Improve Identification and Data Collection for NAS - Revision history

BasilSavitsky: /* Available Tools and Resources */

2024-12-11T21:15:23Z

Available Tools and Resources

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	=Available Tools and Resources=		=Available Tools and Resources=

	'''SAFE Project:'''		'''SAFE Project.''' See the wiki titled "Improve Data Sharing, Analysis, and Monitoring" for more detailed information on the improvement of data collection/analysis to fight the substance use crisis. <ref>https://www.yoursafesolutions.us/wiki/Improve_Data_Sharing,_Analysis,_and_Monitoring/</ref>
	*See the wiki titled "Improve Data Sharing, Analysis, and Monitoring" for more detailed information on the improvement of data collection/analysis to fight the substance use crisis.<ref>https://www.yoursafesolutions.us/wiki/Improve_Data_Sharing,_Analysis,_and_Monitoring/</ref>

	'''The World Health Organization''' has published "Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy." It includes methods of data collection and analysis. <ref>http://apps.who.int/iris/bitstream/handle/10665/107130/9789241548731_eng.pdf;jsessionid=55AE69AD37E7</ref>		'''The World Health Organization''' has published "Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy." It includes methods of data collection and analysis. <ref>http://apps.who.int/iris/bitstream/handle/10665/107130/9789241548731_eng.pdf;jsessionid=55AE69AD37E7</ref>

BasilSavitsky: /* Promising Practices */

2024-12-11T21:14:47Z

Promising Practices

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	'''Kentucky''' established the Public Health Neonatal Abstinence Syndrome Reporting Registry. Their work documents prevention strategies and provides evidence of declining rates of NAS. <ref>https://chfs.ky.gov/agencies/dph/dmch/Documents/NASReport.pdf</ref>		'''Kentucky''' established the Public Health Neonatal Abstinence Syndrome Reporting Registry. Their work documents prevention strategies and provides evidence of declining rates of NAS. <ref>https://chfs.ky.gov/agencies/dph/dmch/Documents/NASReport.pdf</ref>

	'''Missouri Hospital Association.''' After the identification of a possible gap in the ability to accurately measure prevalence of NAS in Missouri, five strategies were developed to improve data capture of NAS and related maternal substance ~~abuse~~ by practitioners, clinical documentation specialists, and medical coding specialists. <ref>https://www.mhanet.com/mhaimages/sqi/brief/issue%20brief_triple%20aim_NAS_0918.pdf</ref>		'''Missouri Hospital Association.''' After the identification of a possible gap in the ability to accurately measure prevalence of NAS in Missouri, five strategies were developed to improve data capture of NAS and related maternal substance use by practitioners, clinical documentation specialists, and medical coding specialists. <ref>https://www.mhanet.com/mhaimages/sqi/brief/issue%20brief_triple%20aim_NAS_0918.pdf</ref>

	= <span style="background-color: #ffffff">Sources</span> =		= <span style="background-color: #ffffff">Sources</span> =

BasilSavitsky: /* Impactful Federal, State, and Local Policies */

2024-11-30T19:06:45Z

Impactful Federal, State, and Local Policies

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	= Impactful Federal, State, and Local Policies =		= Impactful Federal, State, and Local Policies =

	'''Protecting Our Infants Act of 2015 (POIA)''' addresses problems related to prenatal opioid exposure. It called for HHS to review planning and coordination of HHS activities related to prenatal opioid exposure and NAS and to study and develop recommendations for the prevention, identification, and treatment of NAS as well as the treatment of opioid use disorder in pregnant ~~women~~. <ref>https://aspe.hhs.gov/reports/status-report-protecting-our-infants-act-implementation-plan-0#:~:text=IMPLEMENTATION%20STATUS%20OVERVIEW%20%20%20%20Recommendation%20Category,%20%20100%25%20%201%20more%20rows%20</ref>		'''Protecting Our Infants Act of 2015 (POIA)''' addresses problems related to prenatal opioid exposure. It called for HHS to review planning and coordination of HHS activities related to prenatal opioid exposure and NAS and to study and develop recommendations for the prevention, identification, and treatment of NAS as well as the treatment of opioid use disorder in pregnant people. <ref>https://aspe.hhs.gov/reports/status-report-protecting-our-infants-act-implementation-plan-0#:~:text=IMPLEMENTATION%20STATUS%20OVERVIEW%20%20%20%20Recommendation%20Category,%20%20100%25%20%201%20more%20rows%20</ref>

	'''The 2022 National Drug Control Strategy''' calls for developing a data plan and a consolidated database. One major source of administrative data within the data strategy includes the Healthcare Cost and Utilization Project (HCUP) on records of emergency department admissions and inpatient hospital stays from participating states compiled by the Agency for Healthcare Quality and Research (AHRQ). It provide data on drug overdoses and NAS. <ref>https://www.whitehouse.gov/wp-content/uploads/2022/04/National-Drug-Control-2022Strategy.pdf</ref>		'''The 2022 National Drug Control Strategy''' calls for developing a data plan and a consolidated database. One major source of administrative data within the data strategy includes the Healthcare Cost and Utilization Project (HCUP) on records of emergency department admissions and inpatient hospital stays from participating states compiled by the Agency for Healthcare Quality and Research (AHRQ). It provide data on drug overdoses and NAS. <ref>https://www.whitehouse.gov/wp-content/uploads/2022/04/National-Drug-Control-2022Strategy.pdf</ref>

Charliekapinos: /* Available Tools and Resources */

2024-10-23T19:55:57Z

Available Tools and Resources

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	=Available Tools and Resources=		=Available Tools and Resources=

			'''SAFE Project:'''
			*See the wiki titled "Improve Data Sharing, Analysis, and Monitoring" for more detailed information on the improvement of data collection/analysis to fight the substance use crisis.<ref>https://www.yoursafesolutions.us/wiki/Improve_Data_Sharing,_Analysis,_and_Monitoring/</ref>

	'''The World Health Organization''' has published "Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy." It includes methods of data collection and analysis. <ref>http://apps.who.int/iris/bitstream/handle/10665/107130/9789241548731_eng.pdf;jsessionid=55AE69AD37E7</ref>		'''The World Health Organization''' has published "Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy." It includes methods of data collection and analysis. <ref>http://apps.who.int/iris/bitstream/handle/10665/107130/9789241548731_eng.pdf;jsessionid=55AE69AD37E7</ref>

BasilSavitsky: /* Available Tools and Resources */

2024-07-04T18:56:15Z

Available Tools and Resources

← Older revision		Revision as of 11:56, 4 July 2024
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	'''The Center for Health Care Strategies (CHCS)''' published "Data-Sharing Considerations for State Public Health Departments and Medicaid Agencies." This is a useful technical assistance brief that offers considerations, tips, and best practices to facilitate data sharing to support Medicaid-public health partnerships. It provides examples of jurisdictions that have set up effective data-sharing arrangements. <ref>http://www.618resources.chcs.org/wp-content/uploads/618-Data-Sharing-Resource-12.2.20.pdf</ref>		'''The Center for Health Care Strategies (CHCS)''' published "Data-Sharing Considerations for State Public Health Departments and Medicaid Agencies." This is a useful technical assistance brief that offers considerations, tips, and best practices to facilitate data sharing to support Medicaid-public health partnerships. It provides examples of jurisdictions that have set up effective data-sharing arrangements. <ref>http://www.618resources.chcs.org/wp-content/uploads/618-Data-Sharing-Resource-12.2.20.pdf</ref>

	'''EMI Advisors''' provides a dashboard for NAS ~~that~~ includes a data element tool (DET). <ref>https://www.emiadvisors.net/nas-det-dashboard</ref>		'''EMI Advisors''' provides a dashboard for NAS which includes a data element tool (DET). <ref>https://www.emiadvisors.net/nas-det-dashboard</ref>

	'''Registries for Evaluating Patient Outcomes: A User's Guide.''' While not specific to NAS, this guide is useful to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. <ref>https://www.ncbi.nlm.nih.gov/books/NBK208616/</ref>		'''Registries for Evaluating Patient Outcomes: A User's Guide.''' While not specific to NAS, this guide is useful to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. <ref>https://www.ncbi.nlm.nih.gov/books/NBK208616/</ref>

BasilSavitsky: /* Impactful Federal, State, and Local Policies */

2024-07-04T18:54:31Z

Impactful Federal, State, and Local Policies

← Older revision		Revision as of 11:54, 4 July 2024
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	'''The 2022 National Drug Control Strategy''' calls for developing a data plan and a consolidated database. One major source of administrative data within the data strategy includes the Healthcare Cost and Utilization Project (HCUP) on records of emergency department admissions and inpatient hospital stays from participating states compiled by the Agency for Healthcare Quality and Research (AHRQ). It provide data on drug overdoses and NAS. <ref>https://www.whitehouse.gov/wp-content/uploads/2022/04/National-Drug-Control-2022Strategy.pdf</ref>		'''The 2022 National Drug Control Strategy''' calls for developing a data plan and a consolidated database. One major source of administrative data within the data strategy includes the Healthcare Cost and Utilization Project (HCUP) on records of emergency department admissions and inpatient hospital stays from participating states compiled by the Agency for Healthcare Quality and Research (AHRQ). It provide data on drug overdoses and NAS. <ref>https://www.whitehouse.gov/wp-content/uploads/2022/04/National-Drug-Control-2022Strategy.pdf</ref>

	'''Indiana State Department of Health (ISDH)''' In response to the high rate of opioid prescriptions, the Indiana General Assembly charged ISDH to: develop a standard clinical definition of NAS and a standardized process of identifying it, identify the resources hospitals need to do this, and then establish a voluntary pilot program with hospitals to implement this standardized NAS identification. In 2016, 26 of 89 Indiana Birthing Hospitals took part in this pilot screening program. ISDH noted that universal screening in a non-punitive environment would allow us to understand the true prevalence of perinatal substance use and NAS. ISDH) established a task force which provided a standard clinical definition of NAS, stating that the infant must be symptomatic, have two or three consecutive modified Finnegan scores equal to or greater than a total of 24, and either a positive toxicology test OR		'''Indiana State Department of Health (ISDH).''' In response to the high rate of opioid prescriptions, the Indiana General Assembly charged ISDH to: develop a standard clinical definition of NAS and a standardized process of identifying it, identify the resources hospitals need to do this, and then establish a voluntary pilot program with hospitals to implement this standardized NAS identification. In 2016, 26 of 89 Indiana Birthing Hospitals took part in this pilot screening program. ISDH noted that universal screening in a non-punitive environment would allow us to understand the true prevalence of perinatal substance use and NAS. ISDH established a task force which provided a standard clinical definition of NAS, stating that the infant must be symptomatic, have two or three consecutive modified Finnegan scores equal to or greater than a total of 24, and either a positive toxicology test OR a maternal history with a positive verbal screen or toxicology test. <ref>https://www.in.gov/children/files/cisc-2015-0218-Infant-NAS-_Final-_Report.pdf</ref>
	a maternal history with a positive verbal screen or toxicology test. <ref>https://www.in.gov/children/files/cisc-2015-0218-Infant-NAS-_Final-_Report.pdf</ref>

	=Available Tools and Resources=		=Available Tools and Resources=

BasilSavitsky: /* Relevant Research */

2024-07-04T18:51:54Z

Relevant Research

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	* This article documents a study in which the predictive value of an algorithm was used to identify cases of NAS using administrative Medicaid claims data. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6317565/</ref>		* This article documents a study in which the predictive value of an algorithm was used to identify cases of NAS using administrative Medicaid claims data. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6317565/</ref>

	* This article summarizes a study ~~that~~ was performed using publicly available information regarding NAS surveillance activities and definitions. Since current clinical case definitions use different combinations of clinician-observed signs of withdrawal and evidence of perinatal substance exposure, there is discordance in diagnosis codes used in surveillance definitions. This summary provides an understanding of the different clinical case and surveillance definitions ~~that~~ are used across the United States. <ref> Standardization of State Definitions for Neonatal Abstinence Syndrome Surveillance and the Opioid Crisis, retrieved at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687235/</ref>		* This article summarizes a study which was performed using publicly available information regarding NAS surveillance activities and definitions. Since current clinical case definitions use different combinations of clinician-observed signs of withdrawal and evidence of perinatal substance exposure, there is discordance in diagnosis codes used in surveillance definitions. This summary provides an understanding of the different clinical case and surveillance definitions which are used across the United States. <ref> Standardization of State Definitions for Neonatal Abstinence Syndrome Surveillance and the Opioid Crisis, retrieved at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687235/</ref>

	= Impactful Federal, State, and Local Policies =		= Impactful Federal, State, and Local Policies =

BasilSavitsky: /* Key Information */

2024-07-04T18:50:09Z

Key Information

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	= Key Information =		= Key Information =

	The Association of State and Territorial Health Officials (ASTHO) <ref>https://www.astho.org/</ref> has published guidance for standards ~~and consideration~~ for health agencies to improve current NAS surveillance. The document titled, ''Strengthening Health Agencies' Neonatal Abstinence Syndrome Surveillance through Consensus Data and Standards,'' includes the following key components for agencies to improve NAS data collection and surveillance: <ref>https://www.astho.org/globalassets/pdf/strengthening-health-agencies-nas-surveillance-through-consensus-driven-data-standards-practices.pdf</ref>		The Association of State and Territorial Health Officials (ASTHO) <ref>https://www.astho.org/</ref> has published guidance for standards for health agencies to improve current NAS surveillance. The document titled, ''Strengthening Health Agencies' Neonatal Abstinence Syndrome Surveillance through Consensus Data and Standards,'' includes the following key components for agencies to improve NAS data collection and surveillance: <ref>https://www.astho.org/globalassets/pdf/strengthening-health-agencies-nas-surveillance-through-consensus-driven-data-standards-practices.pdf</ref>
	*Understand the landscape of NAS surveillance capacity.		*Understand the landscape of NAS surveillance capacity.
	*Enhance utility of Medicaid protocols		*Enhance utility of Medicaid protocols
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	*Achieve consensus		*Achieve consensus

	'''Understand the Landscape.''' This involves documentation of how state and territory health agencies currently collect NAS data and conduct surveillance. This first step ~~was~~ advanced in the ASTHO report ~~and~~ is foundational to the identification of gaps in standards. Nationally standardized definitions of data and standardized diagnosis codes will improve reporting~~, collaboration, strategies~~ and interventions ~~for NAS~~. In 2019, the Council of State and Territorial Epidemiologists (CSTE) proposed a nationally standardized case definition to capture surveillance measures across jurisdictions to inform clinical and public health treatment and prevention efforts. Some of the states surveyed in the ASTHO report are using these standards while other states are using ICD-9 (779.5) and ICD-10 (P96.1) codes.		'''Understand the Landscape.''' This involves documentation of how state and territory health agencies currently collect NAS data and conduct surveillance. This first step advanced in the ASTHO report is foundational to the identification of gaps in standards. Nationally standardized definitions of data and standardized diagnosis codes will improve collaboration and NAS reporting and interventions. In 2019, the Council of State and Territorial Epidemiologists (CSTE) proposed a nationally standardized case definition to capture surveillance measures across jurisdictions to inform clinical and public health treatment and prevention efforts. Some of the states surveyed in the ASTHO report are using these standards while other states are using ICD-9 (779.5) and ICD-10 (P96.1) codes.

	'''Enhance Utility of Medicaid Protocols.''' This involves expanding Medicaid’s capacity to use NAS data. It also involves improvement of data sharing between public health and Medicaid.		'''Enhance Utility of Medicaid Protocols.''' This involves expanding Medicaid’s capacity to use NAS data. It also involves improvement of data sharing between public health agencies and Medicaid.

	'''Build a Registry for NAS.''' This will ~~provide~~ collaboration in data ~~collected~~ and provide standard information across the country. Steps to build a registry include: <ref>https://www.astho.org/globalassets/pdf/strengthening-health-agencies-nas-surveillance-through-consensus-driven-data-standards-practices.pdf</ref>		'''Build a Registry for NAS.''' This will promote collaboration in collecting data and provide standard information across the country. Steps to build a registry include: <ref>https://www.astho.org/globalassets/pdf/strengthening-health-agencies-nas-surveillance-through-consensus-driven-data-standards-practices.pdf</ref>
	*Identify a purpose.		*Identify the purpose.
	*Determine if a registry is an appropriate means to achieve the purpose.		*Determine if a registry is an appropriate means to achieve the purpose.
	*Identify key stakeholders and how they have used or interacted with registries for other conditions.		*Identify key stakeholders and how they have used or interacted with registries for other conditions.

BasilSavitsky: /* Introductory Paragraph */

2024-07-04T18:40:45Z

Introductory Paragraph

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	=Introductory Paragraph=		=Introductory Paragraph=
	One of the biggest challenges of addressing ~~neonatal abstinence syndrome~~ (NAS) is that it is not consistently identified, and collection of data and reporting is inconsistent. ~~A standardized~~ data collection and surveillance in all states and territories would improve the ability to guide public health strategies and interventions.		One of the biggest challenges of addressing Neonatal Abstinence Syndrome (NAS) is that it is not consistently identified, and collection of data and reporting is inconsistent. Standardized data collection and surveillance in all states and territories would improve the ability to guide public health strategies and interventions.

	= Key Information =		= Key Information =

BasilSavitsky: /* Promising Practices */

2023-12-25T22:03:22Z

Promising Practices

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	=Promising Practices=		=Promising Practices=

	'''The Florida Perinatal Quality Collaborative- NAS ~~Initiative: Key~~ drivers of change~~'''~~<ref>https://health.usf.edu/-/media/Files/Public-Health/Chiles-Center/FPQC/MORE-Webinar-DataCollection-Dec2019.ashx?la=en&hash=99CA53B2C91E9D8425A4908FE96B7CA02C2D9D2A</ref> ~~A review of the data collection process.~~		'''The Florida Perinatal Quality Collaborative.''' The Maternal Opioid Recovery Effort (MORE) implemented an initiative on NAS that reflects a successful data collection process and key drivers of change. <ref>https://health.usf.edu/-/media/Files/Public-Health/Chiles-Center/FPQC/MORE-Webinar-DataCollection-Dec2019.ashx?la=en&hash=99CA53B2C91E9D8425A4908FE96B7CA02C2D9D2A</ref>

	'''~~Missouri Hospital Association~~''' Neonatal Abstinence Syndrome~~: Guidance to Improve Clinical Documentation~~ and ~~Data Capture- Identifies gaps, challenges and solutions for data capture and documentation~~.<ref>https://~~www~~.~~mhanet~~.~~com~~/~~mhaimages~~/~~sqi~~/~~brief~~/~~issue%20brief_triple%20aim_NAS_0918~~.pdf</ref>		'''Kentucky''' established the Public Health Neonatal Abstinence Syndrome Reporting Registry. Their work documents prevention strategies and provides evidence of declining rates of NAS. <ref>https://chfs.ky.gov/agencies/dph/dmch/Documents/NASReport.pdf</ref>

	'''~~Public Health Neonatal Abstinence Syndrome Reporting Registry~~''' ~~The Kentucky Public Health Neonatal Abstinence Syndrome (~~NAS~~) Reporting Registry received fewer reports~~ of ~~Neonatal Abstinence Syndrome (~~NAS~~) in 2019~~<ref>https://~~chfs~~.ky.~~gov/agencies~~/~~dph~~/~~dmch~~/~~Documents~~/~~NASReport~~.pdf~~</ref>~~		'''Missouri Hospital Association.''' After the identification of a possible gap in the ability to accurately measure prevalence of NAS in Missouri, five strategies were developed to improve data capture of NAS and related maternal substance abuse by practitioners, clinical documentation specialists, and medical coding specialists. <ref>https://www.mhanet.com/mhaimages/sqi/brief/issue%20brief_triple%20aim_NAS_0918.pdf</ref>

	~~'''Georgia Department of Public Health Division of Health Promotion''' NAS Annual Surveillance Report – 2017<ref>https://dph.georgia.gov/document/publication/nas-2017-annual-report/download~~</ref>

	= <span style="background-color: #ffffff">Sources</span> =		= <span style="background-color: #ffffff">Sources</span> =