by adding to and repurposing existing information. It makes good sense to leverage investments in data collection, many of which have already been made for other reasons, such as public health surveillance and provider billing: doing so reduces data collection and cost burdens. The California HealthCare Foundation, based in Oakland, is actively pursuing data-upcycling initiatives as part of its mission to make useful information about health care quality publicly available. Two such efforts are highlighted below.

Maternity Care Data
More than 500,000 California women give birth each year; yet little information exists to guide decisions about where to seek high-quality maternity care. Providers themselves often lack information about their own performance. To help fill this gap, the California Maternal Data Center was launched in 2012 (it is cofunded by the California HealthCare Foundation and the Centers for Disease Control and Prevention and operated by the California Maternal Quality Care Collaborative). By repurposing data that hospitals and the state government have long collected, it provides metrics on the quality of maternity care. The California Maternal Data Center links birth certificate data (for example, birth weight, delivering provider) with information included in patient discharge data (for example, diagnostic and procedure codes related to the birth) that hospitals are already required to submit to the state.

With this combination of data, the center is able to produce robust measures, such as rates of cesarean sections, episiotomies, and vaginal birth after C-section, on all California hospitals providing maternity care. With a small amount of additional work, hospitals can voluntarily submit additional data elements from targeted medical chart reviews (that is, reviews of a subset of charts identified by the California Maternal Data Center to be most relevant) to generate other measures, such as elective delivery before thirty-nine weeks. Many participating hospitals are using the center’s data to facilitate quality improvement, and plans are under way to support public reporting at the hospital and physician-practice levels.

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