Overall Accomplishments and Barriers

In 2019, the State Health Officer created the Offices of Health Data, Operations and Research (HDOR), which includes: Data Governance; EPIC (electronic health record); Health Data and Research (non-communicable disease epidemiology); Information Technology Operations; Information Technology Security; Information Technology Support; Revenue Cycle; and Vital Records and Statistics. This reorganization and expansion reflect the more complex and varied work of MSDH and the need for greater data capacity and support to existing and new program areas.

With the creation of HDOR, the Title V Director, MCH program staff, OHDR and SSDI staff have expanded and maintained a productive partnership dedicated to supporting MCH programs. Data Governance has established processes for requesting and sharing data. A renewed partnership with the Office of Vital Records and Statistics has enabled better data sharing of the critical data needed for many of the MCH programs. Many of the legacy data systems in Health Services have been replaced by EPIC. This transition allows MSDH to have a singular, unified electronic health record for individuals that MSDH serves across the agency. Data can then be pulled for surveillance and program reports. The Revenue Cycle and EPIC teams also assisted in further strengthening the relationship with the Mississippi Division of Medicaid by implementing UView, a state-of-the-art chart review platform within the agency’s electronic medical record system, EPIC. The Revenue Cycle and EPIC staff were able to improve the quality and functional use of maternal and child health records at MSDH and to better partner with data exchange with the Division of Medicaid.

The SSDI funding continues to provide software, hardware, and professional development opportunities for analysts and staff in OHDR to advance data capacity. MSDH continues to make modernization, data accessibility and collaborative evidence-based approaches a focus of efforts to enhance the capacity to obtain and use critical maternal and child health data in Mississippi.

Goals and Activities

Goal 1: Build and expand state MCH data capacity to support the Title V MCH Block Grant program activities and contribute to data-driven decision making in MCH programs, including assessment, planning, implementation, and evaluation

SSDI supports the building of Mississippi MCH data capacity to support Title V program efforts and contributes to data driven decision making in public health and clinical programs. This includes needs assessment and Title V MCH Block Grant data support, identification of structural and process measures for Title V program and supporting MCH programs to develop State Performance Measures (SPMs) to address priority needs. To meet this goal, the agency focused on the following activities:

• Provide data support to MCH programs;
• Provide data support for the Title V Block Grant application and reporting processes;
• Develop/review structural/process measures;
• Implement a statewide Needs Assessment for the Title V Block Grant;
• Establish/review performance objectives for all measures; and
• Provide data and technical support for timely and accurate submission of the Title V MCH Block Grant.

Activities in the previous year focused on implementing and analyzing the Title V Needs Assessment, identifying priority needs, selecting national performance measures (NPMs) and state performance measures (SPMs), developing Evidence-based Measures (ESMs), and expanding partnerships with community public health, clinical, family, patient, and academic partners.

The 2020 Title V Maternal and Child Health Comprehensive Needs Assessment collected and captured vital perceptions of mothers, providers, adolescents, children, children and youth with special health care needs and their families. The surveys, key informant interviews, and information from focus groups allowed MSDH to have a general picture of the disparities and needs across MCH populations in the state. These data informed MSDH’s efforts to adjust and realign its MCH priorities to compensate for shifting population and resource needs and create new state MCH priorities.

The MCH/SSDI leadership and partners identified state priorities not addressed by the existing Title V NPMs. MCH/SSDI epidemiologists and program managers assisted MCH program staff in revising the existing NPMs, developing new SPMs and ESMs to align with new priorities. MCH/SSDI epidemiologists also provided epidemiological and statistical support for MCH programs to establish SMART performance objectives for all the MCH Block Grant measures. After finalizing the objectives, MCH/SSDI epidemiologists and program managers recommended the objectives to the State Title V Director for inclusion in the MCH Block Grant.

During the previous grant cycle, the Title V/SSDI workgroup convened to review their existing ESMs and develop new ESMs or revise the current ESMs based on their capacity. Through several meetings, Title V/SSDI work group and partners decided to retire some of the existing ESMs, and proposed new ESMs based on 2020 need assessments results. The current ESMs are being reviewed to assess fit for NPMs and determine if the ESMs align with program priorities and staff capacity.

The Title V/SSDI workgroup provided epidemiological and statistical support for MCH programs to establish SMART performance objectives for all the MCH Block Grant measures. This involved: reviewing recent Mississippi trend data and comparing to Healthy People 2020 objectives, where available. If no Healthy People 2020 objective was available for a specific measure, 1.0% annual relative growth compared to the previous year was determined as a target. After finalizing the objectives, Title V/SSDI epidemiologist and programs’ director recommended the objectives to the State Title V Director for inclusion in the MCH Block Grant.

Goal 2: Advance the development and utilization of linked information systems between key MCH datasets in the state

During previous grant cycles, the agency was able to renew existing MOUs with the Division of Medicaid, expand internal partnerships with the Office of Vital Records and Statistics for the linkage of birth records and program data such as lead poisoning prevention, newborn screening and maternal mortality data, and PRAMS to access essential data about women before, during and just after pregnancy. For the current grant cycle, Health Services will continue to focus on improving its collaboration with internal and external partners. The goals are to identify existing data gaps to meet the Minimum or Core Datasets (M/CDS), initiate all necessary MOUs to close data gaps and access the data elements necessary to meet the M/CDS, and to implement a new data linkage between birth and death records and hospital discharge data or Medicaid eligibility data; and improve the availability and timeliness of linked MCH data reporting and the utilization.

In previous years, the SSDI epidemiologists supported efforts to obtain access, and make available, minimum or core datasets (M/CDS) through various sources. Many of these indicators are utilized, as needed, for the Title V Needs Assessment and various reporting activities. To meet M/CDS, an assessment to evaluate Mississippi’s capacity for reporting on the M/C Indicators was conducted. Much of the data are captured through the Office of Vital Statistics and the Mississippi Department of Medicaid, the two major stakeholders of the MCH programs. To expand SSDI partnerships with the Office of Vital Statistics, no MOU was required. However, to capture data from Department of Medicaid renewing the existing MOU was needed, which has been concluded. For the coming year, SSDI/MCH epidemiologists will continue to analyze both unlinked and linked data sets as needed to support programmatic efforts. MSDH will maintain the data sharing agreement with the Division of Medicaid and increase collaboration with internal and external partners to assess data gaps.

Goal 3: Support program evaluation activities around the National Performance Measures that contribute to building the evidence base for the Title V MCH Block Grant program

Evaluation is an essential part of the evidenced-based public health evaluation process. Health Services and OHDR recognize the need to create and implement proper tools to effectively evaluate MCH programs. Through performance measurement, Title V/SSDI epidemiologists can collect valuable data that can help improve MCH service delivery and client results. However, performance measurement data cannot necessarily answer all questions about how a program is working or how results were achieved. The MCH program staff and epidemiologists track, monitor, and measure programs’ activities and effectiveness.

In the previous year, the SSDI epidemiologist and State Title V Director worked to develop and implement data collection methods to monitor and evaluate MCH program activities (impact evaluation) more effectively. The first phase of development involved utilizing a tool from the Colorado Department of Health to quarterly monitor and track MCH program activities. The reports are submitted quarterly by programs and provide a detailed description of program activities. The spreadsheet was developed to assist programs with the collection of data to determine impact of programmatic activities. This tool allowed Title V workgroup to track, monitor and evaluate activities around the NPMs that contribute to building the evidence base for the Title V MCH Block Grant program. This evaluation tool is no longer in use, but we recognize the importance of conducting ongoing assessment activities as well as provide an understanding of how to evaluate progress made towards performance measures, identify new and emerging issues, and examine the state’s capacity to implement MCH programs. The MCH epidemiologists and SSDI epidemiologist will continue to meet with MCH program staff and track and monitor the status of each activity pertaining to each NPM and SPM within MCH programs.