Annual Performance Plan and Report

Topics on this page: Goal 4. Objective B | Table of Related Performance Measures | Analysis of Results | Plans for the Future | Objective Progress Update Summary

Goal 4. Objective B: Enhance access to and use of data to improve HHS programs and support improvements in the health and well-being of the American people

Transparency and data sharing are of fundamental importance to HHS and its ability to achieve its mission. HHS data and information are used to increase awareness of health and human service issues and to set priorities for improving health and well-being. By making data and information more transparent and more available, HHS promotes public and private sector innovation and action, as well as provides the basis for new products and services that can benefit Americans.

HHS is strongly committed to data security and the protection of personal privacy and confidentiality as a fundamental principle governing the collection and use of data. HHS protects the confidentiality of individually identifiable information in all public data releases, including publication of datasets on the Web. By employing state-of-the-art processes for data prioritization, release, and monitoring, HHS increases the value derived from information in several ways. Consumers are able to access information and benefit directly from using it personally. Public administrators can use these information resources to enhance service delivery and improve customer satisfaction.

Expanded information resources also will bring new transparency to health care to help spark action to improve performance. For example, increased access to health care information can help those discovering and applying scientific knowledge to locate, combine, and share potentially relevant information across disciplines to accelerate progress. It can enhance entrepreneurial value, catalyzing the development of innovative products and services that benefit the public and, in the process of doing so can fuel economic growth through the private sector.

The HHS Data Council coordinates health and human services data collection and includes the following HHS components: ACF, AHRQ, ACL, ASPE, CDC, CMS, FDA, HRSA, IHS, NIH, ONC, OASH, and SAMHSA. All HHS agencies support the access and use of data. Below are performance measures related to use of data to improve health outcomes and well-being. The Office of the Secretary led this Objective’s assessment as a part of the Strategic Review.

Objective 4.B Table of Related Performance Measures

Decrease the number of months required to produce MEPS data files (i.e. point-in-time, utilization and expenditure files) for public dissemination following data collection (MEPS-HC) (Lead Agency - AHRQ; Measure ID - 1.3.21)

Increase the combined count of webpage hits, hits to the locator, and hits to Substance Abuse and Mental Health Data Archive (SAMHDA) for SAMHSA-supported data sets (Lead Agency - SAMHSA; Measure ID - 4.4.10)

Increase the number of strategically relevant data sets published across the Department as part of the Health Data Initiative (Lead Agency - IOS; Measure ID - 1.2)

Increase the electronic media reach of CDC Vital Signs through use of mechanisms such as the CDC website and social media outlets, as measured by page views at http://www.cdc.gov/vitalsigns, social media followers, and texting and email subscribers (Lead Agency - CDC; Measure ID - 8.B.2.2)

Increase the number of consumers for whom Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data is collected (Lead Agency - AHRQ; Measure ID - 1.3.23)

Expand access to the results of scientific research (Lead Agency - IOS; Measure ID - 1.6)

Analysis of Results

HHS is committed to making high-quality and useful health-related data easily accessible in a timely manner. The Medical Expenditure Panel Survey (MEPS) Household Component fields questionnaires to individual household members to collect nationally representative data on demographic characteristics, health conditions, health status, use of medical care services, charges and payments, access to care, satisfaction with care, health insurance coverage, income, and employment. MEPS data is being used to increase the awareness of health and human service issues and generate insights into how to improve health and well-being. Through their efforts from 2006 (baseline) to 2013, AHRQ has reduced the number of months to public release of data from 12 to 10, meeting its targets. It targeted a two week reduction for FY 2014 for the point-in-time file relative to our time for data release accomplished in FY 2012 and met this goal by decreasing to 9.5 months for the number of months to public release of data from the end of data collection.

SAMHSA is tracking information usage from its publicly available resources by tracking a combined count of hits for a pool of key resources: the SAMHSA web site; the treatment locator; and the Substance Abuse and Mental Health Data Archive (SAMHDA). Since January of 2012, advancements are being made to assure the methodology of accurately counting web hits. These advancements resulted in adjustments for targets from FY 2013.The FY 2014 result did not meet the target. It is believed that performance will be strong during 2015. 

In addition to engaging the public, a high priority for the HHS Open Government Plan is to make HHS data more easily and broadly available through its Health Data Initiative (HDI). The mission of the HDI is to help improve health, healthcare, and the delivery of human services by harnessing the power of data and fostering a culture of innovative uses of data in a diverse array of public and private sector settings. This information can be used to increase agency accountability and responsiveness, improve public knowledge of the agency and its operations, further the core mission of the agency, create economic opportunity, or respond to need and demand as identified through public consultation. Also, researchers and analysts may use these data sets to add knowledge and understanding to existing health and human service issues. In FY 2014, HHS published 102 datasets and has federated datasets from states (454) and cities (66) into the catalog as part of the execution plan which recognizes that valuable data also resides at the local level and is a valuable resource for innovators.

CDC Vital Signs is an innovative program at the intersection of science, policy, and communications.  The concept for the CDC Vital Signs Program was developed late in 2009 and the first issue was published on July 6, 2010.  The twelve annual CDC Vital Signs Program topics include the five topics coinciding with the five leading causes of death in the U.S.  An additional three of these twelve topics are known risk factors of these five leading causes of death, namely, obesity, tobacco use, and alcohol use.  Due to the magnitude of morbidity, mortality, and financial cost associated with the indicators addressed in each issue of CDC Vital Signs, small changes in individual behavior, medical care practices, and public health policies that are expected to result from the release and use of this information have the potential to transform the nation’s medical care and public health systems.  CDC Vital Signs' monthly communications targets the public, health care professionals, and policymakers through fact sheets, social media, a website (http://www.cdc.gov/vitalsigns), and a linked issue of the Morbidity and Mortality Weekly Report (MMWR). Its electronic media reach grew from 250,000 potential viewings (page views, social media followers, and texting and email subscribers) in FY 2010 to over 3.5 million potential viewings in FY 2014 due to print, broadcast and cable media interest, and continued promotion to add subscribers to its social and email dissemination channels.

AHRQ has added a new measure to this report tracking Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys.  CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care.  These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.  In FY 2011, the CAHPS program met its goal of 143 Million for whom CAHPS survey data is collected.  However, for FY 2012 and FY 2013, results remained flat at the FY 2011 result.  

Increased access to research publications can help to support innovative breakthroughs and accelerate the pace of scientific discovery.  Developed in 2000, PubMed Central (PMC) serves as a free digital archive for biomedical and life sciences journal literature.  A priority in the Open Government Plan is to increase access to the results of federally funded research.  Increased access to research publications can help to support innovative breakthroughs and accelerate the pace of scientific discovery.  The requirement to make peer-reviewed publications freely available stems from several sources, including the 2008 Consolidated Appropriations Act, which requires NIH-funded investigators to submit or have submitted for them into the National Library of Medicine's (NLM) PubMed Central archive of biomedical and life sciences journal literature an electronic version of their final peer-reviewed manuscript, to be made publicly available no later than 12 months after the official data of publication.   In addition, Section 527 of the 2014 HHS Appropriations Act and February 22, 2013 White House policy memoranda, titled "Increasing Access to the Results of Federally Funded Scientific Research" call upon agencies with more than $100 million a year in the conduct of R&D to develop plans to make peer-reviewed publications stemming from their research freely available.  NLM also works with publishers to collect and archive other articles published in more than 1,600 journals in the biomedical and life sciences.  At HHS, the following agencies are developing public access plans, and will utilize PubMed Central: Food and Drug Administration, the Centers for Disease Control and Prevention, and the Agency for Healthcare Research and Quality.  It is expected that the public access requirements for agencies other than NIH will become effective at the start of FY 2016.  HHS is introducing a new measure to this report that tracks the number of publications that are available to the public through PubMed Central, which includes papers submitted under public access policies as well as other publications contributed to the archive by journal publishers.

Plans for the Future

The MEPS Program continues to meet or exceeded all program assessment data timeliness goals. The accelerated data delivery schedule increases the timeliness of the data and thus maximizes the public good through the use of the most current medical care utilization and expenditure data to inform health care policy and practice. AHRQ is seeking further acceleration for the delivery of the current MEPS Household Component solicitation, with data delivery taking place in FY 2015 through FY 2018.

Given the pace of technological changes associated with automation, SAMHSA continues to carefully monitor and test the methodology used to quantify this type of measurement, expecting improvements for FY 2014 and FY 2015.

HHS expects the number of dataset published to increase in the coming years. Federation of datasets continues as HHS began federating health data from USDA (10) and continues to work with federal agencies like the VA and CFPB to harness additional health specific datasets for a comprehensive catalog of data resources. The HHS IDEA Lab (formerly the Chief Technology Officer's office) is engaged in robust outreach efforts to the HHS community and review of potential submissions. The IDEA Lab continues to educate our data communities on the content of HHS data through increased use of the HealthData.gov blog, expanded social media presence, while benefiting from health data focused events like the well-known Health Datapalooza.

Since 2010, exposure to CDC Vital Signs in any form has expanded tremendously due to growing print, broadcast, cable media, and social media interests that have far outpaced expectations; however, media market saturation is likely at some point in time. As a result, the CDC expects lower but sustainable growth in the future.

AHRQ believes the CAPHS survey has been hampered by excess length, which may be affecting performance improvement. The CAHPS Team and National Committee for Quality Assurance (NCQA) are responding to this issue by conducting analyses to see which items can be eliminated (without affecting reliability or validity) from the CAHPS Core Items and which items need updating. The program anticipates meeting the FY 2014 Target of 145 Million consumers for whom CAHPS survey data is collected and to increase the number of consumers each year by one million through FY 2016.

In FY 2014, the NLM PubMed Central Database included over 3 million journal articles. HHS expects the number to grow in 2015 as the Public Access Policy is expanded to include journal articles developed through funding from CDC, FDA, AHRQ and ASPR, and as NLM continues to archive other articles contributed by journal publishers. In addition, a number of other federal agencies are considering utilizing PMC as their repository for publications.

Objective Progress Update Summary

HHS demonstrated progress toward this objective as shown by the representative performance measures described in the HHS Annual Performance Plan and Report. Further evidence of progress is described below.

• The Medical Expenditure Panel Survey (MEPS), first funded in 1995, is the only national source for comprehensive annual data on how Americans use and pay for medical care. The survey collects detailed information from families on access, use, expenses, insurance coverage, and quality. In an effort to release public use files at an earlier date, data processing efficiencies have been developed and instituted.
• AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys ask consumers and patients to report on and evaluate their experiences with health care. The CAHPS Program has not met the goal of 145 million users in FY 2013 because there was a slower uptake of the CAHPS Survey for Patient Centered Medical Homes (PCMH) than was anticipated. In addition, the Centers for Medicare and Medicaid Services (CMS) is using a newly revised CAHPS Clinician-Group Survey for Accountable Care Organizations (ACOs).
• Substance Abuse and Mental Health Data Archive (SAMHDA) serves as SAMHSA’s primary repository for public access data files. SAMHDA provides free access and on-line analytic tools to the public. SAMHSA plans to promote SAMHDA to improve the amount of web traffic attracted to the site.
• In the first half of FY2014, CDC Vital Signs’ total electronic media reach exceeded 1.5 million communication channels and is on target to reach its year-end goal of 2.9 million communication channels. Anticipating media saturation could slow future growth.
• HHS published 102 datasets and has federated datasets from states (454) and cities (66) into the catalog as part of the execution plan which recognizes that valuable data also resides at the local level and is a valuable resource for innovators.

It was determined that revised measures would help program managers assess the impact their work has on this overall strategy and provide more meaningful insight into objective progress and challenges. Coordination to adapt an existing measure and create a new measure to complement this objective is reflected in the measures above. AHRQ has also added a new measure to track progress. The Department is continuing to support and execute the programs contributing to this objective, monitoring progress, performance, and program integrity while adjusting to any budgetary constraints or changes to programmatic demands.

⁸⁸ Reduction in target reflects a change in the data collection methodology.

⁸⁹ There is no delay between fiscal year funding and the performance year.