Design of a state-based workers' compensation information system

Background: California policy makers have long been hampered by a lack of c redible information for use in making legislative or administrative changes to address serious problems in the workers' compensation system. In 1993, the legislature directed the California Division of Workers' Compensation t o develop a Workers' Compensation Information System (WCIS). Methods: An advisory committee developed key questions and identified data sources regarding injury/illness incidence, costs, promptness of benefit de livery, adequacy of benefits, satisfaction with services, and other outcome s. Results: Key data elements were identified mostly from existing mandated re porting forms for employers and physicians, and from standardized medical b illings. Data collection will be carried out using: 1) rapid electronic dat a interchange (EDI)for a minimum number of data elements; 2) electronic col lection of data on medical services for a sample of claims; and 3) surveys to address adequacy of benefits, satisfaction,vith services, return to work and other outcomes. A state-based repository will analyze data and provide de-identified public we data files. Conclusions: The proposed WCIS will provide information to improve the perf ormance and to increase the accountability of all the participants in Calif ornia's Workers' Compensation system More importantly it will provide infor mation which will allow improved quality in the provision of mandated benef its to injured workers. Am. J. Ind. Med. 35:564-573, 1999. (C) 1999 Wiley-L iss, Inc.