Expired has been added because the outpatient setting includes a wide range of sites, including Emergency Departments and ambulatory surgery centers. The ever-expanding sites of care, combined with the increasing use of electronic data, make it imperative that all health data collection activities, where possible, utilize standardized data elements and definitions. 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. 33. Health Resources and Service Admin. The National Committee is well aware of the numerous efforts currently underway in both the public and private sectors to standardize health data, especially the progress made during the past 10-15 years in developing uniform data sets (Uniform Hospital Discharge Data Set and the Uniform Ambulatory Care Data Set) as well as common claim forms (Uniform Bill 82 and its successor UB 92 and HCFA 1500). The unique identifier must be developed and protected in such a way that the American public is assured that their privacy will be protected. We realized that the industry needed a standardized dataset that provides essential elements for EHR documentation. American Medical Association, Cary Sennett, MD, Ph.D. These elements apply to persons seen in both ambulatory and inpatient settings, unless otherwise specified. North Carolina Department of Human Resources, Division of Medical Assistance, Robert W. Mayes In addition, there are some disabilities, such as severe mental illness or blindness, where ADLs and IADLs are not sufficient measures. Together with marital status, this element provides a picture of potential formal/informal resources available to the person. Operative Report PREOPERATIVE DIAGNOSIS: Recurrent sigmoid volvulus and tumor POSTOPERATIVE DIAGNOSIS: Recurrent sigmoid volvulus and tumor OPERATION: Directions: Discussion Overview: Choose a specific commonly collected data set (UHDDS, CDC, NCDB, UACDS, OASIS, HEDIS, etc.) 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. However, income questions are often considered intrusive, whereas years of schooling are more acceptable to respondents. Attending Physician Identification (inpatient), 22. As recommended by the UACDS, address should be in sufficient detail (street name and number, city or town, county, State, and Zip Code) to allow for the computation of county and metropolitan statistical area. UHDDS Today Hospital or facility identification number or code. Health Care Financing Administration. 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. Administration for Children and Families, Susan N. Postal The immediate goal of the NPI/NPF project is to support HCFA's Medicare Transaction System initiative by providing a single, universal method for enumerating the providers who serve Medicare beneficiaries. Foundation for Health Care Quality, Terry Rudd As a result of the process followed in the conduct of this project and based on careful analysis by its members, the Committee has reached the following conclusions: Because they recognize the significance of this project, respondents also recommended a number of additional items that they would like evaluated and possibly included in a core set of standardized data elements. ASTM Committee E-31, Clifford P. Binder For the first 12 elements, with the exception of unique identifier, information may not need to be collected at each encounter. In the evolving managed care field, the need to follow individuals through a continuum of care and at multiple sites will become increasingly necessary. This listing should be reviewed by the NCVHS and standards organizations and, if found acceptable, recommended for use. Type of Facility/Place of Encounter. The goal has been to develop a set of data elements with agreed-upon standardized definitions that, when needed in a data collection effort, can be used to collect and produce standardized data. Department of Veterans Affairs, John A. Hornik, Ph.D. This project has brought together efforts from several state agencies, including education (for the school data), agriculture (the source of WIC data in some states), as well as health departments. The Committee's efforts, first in the area of inpatient hospital data (the Uniform Hospital Discharge Data Set or UHDDS) and later in the area of ambulatory care (the Uniform Ambulatory Care Data Set or UACDS) have moved the country in the direction of achieving comparability in the health data collected by federal agencies, states, localities and the private sector, as well as in the international community. 37. Health Care Practitioner Identification (outpatient), 21. Also, although different data sets may include the same data element, in most cases it was not possible to verify that the data collection instructions and definitions were the same. Based on the compendium effort, a working list of 47 data elements frequently collected or proposed for collection regarding eligibility, enrollment, encounters and claims in the United States was prepared (see appendix B). 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. With the use of UHDDS-defined data, for example, state and private abstracting systems have been providing comparable state and local data for health planners for many years. 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. Performance monitoring and outcomes research are two areas that are currently hampered by the inability to link data sets from various sources. Substance Abuse and Mental Health Services Administration, Stephen E. Marcus, Ph.D. Primary Source - The primary source that is expected to be responsible for the largest percentage of the patient's current bill. Legal Services of Middle Tennessee, Leonard Bourget Promoting the standardization of health information has been a consistent and defining Committee activity for 25 years. American Foundation for the Blind, Karen Kmetik Of these, approximately 70 percent provided information about their data elements. Participation is voluntary, and HCFA, which is funding its development, has been working to get consensus about the kind of system that would be useful. Self-report and clinician measurements are each valuable, and having both available is especially informative. It will also serve as a quality check as the date of birth approaches the new century mark. For the first 12 elements, with the exception of unique identifier, information may not need to be collected at each encounter. prison), Principal diagnosis of an injury or poisoning. No EP studies. National Institutes of Health, Stanley C. Garnett The Committee recognizes that not all providers are obtaining this detail, but it is anticipated that these data will be more frequently collected in the near future with the growth of computerized prescription information. The usual living/residential arrangement of an individual is important for understanding the health status of the person as well as the person's follow-up needs when seen in a health care setting. UACDS and UHDDS have many similar data elements, which makes it easier to. What clinical information is collected in the Uhdds? See Page 1. To retrieve electronic data B. C.Child A listing of the Core Health Data Elements grouped by level of readiness for implementation is provided after the section with the definitions of each data element. Problems could arise from adding and modifying data items and definitions too frequently. 7. Abbreviation is mostly used in categories: Health Flashcard Care Medical Technology. Congress of the United States, Vicki Hohner Health Resources and Services Administration, William E. Flynn, III 14. Much of the required information can be located on the patients face sheet. 18. National Organization of urse Practitioner Faculties, Peter M. Wheeler OMB is currently investigating the possibility of changes to this classification, and the Committee will await the OMB recommendations. 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. HHS, NID, Division of Epikdemiology and Prevention Research, William J. Sobaski, M.B.A. Operative Report PREOPERATIVE DIAGNOSIS: Obstruction of the rectum in a patient with known colon cancer POSTOPERATIVE DIAGNOSIS: Obstruction of the rectum due to. The State of California has tested the use of a series of data items that are readily known by individuals and which can be combined to link data. To this end, the Committee recommends that the Data Council: 3. Sex, age, and race of the patient. A presentation by AHCPR reported on a study of 10 state data organizations and two statewide hospital associations participating in the Healthcare Cost and Utilization Project (HCUP-3). Managed Behavioral Health News, Melvin Sabshin, M.D. Qualifier for Other Diagnoses (inpatient), 28. Most participants eagerly supported an independent committee, such as this, to gather input and advise the public health and health care communities. College of Nursing, East Tennessee State University, Jimmy Thomas Efird The continuing expansion of types of payments and the combination of payments within groups is ever changing. It is recommended that the year of birth be recorded in four digits to make the data element more reliable for the increasing number of persons of 100 years and older. National Institute of Dental Research, NIH, T. J. Mathews 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. This item attempts to define what actually motivated the patient to seek care and has utility for analyzing the demand for health care services, evaluating quality of care and performing risk adjustment. Hartford Health Department, Clem McDonald, M.D. Expected insurance payer number or code. This term is one that needs study and evaluation before it can be implemented. 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. These data items include birth name, date of birth, place of birth, gender, and mother's first name. ASTM (American Society for Testing and Materials ). The American Academy of Family Physicians, Barbara Faigin Data Elements for Emergency Department Systems, Release 1.0 (DEEDS), is intended for use by individuals and organizations responsible for ED record systems. In addition, home address will allow the application of GIS (Geographic Information Systems) technology to the analysis of health issues. 26. An inpatient admission begins with the formal acceptance by a hospital of a patient who is to receive health care practitioner or other services while receiving room, board, and continuous nursing services. Medicare decided a PAYERID was needed because of the difficulty its contractors were having in transferring claims to other insurance companies, due to incomplete information or multiple names for payers. Several states, including California, Oklahoma, and New York presented findings on using a combination of key data items to perform probabilistic matches. Respondents have indicated a mixed use of this item for inpatients. In some situations, it is possible that a free-form narrative will be collected in place of the codes, to be coded at a later point. 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. College of American Pathologists, Division of Government and Prof. Affairs. Who will have access to the database for research purposes, and to what data, has yet to be determined. Health Care Planning and Policy, Edna Kamis-Gould, Ph.D. Additional evaluation and testing are warranted for this important information. University of Iowa. For those data elements which have been recognized as significant core elements, but for which there is not consensus on definition, support the formation of a public-private working group to conduct or coordinate additional study or research and to further refine definitions. One would be through the use of a state-level or regional-level organization that already has a line of communication with other organizations. Information on all patient problems and diagnoses requiring attention at the encounter are needed to assess the quality of care delivered, to determine what types of health problems are being seen and treated in the different types of ambulatory care facilities, and for assessing the appropriateness of the setting used to perform the services. 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. 22. Functional Status - The functional status of a person is an increasingly important health measure that has been shown to be strongly related to medical care utilization rates. Washington, D.C. 20201, U.S. Department of Health and Human Services, Biomedical Research, Science, & Technology, Long-Term Services & Supports, Long-Term Care, Prescription Drugs & Other Medical Products, Collaborations, Committees, and Advisory Groups, Physician-Focused Payment Model Technical Advisory Committee (PTAC), OS-Patient-Centered Outcomes Research Trust Fund (OS-PCORTF), Health and Human Services (HHS) Data Council, Core Health Data Elements: Report of the National Committee on Vital and Health Statistics. The NCVHS recommends the use of Social Security Number with a check item such as date of birth, while at the same time undertaking the study and evaluation needed to confirm this use or the recommendation of another identifier. Health Care Financing Administration, Steven B. Cohen National Institutes of Health, David . Molly A. Anthony, Ph.D. Another form would be through an organization that already has a WEB page; several organizations indicated that they would be willing to test the sharing of this information through their Internet sites. 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. Ideally, one would also collect income to more fully define socioeconomic status. compare data for inpatients and ambulatory patients in the same or among other facilities. Information is collected by a wide range of users and in a myriad of different formats. Injury Related to Employment - Yes, No. Association of Maternal and Child Health Programs, Karl S. Finison D'Angelo, B.S., M.S. In recent years, the Committee has recognized the importance of electronic standardization efforts which are taking place in the business community. We use cookies to ensure that we give you the best experience on our website. At a minimum, the following classification is suggested: The critical distinction here is whether followup is planned or scheduled, as an indicator of continuing health problems and continuity of care. Updates of activities in each of the agencies are presented to the Committee on a regular basis. Commission on Cancer, Catherine E. Woteki, Ph.D., R.D. Procedures (inpatient) - All significant procedures, and dates performed, are to be reported. The following list of data elements contains those elements selected for the first iteration of this process. Moreover, in the electronic format, in most instances, payments would not be available at the time that patient and medical data are entered. All have significant value and could result in the collection of four separate data elements. Several organizations have volunteered to facilitate dissemination and feedback of the core data elements project. Illinois Hospital and Health Systems Association, Kathy Milholland, Ph.D., R.N. It remains unclear whether the modest health gains seen in low-income and racial/ethnic minority populations in the last thirty years will continue, considering the changes in the U.S. health care system. ICD-9-CM Vol. Standardized data sets can serve many purposes in the current and future health care arena. Massachusetts General Hospital, Harvard Medical School, Jonathan M. Ellen, M.D. 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). American Medical Association, Herbert G. Traxler, Ph.D. The major output of this project to date has been the recommendation of core data elements, definitions, vocabulary and classifications. In these cases, it is possible that the data items, such as person characteristics, are part of a more basic file kept by the organization, and the information for that file was not included. By January 1998, all California State Department of Health data bases will contain five data items to facilitate linkage. Self-Reported Health Status - There was much interest in documenting health status, one element that can precipitate the demand for health care and help determine the prognosis, although there was no consensus on how its definition should be standardized. Primary Diagnosis (inpatient) - The diagnosis that is responsible for the majority of the care given to the patient or resources used in the care of the patient. Another problem is that, although the HHS Data Council has recently established a Health Data Standards Committee, until the past few months, there has been no central location within the Department for monitoring the activities of the data standards groups. The .gov means its official. The Uniform Hospital Discharge Data Set, which is referred to as the UHDDS, is the core data set for inpatient admissions. 28-31. Marital status is discussed in element 6. NCQA (National Committee for Quality Assurance). 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. Georgia Center for Health Information, Patricia K. Miller Maine Health Information Center, Florence B. Fiori, Dr.P.H. New York State Department of Health, Steven Davis 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 currently recommended coding instrument is the ICD-9-CM. Uniform Ambulatory Care Data Set (UACDS). Whichever method is used should be designated. B.The health care practitioner for each clinical service received by the patient, including ambulatory procedures. Health Care Financing Administration, Brenda Spillman National Cancer Institute, NIH, Alfred S. Buck, M.D. Permanente Medical Group University of Pennsylvania Medical Center, Steven Kappel Respondents to this project welcomed the notion of a core data set and standardized forms in this area. National Institutes of Health, National Institute on Aging, Keith J. Mueller, Ph.D. The intent is not to specify a data set for mandated external reporting; the list of recommended data elements is by no means exhaustive, and, unlike earlier activities, is not a "data set" to be used in a specific setting. To obtain the latest plans, at its October 1995 meeting, the NCVHS held a session focused on Standards Development Organizations and related organizations. Emily Friedman Health Policy Analysis, Del Fulgencio Attending Physician Identification (inpatient) - The unique national identification number assigned to the clinician of record at discharge who is responsible for the discharge summary, as recommended by the 1992 UHDDS. Most organizations were supportive in wanting to 'get on board' with standardized data elements. National Perinatal Information Center, Mark J. Segal, Ph.D. What is Uacds? He had visited a number of western European countries speaking with experts in health information infrastructure, and reported that several countries now have a national policy of support for the computerized patient record. More emphasis on the confidential use of SSN is essential. Bureau of Health Professions, HRSA, Fernando M. Trevino, Ph.D., M.P.H. The collection of this element allows for the investigation of issues surrounding health and health care by a person's race and ethnic background. Which of the following data elements is unique to UACDS A. Medicare and many other payers adhere to these guidelines. The Committee's intent is not to specify a data set for mandated external reporting; not every element may be needed in a specific collection effort, and these data elements do not represent all of the important data items that are collected in the field or needed for specific applications. Colorado Hospital Association, Nancy Breen, Ph.D. A. Assistant Secretary for Planning and Evaluation, Room 415F A data element is defined by size (in characters) and type (alphanumeric,. Condition should be recorded to the highest documented level of specificity, such as symptoms, signs, abnormal test results, or other reason for visit, if a definitive diagnosis has not been established at the end of the visit/encounter. The Uniform Ambulatory Care Data Set (UACDS) regulates the area of ambulatory care. UNIFORM AMBULATORY CARE DATA SET. Participation in the system will be voluntary for non-HCFA providers at first. 31. Recommendations and linkage with the current project will be discussed. offices, the location of the usual or principal place of practice should be given. Any unit of data defined for processing is a data element; for example, ACCOUNT NUMBER, NAME, ADDRESS and CITY. A large number were collected by only a few of the data sets. Florida Hospital Association Information Services, George J. Stukenborg, Ph.D. One problem that was encountered was that of requesting what the private organizations consider proprietary information. The data is collected on inpatient hospital discharges for Medicare and Medicaid programs. 27. H.Left against medical advice or discontinued care. Patient's Relationship to Subscriber/person eligible for entitlement -, A.Self Report to the HHS Data Council on the viability of these elements and definitions being adopted in their program. A. Hornik, Ph.D core data elements hampered by the patient participants eagerly supported an Committee. 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