III.E.2.b.iii. States Systems Development Initiative And Other MCH Capacity Efforts - Maryland - 2022
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Since the mid-1990’s, Maryland’s State Systems Development Initiative (SSDI) Project has focused on the following: improving epidemiologic and data capacity at the State level, strengthening the State’s ability to monitor and report on Title V performance measures and indicators, and improving State and local capacity to assess and prioritize needs, develop annual plans, and monitor program performance.
Maryland has implemented a variety of strategies including recruitment of staff with expertise in epidemiology and database development, identification of data sources and proxy measures for monitoring Title V supported programs, completion of Title V needs assessments, and enhanced collaboration with the Maryland Vital Statistics Administration (VSA) to improve data linkages with surveys and surveillance systems for identification of MCH health disparities and program development.
There have been recent noteworthy developments in achieving the goal of direct, annual access to timely electronic maternal and child health data. First, MDH has continued to use a portion of SSDI funds to support an administrative specialist position at Maryland’s VSA to increase data support capacity within the office. This has resulted in the development and approval of data use agreements (DUA) for annual access to de-identified record level birth and death certificate data to be shared with MCHB’s Office of Quality Initiatives. Receipt of these data in 2018 led to the production of a comprehensive Perinatal Periods of Risk (PPOR) analysis for the years 2010-2016, and the creation of census tract level risk maps to help coordinate and enhance local program design to improve preconception and maternal health across the state. The PPOR analysis and VSA data were also used to create jurisdiction-level Fetal and Infant Mortality Review (FIMR) profiles which continue to inform about fetal and infant deaths, and areas to focus prevention efforts aimed at reducing rates and addressing disparities.
These data have also been used to produce and subsequently update an MCH Indicators Monitoring System and Trend Analysis that was developed to track Maryland’s NOM and NPM data annually by jurisdiction and race. This system and the trend analysis have been shared with MCHB staff to improve awareness and knowledge of progress in these areas. The tracking data system has been presented during the Bureau’s program leads as well as for the development of measures for the Statewide Integrated Health Improvement Strategy with Maryland’s Total Cost of Care. These data were also linked to Birth Defects Reporting and Information System (BDRIS) data to allow for analysis of maternal preconception and prenatal health factors as they relate to birth defects.
The addition of an epidemiologist with SSDI funds supports the analysis of each of these data sources in addition to the Child Fatality Review (CFR) and Maternal Mortality Review (MMR) case review data to further support Title V needs assessment and performance measure reporting. The SSDI epidemiologist also provides data support for the state’s CDC SUID (Sudden Unexplained Infant Death) Case Registry grant, which aims to strengthen public health surveillance of SUID in Maryland through the efforts of the State CFR team.
Planned areas for continued development for the Epidemiology team include: assessing the disparities within the maternal and child health population through data analysis and geographic information system (GIS) mapping; measuring the impact of health conditions and respond to data requests by agency executives, legislators, federal and local partners, and the public; and staying current on best practices through participating in Associations Maternal and Child Health Programs (AMCHP) and CityMatCH events.
Since the mid-1990’s, Maryland’s State Systems Development Initiative (SSDI) Project has focused on the following: improving epidemiologic and data capacity at the State level, strengthening the State’s ability to monitor and report on Title V performance measures and indicators, and improving State and local capacity to assess and prioritize needs, develop annual plans, and monitor program performance.
Maryland has implemented a variety of strategies including recruitment of staff with expertise in epidemiology and database development, identification of data sources and proxy measures for monitoring Title V supported programs, completion of Title V needs assessments, and enhanced collaboration with the Maryland Vital Statistics Administration (VSA) to improve data linkages with surveys and surveillance systems for identification of MCH health disparities and program development.
There have been recent noteworthy developments in achieving the goal of direct, annual access to timely electronic maternal and child health data. First, MDH has continued to use a portion of SSDI funds to support an administrative specialist position at Maryland’s VSA to increase data support capacity within the office. This has resulted in the development and approval of data use agreements (DUA) for annual access to de-identified record level birth and death certificate data to be shared with MCHB’s Office of Quality Initiatives. Receipt of these data in 2018 led to the production of a comprehensive Perinatal Periods of Risk (PPOR) analysis for the years 2010-2016, and the creation of census tract level risk maps to help coordinate and enhance local program design to improve preconception and maternal health across the state. The PPOR analysis and VSA data were also used to create jurisdiction-level Fetal and Infant Mortality Review (FIMR) profiles which continue to inform about fetal and infant deaths, and areas to focus prevention efforts aimed at reducing rates and addressing disparities.
These data have also been used to produce and subsequently update an MCH Indicators Monitoring System and Trend Analysis that was developed to track Maryland’s NOM and NPM data annually by jurisdiction and race. This system and the trend analysis have been shared with MCHB staff to improve awareness and knowledge of progress in these areas. The tracking data system has been presented during the Bureau’s program leads as well as for the development of measures for the Statewide Integrated Health Improvement Strategy with Maryland’s Total Cost of Care. These data were also linked to Birth Defects Reporting and Information System (BDRIS) data to allow for analysis of maternal preconception and prenatal health factors as they relate to birth defects.
The addition of an epidemiologist with SSDI funds supports the analysis of each of these data sources in addition to the Child Fatality Review (CFR) and Maternal Mortality Review (MMR) case review data to further support Title V needs assessment and performance measure reporting. The SSDI epidemiologist also provides data support for the state’s CDC SUID (Sudden Unexplained Infant Death) Case Registry grant, which aims to strengthen public health surveillance of SUID in Maryland through the efforts of the State CFR team.
Planned areas for continued development for the Epidemiology team include: assessing the disparities within the maternal and child health population through data analysis and geographic information system (GIS) mapping; measuring the impact of health conditions and respond to data requests by agency executives, legislators, federal and local partners, and the public; and staying current on best practices through participating in Associations Maternal and Child Health Programs (AMCHP) and CityMatCH events.
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