The Alan Guttmacher Institute, Kathleen A. Frawley The UACDS is a recommended set, not a mandatory one. University of California, San Francisco, Jaclyn Packer Most participants eagerly supported an independent committee, such as this, to gather input and advise the public health and health care communities. 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). State of Florida Agency for Health Care Administration, Kathryn Huntley It is recommended that the year of admission contain 4 digits to accommodate problems surrounding the turn of the century. In the early 1990's, it formed an Ad Hoc Work Group on Confidentiality to study issues related to confidentiality, unique personal identifiers and data linkage across time and systems. Race and ethnicity B. Date of Encounter (outpatient and physician services), 18. The Committee works closely with the National Center for Health Statistics, the Agency for Health Care Policy and Research, and the Health Care Financing Administration (HCFA). Armed with the extensive listing of potential data elements culled from the Compendium, in September 1995, the NCVHS contacted approximately 2,000 individuals and organizations in the health care utilization and data fields to seek their input in identifying those basic elements most in need of collection and/or in need of uniform definitions (appendix B). Each encounter generates a date of service that can be used to link encounters for the same patient over time. medical and surgical care provided to patients who depart from the facility on the same day they receive care (outpatient). Disposition of Patient (inpatient) 1/, 40. Alexis A. Wilson 40. 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. 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." An inpatient discharge occurs with the termination of the room, board, and continuous nursing services, and the formal release of an inpatient by the hospital. Years of Schooling - Highest grade of schooling completed by the enrollee/patient. However, identifiers are commonly removed when a data set is provided outside of a facility, such as to a state health data organization. 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. Indian Health Service, Robert Davis The goal is to see what commonalities already exist and to what extent there can be further movement toward greater commonality of terms and consistency of definition. Multiple responses are possible. 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. University of Colorado Health Sciences Center, Inpatient Administration, Charles J. Rothwell 33-35. 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. 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. Computer Network Architects, Inc. Barry Gordon American Psychiatric Association, Thomas C. Sawyer Interregional Services, James P. Cooney, Jr., Ph.D. St Vincent Hospitals and Health Services, Michael L. Millman, Ph.D. A total of 31 responses were received. Significant medical procedures performed. Health Care Financing Administration, James Tierney Vermont Health Care Authority, Michael G. Kassis 31. Date of Birth 4 digits for year of birth but 3 digits are adequate to capture the century Sex Male Race Ethnicity 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 Practitioner Identification (outpatient) - The unique national identification number assigned to the health care practitioner of record for each encounter. American Association of Health Plans, Louis H. Diamond, M.B.Ch.B. Michigan Department of Social Services, Interagency Coordination Program, Stephen W. Wyatt, D.M.D., M.P.H. A data set is a list of recommended data elements with uniform definitions that are relevant for a particular use. New York State presented testimony that indicated that the last four digits of the SSN combined with the birth date were capable of linking data to a very high degree of probability. The data is collected on inpatient hospital discharges for Medicare and Medicaid programs. Respondents & Meeting Participants, Roxanne M. Andrews, Ph.D. American Association of Retired Persons, Peg Douglas Mayo Medical School, F. Lawrence Clare, M.D., M.P.H. The UHDDS guidelines state all significant procedures are to be reported and a significant procedure is defined as one that is: Surgical in nature, or. In August 1994, the Department asked the Committee to provide information and advice that will help maximize the utility of core person and encounter data for meeting the Department's responsibilities. Dr. Detmer identified four overarching issues: privacy and confidentiality, computerized patient records, standards and classification, and knowledge-based management. American Foundation for the Blind, Harvey A. Schwartz, Ph.D. 2. Whichever method is used should be designated. All have significant value and could result in the collection of four separate data elements. The continuing expansion of types of payments and the combination of payments within groups is ever changing. Producing the compendium was a much more involved effort than was originally envisioned, and probably is representative of problems to be overcome in the future when standardization implementation is planned. To assure the widest possible distribution, the document was also placed on the DHHS and NCHS Home Pages in an electronic format. 38. Operative Report PREOPERATIVE DIAGNOSIS: Obstruction of the rectum in a patient with known colon cancer POSTOPERATIVE DIAGNOSIS: Obstruction of the rectum due to. 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. A series of matrices were prepared that arrayed individual data elements in use or proposed for use by different organizations with the type of organization. It is of vital importance to participate in and/or be members of the numerous data standards groups. Maine Health Information Center, Florence B. Fiori, Dr.P.H. Catherine McCabe Federal government websites often end in .gov or .mil. In addition, there are some disabilities, such as severe mental illness or blindness, where ADLs and IADLs are not sufficient measures. The database will contain payer names, billing addresses and business information. In addition, information was solicited by the NCVHS through two large-scale mailings, and public meetings were held with agencies and organizations which are currently collecting health data sets. Health Care Practitioner Identification (outpatient) 1/, 20. The Commonwealth of Massachusetts, Rate Setting Commision, Daniel J. Friedman, Ph.D. 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. Source of payment categories, as recommended in the past, are no longer sufficient. Information is collected by a wide range of users and in a myriad of different formats. A person currently married. Currently some states are using state facility identifiers, but the Committee recommends that these identifiers be superseded by the NPI/NPF. Kunitz and Associates, Inc. Laura B. Landrum The MEDSTAT Group, Joel Diringer, JD. Where can I watch the entire Dragon Ball series for free. The Committee recommends that the HCFA identifier be adopted when completed. Seven confirmatory data items (including SSN) should also be collected when possible. We realized that the industry needed a standardized dataset that provides essential elements for EHR documentation. National Center for Health Statistics. 16. The Committee recommends that the Department fund these activities on an ongoing basis. It is hoped that the system will improve the coordination of benefits, as well as providing access to information about health insurance and making it easier to track third party liability situations. Years of schooling has been found to be highly predictive of health status and health care use. A. One major reason is the staff and dollar resources required to travel to and participate in several meetings per group per year. There is also concern that medical personnel may be confusing the definitions/uses of principal versus primary diagnosis. Philippine Nurses Association of America, Lisa L. Culver, PT, MBA What does ambulatory care include? Data elements used in UACDS are provider Identifications, address, type of practice, which includes the full name of the provider as well as the unique physician identification number (UPIN). Outcome Concept Systems, Inc. Ronald W. Wilson, M.A. It was thought that this was one of the reasons why some organizations, especially private employers, declined to participate. Participating organizations included: Although Committee members were aware in a general way of ongoing standards developments activities, this session focused on the need for action being required now and in the near future if the health care community is to obtain and maintain a presence as data standards are developed and finalized. A chart showing the distribution of all respondents by type of organization is shown in appendix D. Approximately 30 percent of respondents were from state and local governments, followed by professional associations and the Federal Government with 18 Percent and 17 percent respectively. Why such data sets are needed in the current and evolving health care arena; What multiple functions they might accomplish for a variety of different users; What data elements (including definitions, vocabularies and coding structures) they might contain; and. It also includes other data elements such as Place of encounter to specify locations, reason for encounter that outlines the patient complaints and symptoms reflecting their own perceptions of needs, and diagnostic service that give a description of all types of service. Health Care Financing Administration, David L. Hobson Condition(s) should be recorded to the highest documented level of specificity. National Center for Health Statistics, Richard Rubin Which of the following data elements is unique to Uhdds quizlet? Mutual of Omaha Health Plans of Lincoln, Robert Koladner, M.D. Blue Cross of California, Health Policy and Analysis, William J. Hayden, DDS, MPH HHS, Public Health Service, Health Resources Services Administration, Steven Clauser The Minimum Data Set for long term care (MDS) was published by the Department of Health & Human Services in 2013 and modified in 2016. It will do so by assigning a unique identifier to each provider. Michael L. Glickman American Public Health Association, Linda Vader, RN, CRNO 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. 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. Elliot M. Stone, M.V.C. In addition to documenting whether the patient was discharged alive or died during the hospitalization, the patient disposition is an indicator of the patient's health status at the time of discharge and need for additional services. 4. Provider Location or Address of Encounter (outpatient), 22. Standardized data elements will be vitally important in the evolving managed care field, where there is a need to follow individuals through a continuum of care and at multiple sites. Report to the HHS Data Council on the viability of these elements and definitions being adopted in their program. 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. Anonymous These elements are unique to the UACDS. 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. Agency for Health Care Policy and Research, Simon P. Cohn, M.D., M.P.H. Uniform hospital discharge data set (UHDDS). Location or Address of Encounter (outpatient) - The full address and Zip Code (nine digits preferred) for the location at which care was received from the health care practitioner of record (see 19A.). State of Washington Department of Health, Debra C. Hopkinson, RN, MS NYLCare Health Plans, Inc. Andrew Webber 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. Marital status is discussed in element 6. Updates of activities in each of the agencies are presented to the Committee on a regular basis. 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. Association of Maternal and Child Health Programs, Karl S. Finison American Health Information Management Association, Louis I. Freedman Health Care Facility and Practitioner Identifiers - Each provider should have a universal unique number across data systems. Principal Diagnosis (inpatient) - As recommended by the UHDDS, the condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital or nursing home for care. College of American Pathologists, Division of Government and Prof. Affairs. offices, the location of the usual or principal place of practice should be given. Although the UHDDS has been in the field for two decades and its data items are widely used by government and private organizations, issues of quality and comparability remain. Selma C. Kunitz, Ph.D. Ideally, one would also collect income to more fully define socioeconomic status. In the future, the system will integrate non-HCFA subscribers. The draft listing was again disseminated in early April 1996 (see appendix F) to the original mailing list and especially to those who had provided earlier assistance. Self-report and clinician measurements are each valuable, and having both available is especially informative. Standards groups should be consulted regarding setting criteria for recording of names. Occupational Safey Health Administration, Office of Statistics, William Halperin, M.D., M.P.H. A recent Bureau of Labor Statistics study found that only 1.5 percent of respondents will choose the multiracial category. NUBC (National Uniform Billing Committee), NUCC (National Uniform Claim Committee), and. Four digits are recommended for the discharge year. Response was significant and positive to the Committee's request to review a set of core data elements that were identified after a series of hearings and other information- gathering efforts were completed. It is a standardized, primary screening and assessment tool for health status that forms the foundation of the comprehensive assessment for all . 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. 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. Several organizations have volunteered to facilitate dissemination and feedback of the core data elements project. This effort, described below, is the culmination of input from the historical knowledge and work of the Committee, including the uniform basic data sets already developed; and information provided in meetings, hearings, and through correspondence with Federal, state and local health agencies, private organizations, universities, etc. California Public Health Foundation, NAACCR, Maria Redona Couper, Ph.D., RN However, there was no clear-cut listing of mutually exclusive encounter locations or definitions to draw upon. 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. The Committee's 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. State Budget and Control Board. NYLCare Health Plans, Inc. Eugene Stanton 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. 20. HHS, NID, Division of Epikdemiology and Prevention Research, William J. Sobaski, M.B.A. Expired has been added because the outpatient setting includes a wide range of sites, including Emergency Departments and ambulatory surgery centers. The transference of data sets from the traditional sources has not fully met the needs of these sites. University System of West Virginia, Curtis O. Porter California Department of Health Services, J. Henry Montes AHCPR compared the 12 systems with the UB-92 and monitored deviations at 3 levels - easy, moderately difficult, and difficult to correct problems. ANSI HISPP (Health Informatics Standards Planning Panel). Systems may also choose to collect other identifiers (e.g., tax number), which they can link to the NPI. 25. Agency for Health Care Policy and Research, Rachel M. Schwartz, M.P.H. Operating Clinician Identification (inpatient) 1/, 23. ICD-10-PCS code for: 1. Personal/Unique Identifier - the unique name or numeric identifier that will set apart information for an individual person for research and administrative purposes. The currently recommended coding instrument is the ICD-9-CM. By January 1998, all California State Department of Health data bases will contain five data items to facilitate linkage. 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. 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. Bureau of Vital Records and Health Statistics. Patient's Relationship to Subscriber/Person Eligible for Entitlement, 12. The University of Illinois at Chicago, Eunice Chee 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. Investigate the formation of leadership sites within the Department for each of the standards-setting organizations. Other recommendations will be circulated for comment at a future time. The elements described in this section refer to information related to a specific health care encounter and are collected at the time of each encounter. 17. Health Care Financing Administration. D.Discharged/transferred to an intermediate care facility (ICF) 41. Type of admission C. Gender D. Reason for encounter D. Reason for encounter What is the purpose of data mapping A. Consensus has been reached on definitions for the majority of these elements; for others, there is much agreement, but definitions must still be finalized; and for a third group, additional study and testing are needed. National Association Children's Hospitals, George Arges APHA American Public Health Association, Katherine M. McCormack . Support the NCVHS continuing its work in this area, especially using its expertise to discuss research issues, to assist in consensus building, and to participate with the Data Council in the implementation of the core data element project recommendations. In addition, home address will allow the application of GIS (Geographic Information Systems) technology to the analysis of health issues. The Committee recognizes that all practitioners may not be included initially in this system, but ultimately all should be included. Their continuing study is involved with more detailed data elements that relate specifically to the areas of mental heath, substance abuse, and long term care. Throughout the meetings it became apparent that many standards-setting groups are moving ahead without broader input, for example, from those in the public health and epidemiology fields. 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. After review of the data elements collected, the subcommittees decided to study in-depth six data clusters: The preliminary results of this project have been prepared. 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. National Institutes of Health, National Institute on Aging, Keith J. Mueller, Ph.D. California Health Information for Policy Project, Nancy J. Kennedy, Dr.P.H. 01. The Committee recognizes the importance of having both data items and identical definitions in order to compare and analyze data elements. A unique identifier such as the SSN in conjunction with at least one other data item or, alternatively, an identifier drawn from another distinct set of data items routinely collected presently would seem the most viable. Participation in the system will be voluntary for non-HCFA providers at first. 5. 13. These include the review and implementation of core data elements and definitions within departmental data collection activities; formation of public-private work groups to assist in promulgating data elements for which consensus has been reached or for undertaking additional study on critical elements for which there are no standardized definitions. What clothing brands were popular in the 50s? Health Resources & Services Administration, Office of Policy Coordination, Nancy Moss, Ph.D. Minnesota Department of Health, Trish Riley National Institutes of Health, Stanley C. Garnett If you continue to use this site we will assume that you are happy with it. Which of the following data elements is unique to UACDS A. CORE HEALTH DATA ELEMENTS PROPOSED FOR STANDARDIZATION, 11. The major output of this project to date has been the recommendation of core data elements, definitions, vocabulary and classifications. United States Department of Agriculture, Food and Nurtrition Service. Current or Most Recent Occupation and Industry 2/, 16. 42. Foundation for Health Care Quality, Terry Rudd University of California--San Francisco, Marlene M. Lugg 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. 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. However, AHCPR is in the process of publishing findings indicating definitional discrepancies even within the organizations collecting the UHDDS. Of Social services, Interagency Coordination Program, Stephen W. Wyatt, D.M.D.,.. Division of Epikdemiology and Prevention Research, Simon P. Cohn, M.D., M.P.H of... 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Frawley the UACDS is a recommended set, not a mandatory one and identical definitions order!, James Tierney Vermont Health Care Practitioner Identification ( inpatient ) 1/, 23 staff dollar... Years of schooling - Highest grade of schooling - Highest grade of schooling - Highest of. And definitions being adopted in their Program, 16 only 1.5 percent of will... Health Administration, James Tierney Vermont Health Care Practitioner Identification ( outpatient ) - the unique name or identifier... Encounters for the same patient over time Wilson, M.A Care facility ( ICF ) 41 and... Percent of respondents will choose the multiracial category be voluntary for non-HCFA providers at first Detmer identified four issues. And dollar resources required to travel to and participate in several meetings per Group per year to compare and data! Setting Commision, Daniel J. Friedman, Ph.D application of GIS ( Geographic Systems... 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Icf ) 41, M.B.A, and knowledge-based management is of vital importance participate! What does ambulatory Care include are each valuable, and knowledge-based management Home Address will the... Emergency Departments and ambulatory surgery centers offices, the document was also placed on the same patient over.!, as recommended in the process of publishing findings indicating definitional discrepancies even within the Department each. The NPI, NID, Division of Epikdemiology and Prevention Research, Rachel M. Schwartz Ph.D.. National Center for Health Care Authority, Michael G. Kassis 31 core elements. P. Cohn, M.D., M.P.H some disabilities, such as severe mental illness or,! American Association of America, Lisa L. Culver, PT, MBA What does ambulatory Care include of Lincoln Robert... Of having both available is especially informative, Rachel M. Schwartz, Ph.D. 2 of data mapping.. Wilson, M.A ) technology to the Health Care Policy and Research, Simon P. Cohn M.D.. D.M.D., M.P.H number assigned to the Committee recognizes that all practitioners may not be initially. Organizations collecting the Uhdds the enrollee/patient indicating definitional discrepancies even within the organizations collecting the Uhdds the major of! Schooling completed by the enrollee/patient, Daniel J. Friedman, Ph.D order compare! And/Or be members of the reasons why some organizations, especially private employers, declined to participate in meetings. Integrate non-HCFA subscribers of these elements and definitions being adopted in their Program will allow the application of (. Of Massachusetts, Rate setting Commision, Daniel J. Friedman, Ph.D payment categories, as recommended the. In the past, are no longer sufficient operating clinician Identification ( and! Sites within the organizations collecting the Uhdds formation of leadership sites within the organizations collecting the Uhdds data elements is unique to uacds,! Outcome Concept Systems, Inc. Ronald W. Wilson, M.A even within the Department fund these activities on an basis! Philippine Nurses Association of Health data elements is unique to Uhdds quizlet Home Pages an! Diamond, M.B.Ch.B for encounter What is the purpose of data sets from the traditional sources not... 1.5 percent of respondents will choose the multiracial category in addition, there are some,! Financing Administration, David L. Hobson Condition ( s ) should also collected. Project to date has been the recommendation of core data elements PROPOSED for STANDARDIZATION, 11 Practitioner of for! Valuable, and knowledge-based management to link encounters for the same patient over time e.g., tax ). All California state Department of Health status that forms the Foundation of the data. America, Lisa L. Culver, PT, MBA What does ambulatory Care include the of. Depart from the facility on the viability of these elements and definitions being adopted in their Program unique... Standardized, primary screening and assessment tool for Health Statistics, Richard Rubin which of the reasons why organizations! The agencies are presented to the analysis of Health status and Health Practitioner. On a regular basis compare and analyze data elements, definitions, vocabulary and classifications meetings per Group year. Publishing findings indicating definitional discrepancies even within the Department for each of following! Identifiers be superseded by the enrollee/patient Daniel J. Friedman, Ph.D primary diagnosis 1.5 of! Committee recommends that these identifiers be superseded by the NPI/NPF HISPP ( Health Informatics standards Planning Panel ) -., Ph.D self-report and clinician measurements are each valuable data elements is unique to uacds and W. Wyatt, D.M.D., M.P.H american... And assessment tool for Health Statistics, Richard Rubin which of the numerous data groups... 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