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. Paul Y. Ertel, M.D. MPH Currently there is little or no input from the public health field for several reasons. Purpose: to identify data elements for a uniform minimum data set on ambulatory care CMS1500 (Claim form for Medicare/Medicaid Outpatient claims) is main vehicle used to collect UACDS data elements . 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. Work on this topic is currently ongoing in the NCVHS Disability and Long-Term Care Statistics Subcommittee. Dr. Detmer identified four overarching issues: privacy and confidentiality, computerized patient records, standards and classification, and knowledge-based management. 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. The collection of information on medications is crucial to understanding the health care encounter and the services provided to a patient. The report provides important background information on coordinators and promoters of standards development; lead standards-development organizations; organizations developing performance measures indicators; departmental organizations; international organizations; and others. H.Left against medical advice or discontinued care. 31. Commission on Cancer, Catherine E. Woteki, Ph.D., R.D. These discussions led to the issue of needing DHHS staff dedicated to participating in the meetings of numerous data standards committees, advising the Department, and producing further iterations of data elements as future agreement is reached. It is anticipated that the introduction of ICD-10 will alleviate this problem. G.Discharged/transferred to home under care of a Home IV provider Type of admission C. Gender D. Reason for encounter D. Reason for encounter What is the purpose of data mapping A. American Foundation for the Blind, Karen Kmetik To transmit electronic data C. To create a process for transmitting data to external users D. Health Care Financing Administration, David L. Hobson 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. 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. Department of Veterans Affairs, Veterans Health Administration, Deborah L. Parham, R.N., Ph.D. Name - Last name, first name, middle initial, suffix (e.g., Jr., III, etc.). 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. UACDS differs from UHDDS with data elements specific to ambulatory . However, the information is still considered useful to collect for trend purposes and for some indication of patients' coverage by third-party payers. 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. 23. University of Missouri, Kansas City, School of Dentistry, David K. Henderson, M.D. The Committee acknowledges that there are differences in coding guidelines for reporting diagnosis in inpatient and outpatient settings, and this may result in a lack of comparability in data between the two settings. 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). 7. In addition to the presentations at the meetings, more than 100 written responses to the solicitation letter were reviewed and considered. The UACDS is a recommended set, not a mandatory one. Birth Weight of Newborn (inpatient) - The specific birth weight of the newborn, recorded in grams. Date of Birth Month, day, and year of birth. National Indian Council on Aging, Inc. Jacqueline R. Bennett Hartford Primary Care Consortium, Inc. Thomas H. Dial, Ph.D. While reviewing the draft list of data elements, respondents indicated a number of additional data elements that they felt were important core elements. Although the Committee serves a very useful purpose in bringing together the experts to discuss and consider these elements, it takes dedicated departmental staff to keep the process underway on a day-to-day basis. UHDDS Today Hospital or facility identification number or code. 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. 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). 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. To transmit electronic data C. To create a process for transmitting data to external users D. 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. The Alan Guttmacher Institute, Kathleen A. Frawley Health Resources and Services Administration, Lorne A. Phillips, Ph.D. and is the best alternative to insure the availability of small area data. What does ambulatory care include? 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. American Medical Association, Herbert G. Traxler, Ph.D. 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. HHS, HCFA, Office of Managed Care, Gordon Bonnyman To transmit electronic data C. To create a process for transmitting data to external users D. Describe each data set . 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. The major output of this project to date has been the recommendation of core data elements, definitions, vocabulary and classifications. 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. Before sharing sensitive information, make sure youre on a federal government site. E.Discharged/transferred to another type of institution for inpatient care or referred for outpatient services to another institution Although it is best understood in conjunction with a socioeconomic indicator, researchers may gain a better understanding of the trends and impact of care on racial/ethnic minorities in the U.S. The Committee supports the HHS Data Council in its formation of the Health Data Standards Committee to focus attention on the needs for standardized data both within the Department and in the health care community at large and to foster collaboration and consensus with the major standards-setting organizations. In addition to requesting a written response from these experts, they were invited to participate in one of two special meetings organized by the Committee to discuss the project and to seek input. 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. Of these, approximately 70 percent provided information about their data elements. 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). Other Diagnoses (inpatient) - As recommended by the UHDDS, all conditions that coexist at the time of admission, or develop subsequently, which affect the treatment received and/or the length of stay. The primary diagnosis is not part of the UHDDS, and in most diagnostic situations, the principal and primary diagnoses will be identical. Massachusetts Department of Public Health, Richard H. Friedman 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. 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. Which is a data element of the Uniform Ambulatory Care data set Uacds )? A data element is defined by size (in characters) and type (alphanumeric,. The Committee encourages the Department and its partners to give high priority to conducting evaluation and testing on such elements and also seeks to alert organizations developing standards or data sets to leave place holders for their inclusion. Additionally, includes optional data elements to describe the patients living arrangements and marital status. 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).
