Clinical Data Drives Insight and Innovation to Transform Our Healthcare System

CRISP’s most important use is the direct delivery of important clinical information to doctors, nurses and other providers to help them give the best possible care to patients. As CRISP handles more and more data each year, the information we managed can also be used to develop insights about clinical outcomes and making healthcare work better for us all. CRISP offers two key programs for supporting the “Learning Health System”: The CRISP Research Initiative and the CRISP Quality Improvement Program. These efforts provide access to researchers and healthcare providers to patient data – in identified form for providers with a care relationship or with patient consent – or in a “limited data set” with basic identifiers like name, address, and medical record number removed to protect patient privacy. These projects allow participants in the CRISP HIE to better optimize processes and the user experience to help increase the likelihood of positive outcomes for patients.

Quality Improvement

As the state-designated health information exchange for Maryland and HIE service provider for Washington, DC, West Virginia, and the Mid-Atlantic region, CRISP works to support various uses of the clinical data flowing through the health information exchange. On May 31st, 2018, The CRISP Clinical Advisory Board approved a use case for CRISP-mediated data to be made available to participating organizations for Quality Improvement (QI) studies as defined under HIPAA.

The Importance of Quality Improvement

Healthcare providers make decisions in collaboration with their patients every day. As much as healthcare delivery is evidence based, putting that evidence into practice requires significant effort. Did a new service make outcomes better? QI activities help answer that question. For example, many providers are now using the CRISP Reporting Services – Pre-Post Report to take advantage of the Maryland Health Services Cost Review Commission’s case mix data set to look at hospitalization admissions, emergency department visits, and costs related to care for their patients. By comparing these data before and after an intervention, providers can better understand the effectiveness of a new program or service – like adding a diabetes educator to a practice or using a new surgical technique. These studies are intended for informing the provider organization and are not approved for general publication.

What We Require

CRISP does not directly approve these projects, but QI activities must be reported to CRISP through the submission of a Quality Improvement Attestation Form to attest that the activity meets the definition of a QI activity under HIPAA and to enable CRISP to audit the activity for appropriate use. CRISP monitors the activities of credentialed users of our tools and services and checks their access using various auditing tools to ensure that an individual user is only searching for appropriate patients on the CRISP network (i.e., they or their delegator has a current care relationship with the patient). In the case of a QI activity, a quality improvement analyst may not have a direct care relationship with the patients they are accessing. We therefore require for each QI activity a list of credentialed users who will be accessing data. Participating organizations conducting QI studies must maintain a current list of their patients using one of the several methods CRISP accepts for maintaining a current patient list.

Additional Information

When assessing a patient on the CRISP Query Portal, select “Healthcare Operations” when choosing the purpose for accessing patient data.

Note that Quality Improvement activities are not research under federal law and the CRISP Participation Agreement. If your organization intends to create generalizable knowledge through a study (e.g., publish a paper in a journal), you cannot use the QI attestation process; instead, you should submit a research data use request. More information about this process and the CRISP Research Initiative is available below.

Once completed, please email the signed Quality Improvement Attestation Form to Dr. Ross D. Martin, Program Director, CRISP Research Initiative, at ross.martin@crisphealth.org. If you have any questions, you can email or call at 202-697-3077.

How CRISP Provides Access to Data Research

Research Subcommittee

Approved Cases

Approved Data Requests

CRISP Research Initiative

Every week, CRISP receives and sends millions of pieces of data in support of our mission to facilitate care, reduce costs, and improve health outcomes. This data can also provide powerful insights about how we can do better. Some call this creating a Learning Health System. Research is a fundamental part of the learning cycle.

Research represents the newest permitted purpose (effective April 20th, 2016) for data sharing under the CRISP Participation Agreement. The state regulatory framework to support this permitted purpose went into effect on June 20th, 2016. Prescription Drug Monitoring Program (PDMP) data may also be made available in the future for data requests that comply with state regulations (see the section on disclosures for research, analysis, education and public reporting).

Information for Researchers

Requesting Data from CRISP

Data Sources Available

Process Overview

Costs for Research Access

For More Information