These data assist in the examination of disparities in stage of illness, care, and outcome, some of which have been documented in the past among racial and ethnic groups. No EP studies. University of Pennsylvania Medical Center, Steven Kappel The Committee recognizes the need for uniform, comparable standards across geographic areas, populations, systems, institutions and sites of care to maximize the effectiveness of health promotion and care and minimize the burden on those responsible for generating the data. Procedures and Services (outpatient) - As recommended by the UACDS, describe all diagnostic procedures and services of any type including history, physical examination, laboratory, x-ray or radiograph, and others that are performed pertinent to the patient's reasons for the encounter; all therapeutic services performed at the time of the encounter; and all preventive services and procedures performed at the time of the encounter. There is also concern that medical personnel may be confusing the definitions/uses of principal versus primary diagnosis. What clinical information is collected in the Uhdds? The primary diagnosis is not part of the UHDDS, and in most diagnostic situations, the principal and primary diagnoses will be identical. In addition, home address will allow the application of GIS (Geographic Information Systems) technology to the analysis of health issues. The NPI/NPF will provide a common means of uniquely identifying health care providers, including institutions, individuals, and group practices, both Medicare providers and those in other programs. Self-report and clinician measurements are each valuable, and having both available is especially informative. Oklahoma Department of MH and SA Services, Don Eugene Detmer, M.D. The response to the Committee's activities through both participation in meetings and written comments indicates that the health care information field is solidly in favor of the identification and use of standardized data elements and definitions. One problem that was encountered was that of requesting what the private organizations consider proprietary information. Health Care Facility and Practitioner Identifiers - Each provider should have a universal unique number across data systems. Several states, including California, Oklahoma, and New York presented findings on using a combination of key data items to perform probabilistic matches. State of Washington Department of Health, Maria Rey Summaries of the meetings can be found in appendix C. Both meetings were successful at bringing together experts in the field and expanding the knowledge base of the Committee. In addition, there are some disabilities, such as severe mental illness or blindness, where ADLs and IADLs are not sufficient measures. ICD-9-CM Vol. At the March 1996 NCVHS meeting, many of the same standards-setting groups were present and indicated their support of the Committee's efforts. For the first 12 elements, with the exception of unique identifier, information may not need to be collected at each encounter. ANSI ASC X-12 (Accredited Standards Committee), WEDI (WorkGroup on Electronic Data Interchange). AHCPR compared the 12 systems with the UB-92 and monitored deviations at 3 levels - easy, moderately difficult, and difficult to correct problems. A detailed report of these findings is in the process of publication by AHCPR, but findings have shown that even well-recognized standards are not consistently followed. Health Care Financing Administration, Emily Friedman Office of Inspector General. Health Care Financing Administration. National Institutes of Health, Stanley C. Garnett This group, or a separate group, could also be the focus for evaluating additions to the list of core data elements and for setting up methods for testing and promulgating the final products. Participants in the various meetings had discussed ways to disseminate new data items, seek input, and inform data collectors of recommended elements and definitions. Health Resources and Services Administration, Tameron Mitchell, R.D., M.P.H. Agency for Health Care Policy and Research, J. Lee Annest, Ph.D. A listing of all participants in the two meetings as well as those who provided written responses at any point in the process is found in appendix E. The Committee reviewed all of the input received from the hearings, meetings, letters and other communications. Because the PAYERID system is still being developed, and because HCFA currently has no plans to categorize payers, the Committee recommends the current UHDDS categories while encouraging continued study and evaluation of categories used by other data collectors. At the October 1995 meeting of the NCVHS, a session was held at which the Department of Veterans Affairs, the Georgia State Department of Health, and others, demonstrated their institutions' integrated financial, clinical, consumer, and public health information systems that are currently in place or being tested. Kaiser Foundation Health Plan, Matthew McKearn Attending Physician Identification (inpatient) 1/, 22. A significant procedure is one that is: Surgery includes incision, excision, amputation, introduction, endoscopy, repair, destruction, suture, and manipulation. National Organization of urse Practitioner Faculties, Peter M. Wheeler Providers, Insurers, and universities represented about 7 percent each. Department of Agriculture, Theresa Wulbrecht Standardized data sets, starting with the UHDDS developed by the NCVHS, have been in use for more than two decades. Gender - Male, Female. These activities could take several forms. The currently recommended coding instrument is the ICD-9-CM. The set includes reasons for the encounter, living arrangements, and marital status. The collection of this element allows for the investigation of issues surrounding health and health care by a person's race and ethnic background. Of these, approximately 70 percent provided information about their data elements. The Committee recognizes that all practitioners may not be included initially in this system, but ultimately all should be included. Non-excision all debridement of stage three pressure ulcer of subcutaneous tissue of buttock. Multiple responses are possible. D'Angelo, B.S., M.S. 1. American Psychiatric Association, Thomas C. Sawyer Describe each data set element, who developed the data set, and compare the similarities and differences of each data set to the others for the following 3 data sets: Hi there, would you like us to [] The data sets promulgated by the NCVHS have become de facto standards in their areas for data collection by Federal and state agencies, as well as public and private data abstracting organizations. Discharge Date (inpatient) - Year, month, and day of discharge as currently recommended in the UHDDS and by ANSI ASC X12. Legal Services of Middle Tennessee, Leonard Bourget To this end, the Committee has advised the Department on such matters as Federal-state relationships, nomenclatures and classification systems, core data sets, and access and confidentiality issues. Health Resources & Services Administration, Office of Policy Coordination, Nancy Moss, Ph.D. The Uniform Hospital Discharge Data Set, or UHDDS, is used for reporting inpatient data in acute-care, short-term care, and long-term care hospitals. 13. To transmit electronic data C. To create a process for transmitting data to external users D. Describe each data set . They do represent those items that are routinely collected in many efforts, such as basic person information, as well as items specific to inpatient or ambulatory care settings, such as provider information, diagnoses, and services. The NCVHS notes that the Department of Veterans Affairs routinely collects this element, and thus approves the continued inclusion in this core list, pending a review of uses and users of this element. Health Insurance Association of America, John I. Gallin, M.D. ANSI HISPP (Health Informatics Standards Planning Panel). The currently recommended coding instrument is the ICD-9-CM. Disposition of Patient (inpatient) 1/, 40. Physician including specialty or field of practice, Includes, but is not limited to, the patients complaints and symptoms reflecting his or her own, perception of needs, provided verbally or in writing by the patient at the point of entry into the, Race and ethnicity in the United States Census, Centers for Medicare and Medicaid Services, Health Insurance Portability and Accountability Act, Access to our library of course-specific study resources, Up to 40 questions to ask our expert tutors, Unlimited access to our textbook solutions and explanations. Connecticut Children's Medical Center, Geraldine Oliva Race and ethnicity B. Other potential problems include lack of numbers for newborns, legal and illegal non-citizens and persons who wish to hide their identity, as well as a recommendation that a system would need to be established to assign and track dummy numbers. Federal government websites often end in .gov or .mil. In the 1992 revision of the Uniform Hospital Discharge Data Set (UHDDS), the NCVHS recommended "using the Social Security Number(SSN), with a modifier as necessary, as the best option currently available for this unique and universal patient identifier." Presentations were received from state health departments, including California, Oklahoma, and New York; organizations such as the Joint Commission on the Accreditation of Healthcare Organizations; and individuals such as Dr. James Cooney, Associate Director, Georgia Center for Health Policy, who had participated in earlier Committee efforts to define uniform data sets. Department of Health and Human Services, Cheryl Beversdorf Patient's Stated Reason for Visit or Chief Complaint (outpatient). 7. The Committee recommends the following actions specifically related to the core data elements: 3. Years of Schooling - Highest grade of schooling completed by the enrollee/patient. The Committee could recommend such an activity, but it would require departmental staff to actually design, input data, and monitor and update the site. Additionally the move in the health care payment system to managed care has increased the need to be able to link data sets and individual records across time, facility, and broader geographic locations. American Medical Association, Zili Sloboda, Sc.D. It is important to note for this report, however, that the two subcommittees are in agreement with the core data elements that are described herein. For those elements that the Committee recommends as being ready to standardize, request each of the data collection entities within the Department to review the set of data elements and to match data contents and definitions with similar items that they are currently collecting or plan to collect. University of Missouri, Kansas City, School of Dentistry, David K. Henderson, M.D. and is the best alternative to insure the availability of small area data. There is not one agreed-upon coding system for this item; the International Classification of Primary Care, and the Reason For Visit Classification used by the National Ambulatory Medical Care Survey are two such systems. These data items include birth name, date of birth, place of birth, gender, and mother's first name. A commonly used measure is the person's rating of his or her own general health, as in the five-category classification, "excellent, very good, good, fair, or poor." The type of data collected in each different facility's patient health records is established by required standards or regulations. University of Iowa. IPRO - Corporate Headquarters, Nancy G. Stetson, B.S.N., M.A. Patient's Expected Sources of Payment, 12. 41. 28-31. The data sets that are currently standardized are prime examples of satisfying multiple purposes with a single data set. Footnotes: 1/ element for which substantial agreement has been reached but for which some amount of additional work is needed; 2/ element which has been recognized as significant but for which considerable work remains to be undertaken. Social Security Administration, Andrew A. Michael L. Glickman One would be through the use of a state-level or regional-level organization that already has a line of communication with other organizations. No decisions have been made by the Department on any of these recommended revisions of either the UHDDS or the UACDS. Participation in the system will be voluntary for non-HCFA providers at first. If there appear to be two procedures that are principal, then the one most related to the principal diagnosis should be selected as the principal procedure. New Hampshire Division of Public Health Service, Robert Roscoe Facility Identification - The unique HCFA identifier as described above. At the present time, standards- setting organizations should assign place holder(s) for this element. Other Diagnoses (outpatient) - The additional code(s) that describes any coexisting conditions (chronic conditions or all documented conditions that coexist at the time of the encounter/visit, and require or affect patient management). They currently are not developing a system of categories to accompany the IDs. A range of organizations was contacted including health plans/insurers, trade or professional associations, employers, data standards organizations, and Government. The data is collected on inpatient hospital discharges for Medicare and Medicaid programs. By January 1998, all California State Department of Health data bases will contain five data items to facilitate linkage. 17. Classify common law marriage as married. Joint Commission on Accrediation of Healthcare Organizations, Susan B. Cahn, M.A., M.H.S. Birch & Davis Health Management Corporation, Inc. George F. Grob The latter element, which describes all conditions requiring evaluation and/or treatment or management at the time of the encounter as designated by the health care practitioner, has been divided into two elements: 1) the diagnosis chiefly responsible for services provided, and 2) other diagnoses. Future projects may undertake to seek consensus among some of these items. Marital status is one element that is sometimes used as a surrogate for the social support system available to an individual and can be important for program design, targeting of services, utilization and outcome studies, or other research and development purposes. Place the Committee's report, elements and definitions on an appropriate departmental Home Page as guidance to the field and as a means of encouraging use and soliciting further comments and suggestions while the report is under review within the Department. The unique identifier must be developed and protected in such a way that the American public is assured that their privacy will be protected. Although there is agreement that "payments" or "costs" are needed, most participants agreed that it is virtually impossible to collect these items consistently across time and locations. The National Committee on Vital and Health Statistics (NCVHS) and the Department of Health and Human Services, which it advises, have initiated and completed the first iteration of a process to identify a set of core health data elements on persons and encounters or events that can serve multiple purposes and would benefit from standardization. Because the full residential address could serve as a proxy personal identifier, confidentiality of the complete information must be safeguarded in public use of the data. Patient's Relationship to Subscriber/person eligible for entitlement -, A.Self 35. To identify the large number of organizations involved in various aspects of health data standards, staff at NCHS produced a report (see appendix H) describing the various groups by type of organization. 32. The Committee has appointed a liaison to participate in selected meetings of the American National Standards Institute (ANSI) Accredited Standards Committee (ASC) X-12, a private sector coalition that is developing transmission standards for health data. 6. Thomas P. Gross, M.D., MPH Just trying to obtain data from some large organizations was quite difficult; responses were not received in a timely fashion, and when received, the data layouts often were computerized lists rather than lists of data items with their definitions. The personal/unique identifier is the element that is the most critical element to be collected uniformly. 8. Grouping of similar services provided on different dates, as is often the case under batch billing, can be problematic if specificity of data elements is lost; the objective is to encourage identifying a unique date of record for each encounter. Administration for Children and Families, Susan N. Postal What are the Root Operations? Report to the HHS Data Council on the viability of these elements and definitions being adopted in their program. Work on this topic is currently ongoing in the NCVHS Disability and Long-Term Care Statistics Subcommittee. The focus of the NCVHS effort has been on the content of the data to be transmitted, rather than the method of transmission. Personal Identification The unique number assigned to each patient within a hospital that distinguishes the patient and his or her hospital record from all others in that institution. 30. Development of a unique identifier does not necessarily mean that the individual is identifiable to users. Work has been undertaken in the past to try to bring some semblance of order to selected areas of health data collection, especially in the areas of hospital inpatients and physician office visits. Before sharing sensitive information, make sure youre on a federal government site. It will also serve as a quality check as the date of birth approaches the new century mark. What is Uacds? And now, with movement toward HMO's, PPO's, and other types of managed care, there may be a greater need to share identifiable data. Dave Baldridge Currently, data are often shared within a facility in an identifiable format. Some recommendations in the area of mental health and substance abuse are included here. Race and ethnicity 04a. Southern California Public Health Association, John R. Lumpkin, M.D., M.P.H. medical and surgical care provided to patients who depart from the facility on the same day they receive care (outpatient). Promote consensus by identifying areas of agreement on data elements and data sets among different stakeholders and areas that will require further research and development before consensus can be reached. Which of the following data elements is unique to UACDS? Birth Weight of Newborn (inpatient) - The specific birth weight of the newborn, recorded in grams. Type of admission C. Gender D. Reason for encounter D. Reason for encounter What is the purpose of data mapping A. The NCVHS recommends continued monitoring of provider practices with regard to coding and revision of these recommendations if current guidelines continue to be ignored. 27. Using items such as first name of mother; first digits of last name; date of birth; place of birth, etc., matches could be obtained without identifying the individual. Respondents & Meeting Participants, Roxanne M. Andrews, Ph.D. If you continue to use this site we will assume that you are happy with it. What does ambulatory care include? Georgia Center for Health Information, Patricia K. Miller A. G.Discharged/transferred to home under care of a Home IV provider The NCVHS Subcommittee on Ambulatory and Hospital Care Statistics commented in the 1994 UACDS revision that years of schooling completed is the most feasible socioeconomic element to collect in the UACDS. White, M.P.H., Ph.D. 19. Bureau of Vital Records and Health Statistics. Health Resources and Services Administration, Lorne A. Phillips, Ph.D. The Committee encourages the use of the above definition, while continuing to study and evaluate other residential categories, such as those used by the Bureau of the Census. Office of the Assistant Secretary for Planning and Evaluation. Another issue was the role of the National Committee itself as the source of information on common data elements. Patient's Stated Reason for Visit or Chief Complaint (outpatient) 2/, 29. Office of Statewide Health Planning and Development. National Center for Health Statistics, Richard Rubin Equifax Healthcare Information Services, Inc. Katherine S. McCarter, MHS Health Resources and Services Administration, William E. Flynn, III These elements are unique to the UACDS. Examples include information on health behaviors, such as smoking and alcohol consumption; information on preventive services; language ability; severity of illness indicators; provider certainty of diagnostic information; information to link a mother's and infant's charts; information on readmissions and complications. Office of Personnel Management, Jacqueline Darroch Forrest, Ph.D. Members of the Committee and DHHS staff participate when possible, however, the increasing numbers of groups and meetings is problematic from a staff and budget point of view. Center for Health Policy Studies, Carrie Dunkle, RN This item already is collected by most state health data organizations collecting hospital discharge information and offers the only readily available information on the fiscal dimensions of care and the relative costs of different types of care. HBO and Company. The UHDDS currently in use was promulgated by the Department in 1985; the NCVHS recommended and circulated a revision in 1992, with additional recommendations from an Interagency Task Force in 1993. Agency for Health Care Policy and Research, Rachel M. Schwartz, M.P.H. Review state-of-the-art of widely-used core data sets in the United States and other countries (including coding and formatting features that allow for flexibility); Obtain input, through hearings and other means, from the diverse parties who will report and use standardized data sets; Interact closely with recognized standards-setting groups; and. For the first 12 elements, with the exception of unique identifier, information may not need to be collected at each encounter. A. Elliot M. Stone, M.V.C. Whether an injury is work related or not can be of significant importance both in the area of injury prevention and in medical care payment. FACEP Additional evaluation and testing are warranted for this important information. Blue Cross of California, Health Policy and Analysis, William J. Hayden, DDS, MPH 4. 4. Center for Health Policy Studies, Rachael Block The Committee recognizes that a person's social support system can be an important determinant of his or her health status, access to health care services, and use of services. Consideration of these various issues and additional study and evaluation are needed before recommendations can be made for standardizing functional status measurement.
Johns Hopkins Urology Locations, Percy Jackson Monologue, Articles D
Johns Hopkins Urology Locations, Percy Jackson Monologue, Articles D