Why is ACNM working on a new data collection project?
ACNM members and leadership have had a strong commitment to data collection for many years, and in 1997 began the ACNM Benchmarking Project which has grown considerably in recent years. The growth of the Benchmarking Project is impressive, and the imperative for quality measurement is building. This project will allow improvements in the way data is collected for Benchmarking and for other projects. It's critical that ACNM invest in infrastructure to improve the quality of outcomes reporting by CNMs and CMs to fully leverage the opportunities in our evolving health care system. These opportunities include participating in quality improvement initiatives, developing new evidence to guide practice and shared decision making, taking advantage of new payment models that reward high-quality, high-value care, and meeting reporting requirements.
How is this project different from the ACNM Benchmarking Project?
The ACNM Benchmarking Project relies on aggregate data-totals and rates describing a practice's caseload for an entire year. With this project, ACNM is moving toward so-called "patient-level" data collection, that is, data that are collected and contributed one woman at a time. Like the ACNM Benchmarking Project, patient-level data can support quality improvement initiatives. However, patient-level data have many more potential uses.
How does ACNM plan to use the data?
ACNM plans to use the data to support members' quality improvement/quality assurance activities, midwifery research, and ACNM's advocacy efforts, including efforts to improve access to and payment for midwifery care. ACNM is exploring further use of the data to report to state and federal performance reporting programs.
How is ACNM partnering with other organizations on this project?
ACNM has chosen a vendor, Maternity Neighborhood, that already hosts the American Association of Birth Centers Perinatal Data Registry. The goal is to enable data to flow simultaneously into both data sets, and to develop data standards that enable research studies across birth settings and practice models. Discussions are underway to enable exchange and aggregation of data with MANAStats via the Maternity Neighborhood platform, as well.
The first stage of the project was enabled by matching funding from the American Midwifery Certification Board (AMCB) with an aim of extending the reach of registry participation beyond ACNM members and providing a more accurate "data picture" of midwifery in the United States.
ACNM is also participating with multiple professional societies and stakeholders in the ACOG-sponsored Women's Health Registry Alliance, working with a common mission to "improve women's health outcomes through collaboration in use and development of multiple databases and registries." Finally, ACNM has joined the Obstetric Health Information Initiative, sponsored by the Society of Maternal-Fetal Medicine, to work toward common standards for data and clinical content in electronic health records (EHRs).
What is the Maternity Neighborhood?
Maternity Neighborhood is a mission-driven digital health company working to improve maternity care. Co-founded by a midwife, the company launched its first product, the Private Practice EHR in 2011, which won recognition as one of the top 50 Health IT innovations in 2012 by the Institute of Medicine. In addition to developing a growing suite of products to support clinical care and practice management, Maternity Neighborhood has developed a secure data platform to enable partners to share data for multiple uses, including research and quality improvement. In 2013, the company contracted to become the technology partner for the American Association of Birth Centers "Strong Start" grant from the Centers for Medicare & Medicaid Services (CMS), and migrated AABC's Perinatal Data Registry (PDR) to the platform.
Also in 2013, Maternity Neighborhood completed a Technology Development Plan for patient-level data collection, storage, and analysis of outcomes by Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs). The 3-month project involved key informant interviews with internal and external stakeholders; a survey of the ACNM membership exploring attitudes about and use of health IT and participation in data collection; analysis of relevant research, reports, legislation, and commentaries to identify trends and factors in the broader landscape; and a day-long workshop with ACNM leaders. The Technology Development Plan is available at http://www.midwife.org/Future-Midwifery-Data-Collection. Interested members can learn more about Maternity Neighborhood at www.maternityneighborhood.com.
What about privacy and data security?
ACNM chose Maternity Neighborhood in part because their data platform already meets stringent federal standards for health care data security. ACNM and Maternity Neighborhood are currently evaluating best practice for additional privacy and security requirements for the various potential uses of registry data, including quality reporting, querying, and research uses. ACNM and Maternity Neighborhood will implement protections, policies, and a governance structure that protect ACNM, the clinicians participating in the registry, and, most importantly, the women and babies contributing their data.
Will I need to use a specific EHR or buy products from Maternity Neighborhood to contribute data to ACNM?
No. Maternity Neighborhood will host the registry and provide other services to ACNM, but midwives will not be required to purchase anything from Maternity Neighborhood in order to participate. The registry will eventually be able to accept data directly from EHRs and other digital tools, including but not limited to products developed by Maternity Neighborhood.
When will the ACNM data registry be ready to use?
Achieving the vision of the 2013 Technical Development Strategy will be a long-term, multi-year endeavor. We expect the project to continue to evolve based on the changing landscape and the ability to leverage other projects undertaken on the Maternity Neighborhood platform, which complement ACNM's project and help to reduce our overall cost, while also enhancing interoperability between midwifery data collection systems. ACNM is currently engaged in the first phase of work with Maternity Neighborhood, which involves designing the data collection and analytics workflows, establishing standards for data definitions and attribution, and other critical groundwork.
How can I learn more about this during the Annual Meeting?
Interested members can learn more at the Maternity Neighborhood Exhibit Hall booth #203 during exhibit hours, or at the session, "The National Quality Movement and Midwifery: Get on the Bus or be Left Behind" on Thursday May 15, 1:00 - 2:00PM in Governor's Square 14. Anyone interested in midwifery data collection is also invited to join Maternity Neighborhood staff for an informal gathering at a local Mexican restaurant on Wednesday evening, May 14. Conference attendees can come by the Maternity Neighborhood exhibit booth for details.