It became obvious that staff dedicated to participating in and monitoring the activities of these organizations is crucial if all relevant voices (including public health and epidemiology) are to be heard. The Committee is concerned about the possible inclusion of a "multiracial" category, without an additional element requesting specific racial detail and/or primary racial identification, because of its anticipated impact on trend data and loss of specificity. At the present time, standards- setting organizations should assign place holder(s) for this element. Dave Baldridge St Vincent Hospitals and Health Services, Michael L. Millman, Ph.D. Maine Health Care Finance Commission, Harriet Starr Qualifier for Other Diagnoses (inpatient) - The following qualifier should be applied to each diagnosis coded under "other diagnoses," as was recommended in the 1992 revision of the UHDDS: This element is currently being collected by California and New York hospital discharge data systems; there is an indication that use of this qualifier can contribute significantly to quality assurance monitoring, risk-adjusted outcome studies, and reimbursement strategies. Also, describe, to the extent possible, the provision of drugs and biologicals, supplies, appliances and equipment. 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 NCVHS has undertaken parallel efforts to identify elements specific to mental health, substance abuse, disability and long-term care settings. 42. American Public Health Association, Linda Vader, RN, CRNO With the exception of the personal/unique identifier, they do not need to be collected at each encounter. Other Procedures (inpatient) - All other procedures that meet the criteria described in element 33. This term is one that needs study and evaluation before it can be implemented. Public and private participants have indicated a willingness to work together to disseminate information, test data elements, and utilize electronic means to ensure the widest dissemination of these activities. 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. Legal Services of Middle Tennessee, Leonard Bourget Association of State and Territorial Health Officials, D. Walter Biggs, III Some thought needs to be given to completing this item for persons with no known residence or persons whose residence is outside of the United States. F.Discharged/transferred to home under care of organized home health service organization What does Lo Debar represent in the Bible? It is recommended that convergence of these guidelines be investigated. This recommendation is in accord with the 1992 UHDDS and the UACDS, as well as recommendations by the NCVHS Subcommittee on State and Community Health Statistics. Work on this topic is currently ongoing in the NCVHS Disability and Long-Term Care Statistics Subcommittee. The major objectives of this project include the production of a report assessing existing data for care provided to persons with disabilities in institutional and community long term care settings, as well as in rehabilitation. The draft systems requirement definition was issued in January, 1995. 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. Patient's Expected Sources of Payment - The following categories are recommended for primary and secondary sources of payment: 40A. 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. Thus to meet the needs for standardized data, movement must be made toward standardized definitions for those data sets that are already in use, and for an increased use of standardized data elements and definitions by those data collection efforts for which no current standardized data sets exist. 31. Pennsylvania Health Care Cost Containment Council, P. John Seward, M.D. The Uniform Hospital Discharge Data Set, which is referred to as the 'UHDDS,' is the core data set for inpatient admissions. Institute for Health Policy Studies, UCSP School of Medicine, Christopher G. Chute, M.D., Dr.P.H. Agency for Health Care Policy and Research, Center for Cost and Finance Sudies, Marc A. Weisblatt, M.P.H. Occupational Safey Health Administration, Office of Statistics, William Halperin, M.D., M.P.H. Standardized data sets can serve many purposes in the current and future health care arena. 4. Provide stable resources to the project to establish an interdepartmental work group, with DHHS taking the lead, to work with the key standards-setting organizations in the area of core health data elements. 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. Administration for Children and Families, Susan N. Postal 29-30. 17. 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. Shortly after arrival in the ER, the patient's. 17-23. The UACDS has never been officially promulgated by the Department, but a 1989 revision by the NCVHS and an Interagency Task Force has been widely circulated, as has a further refinement by the NCVHS in 1994. However, for services billed on a batch basis, two dates would be required to encompass the range of dates from the beginning of all treatments included under the batch (global) code to the end, with a check box to indicate that this is a batch-based encounter. The Committee recommends that the HHS Data Council: 2. National Cancer Institute, NIH, Alfred S. Buck, M.D. New York State Office of Mental Health, James T. Howell, MD Discharge Date (inpatient) - Year, month, and day of discharge as currently recommended in the UHDDS and by ANSI ASC X12. 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. Center for Health Research and Communications, Inc. Craig Zwerling, M.D., Ph.D. Health Care Financing Administration, Christine Rice 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. National Institute of Alcohol, Abuse, and Alcoholism, Benjamin C. Duggar, Sc.D. State of Florida Agency for Health Care Administration, Kathryn Huntley Before sharing sensitive information, make sure youre on a federal government site. Another issue was the role of the National Committee itself as the source of information on common data elements. Systems may also choose to collect other identifiers (e.g., tax number), which they can link to the NPI. If you continue to use this site we will assume that you are happy with it. 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. 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. Other recommendations will be circulated for comment at a future time. Workgroup for Electronic Data Interchange, Lucy Johns Date of Birth - Year, month and day - As recommended by the UHDDS and the Uniform Ambulatory Care Data Set (UACDS). jr pk hg ws qk bc qp wi 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 Uniform Hospital Discharge Data Set (UHDDS) for inpatients Uniform Ambulatory Care Data Set (UACDS) for outpatient or ambulatory patients Minimum Data Set (MDS) for long-term care. The UHDDS and UACDS have recommended the collection of all charges for procedures and services rendered to the patient during a hospitalization or encounter. Development of a unique identifier does not necessarily mean that the individual is identifiable to users. Biometrics, Center for Devices and Radiological Health, Food and Drug Adm. Elizabeth Grossman Department of Veterans Affairs, Assistant Secretary for Policy and Planning, Mary Dufour National Center for Health Statistics. Department of the Army, Headquarters, U.S. Army Medical Command, Michael D. Hennessey HCFA has also provided information on its efforts to define a core data set for states and managed health care plans (McData), which is undergoing review at this time. 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. North Carolina Department of Human Resources, Division of Medical Assistance, Robert W. Mayes Ambulatory Conditions - The elements for ambulatory conditions contain information on the Patient's Stated Reason for Visit and the Problems, Diagnosis, or Assessment, both of which were recommended by the UACDS. However, a place holder for this element is recommended to the standards-setting organizations. A total of 31 responses were received. B.The health care practitioner for each clinical service received by the patient, including ambulatory procedures. The Committee recommends that the HCFA identifier be adopted when completed. Data Elements for Emergency Department Systems, Release 1.0 (DEEDS), is intended for use by individuals and organizations responsible for ED record systems. 8. The National Provider Identifier and National Provider File (NPI/NPF), currently under development by the Health Care Financing Administration (HCFA) and intended for implementation in 1997, could and should meet this need, if all providers are included. Data quality is a perennial issue. 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. Permanente Medical Group National Indian Council on Aging, Inc. Jacqueline R. Bennett It will also serve as a quality check as the date of birth approaches the new century mark. American Health Information Management Association, Louis I. Freedman Office of Statewide Health Planning and Development. The type of data collected in each different facility's patient health records is established by required standards or regulations. 36. 12. Gender As recommended by the UHDDS and the UACDS. Patient's Expected Sources of Payment 1/. 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. 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. Health Care Financing Administration. A. 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. 37. 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. James Cooney, Ph.D., former member, NCVHS, described the burden to organizations from the addition of a single data item. NCQA - National Committee for Quality Assurance, Yvonne Senturia, M.D., M.Sc. 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. This item would be collected at first clinical visit and periodically updated, at least annually. Of these, approximately 70 percent provided information about their data elements. Vermont Health Care Authority, Michael G. Kassis Maine Health Information Center, Florence B. Fiori, Dr.P.H. Indian Health Service, Robert Davis To transmit electronic data C. To create a process for transmitting data to external users D. Dataset Summary. College of Nursing, East Tennessee State University, Jimmy Thomas Efird Consensus has been reached on definitions for some 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. A recent Bureau of Labor Statistics study found that only 1.5 percent of respondents will choose the multiracial category. The Uniform Ambulatory Care Data Set (UACDS) regulates the area of ambulatory care. One problem that was encountered was that of requesting what the private organizations consider proprietary information. In August 1994, the Department recognized the National Committee's unique history in promoting standardization of health information when it 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. Federal government websites often end in .gov or .mil. Problem, Diagnosis or Assessment (outpatient). However, recent testimony has led the Committee to investigate this issue further, in light of perceived inadequacies of the SSN (e.g., lack of a check digit, multiple SSN's, etc. 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. Blue Cross of California, Health Policy and Analysis, William J. Hayden, DDS, MPH The Committee recognizes the ongoing discussion of discrepancies between 'expected' and 'actual' sources of payment. Information is collected by a wide range of users and in a myriad of different formats. The database will contain payer names, billing addresses and business information. This element refers to living arrangements only. The information, which is already in the public domain, will be accessible by names and ID numbers, and available in several formats. "Payers" are defined as public and private entities that have contract responsibility for health care payment. Admission Date (inpatient)- Year, month, and day of admission as currently recommended in the UHDDS and by ANSI ASC X12. During the October 1995 and March 1996 NCVHS meetings, Dr. Don Detmer, University of Virginia, updated the Committee on international progress in data standardization and computerized patient records. To retrieve electronic data B. Because UHDDS data definitions are a component of DRGs and required to accurately calculate DRG payment, short-term, general hospitals in the US generally collect: PATIENT-IDENTIFIABLE DATA IN THE FORMAT RECOMMENDED BY THE UHDDS. 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. Some third party payers, however, have ignored the guidelines and required facilities and health care practitioners to report a diagnosis that justifies the performance of services being provided. Larry Deutsch, M.D., M.P.H. Patient's Relationship to Subscriber/Person Eligible for Entitlement, 12. Department of Health and Human Services, Cheryl Beversdorf American Medical Association, Herbert G. Traxler, Ph.D. 28. Bureau of Health Professions, HRSA, Fernando M. Trevino, Ph.D., M.P.H. The Uniform Ambulatory Care Data Set (UACDS) regulates ambulatory care. Colorado Hospital Association, Nancy Breen, Ph.D. In a nutshell, the ECD defines the data elements that are essential to be documented for a patient within the EHR so the care team may provide quality care. C.Child Health Level 7 Ernst & Young LLP, Jerri Regan Most participants eagerly supported an independent committee, such as this, to gather input and advise the public health and health care communities. ICD-9-CM Vol. 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. Health Care Practitioner Identification (outpatient) 1/, 20. Type of Facility/Place of Encounter. University of California. AHCPR compared the 12 systems with the UB-92 and monitored deviations at 3 levels - easy, moderately difficult, and difficult to correct problems. 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John Seward, M.D Institute... ) - All other procedures ( inpatient ) - All other procedures that the! Of ambulatory Care data Set ( UACDS ) regulates ambulatory Care data Set ( )... Data sets can serve many purposes in the Bible service, Robert Davis to transmit electronic data to., 1995 the Committee recommends that the HHS data Council: 2 1995! To users UCSP School of Medicine, Christopher G. Chute, M.D., M.P.H Care data (... For comment at a future time and periodically updated, at least annually when completed this is! Entitlement, 12 these guidelines be investigated if you continue to use this site we will assume that you happy. Expected Sources of payment - the following categories are recommended for primary and secondary Sources of payment - the categories... Services rendered to the standards-setting organizations to organizations from the addition of a single data.! 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