The use of big data is revolutionizing many industries, although as with many things having to do with information technology, health care as an industry has been relatively slow in using big data. Perhaps nowhere is this more evident than in maternity care.
Pregnancy and delivery are the most common reasons for hospital admissions in California and the nation. Notwithstanding improvements in maternity outcomes and infant mortality rates in recent decades, increasing concerns have been voiced in recent years about the high and highly variable rates of early elective deliveries and Cesarean sections (C-sections), and the costs and complications associated with these procedures.
Large health care data sets are available within various state agencies that can provide a better understanding about opportunities for quality improvement (QI), but barriers to accessing those data have prevented researchers from using them to their full potential. Better methods and systems are needed to access, use, and disseminate available data so that, among other things, they can be used to support clinical decision-making and better align performance measures and payment models with care delivery.
Medi-Cal is the largest single payer for maternity care in California, covering more than half of the state’s deliveries. As such, it would seem evident that evaluating Medi-Cal claims data would hold great potential for identifying opportunities for improving the quality and efficiency of maternity care for hundreds of thousands of Californians each year.
With the above in mind, on June 19-20, 2014, the Institute for Population Health Improvement (IPHI), UC Davis Health System, in collaboration with the California Department of Health Care Services (DHCS) and the California Health Care Foundation (CHCF), convened a symposium to explore ways to improve the quality of maternity care in California through better use of Medi-Cal and other data. A diverse group of approximately 150 individuals came together for the two-day symposium, Using Data to Improve Maternity Care in California: Research Collaborations and Future Opportunities (see Appendix for the agenda). Attendees included persons who create, manage, and use data, including consumers, providers, researchers, health plans, and state and local health agency staff.
This report highlights in summary form many of the issues raised at the symposium, including comments by invited panelists and presenters and comments from attendees that were made during breakout discussions and question and answer sessions.