UNIT 6 SEMINAR HI300: I NFORMATION TECHNOLOGY AND SYSTEMS FOR HEALTHCARE PROF JOHNSEN Secondary Data Sources AGENDA ❖Discussion Board Reminders ❖ Secondary Data Sources ❖Unit Assignment Secondary Data Sources ▪The health record’s primary purpose is patient care and reimbursement for encounters. ▪In order to see trends in a population of patients, you look at the data that is extracted from the records and enter it into databases – registries, indexes, etc. ▪These data sources are referred to as secondary data sources. HIM Roles in Managing Secondary Records and Databases Establishing database: oDetermining content of database oEnsuring compliance with laws, regulations, and accreditation standards oData dictionary oData steward: oversees that data put in database or registry is accurate and complete Differences Between Primary and Secondary Data Sources ❑Primary data source: medical record… b/c it contains information about a patient that has been documented by a healthcare professional ❑Secondary data source: data contained in indexes, registries and similar databases ❑Ways to classify data: 1. Patient-specific/identified data ◦ Patient identified within the data. Every fact recorded in the record relates to a patient by name. 2. Patient identifiable data ◦ If identify of patient can be derived or inferred from the data with or without the assistance of a computer. Can the patient be identified by date of birth, phone #, zip code, 3. Aggregate data ◦ Data on groups of patients without identifying any particular patient individually Purposes and Users of Secondary Data Sources Four major purposes to collect secondary data: 1. Quality, performance, and patient safety 2. Research – data entered into databases help researchers determine treatment plans 3. Population health – require information be reported about certain diseases to prevent spreading 4. Administration – facilities are required to check physicians in the national database for information on previous malpractice or action against the physician Internal Users ❑Users within the organization ❑Examples: Medical staff, Management staff ❑Identify patterns and trends that are helpful in patient long term care, benchmarking with other facilities. External users ❑Individuals and institutions outside the facility ❑Examples: State data banks, Federal agencies ❑Federal government collects data from states on vital events like births and deaths Types of Secondary Data Sources Facility-specific indexes: enable health records to be located by diagnosis, procedure, physician. Originally kept on cards, now in computerized databases due to technology. Broken down into several types… let’s discuss those types! Master Population/Patient Index (MPI) Contains patient identifiable data : o Name o Address o Date of birth o Dates of hospitalization or encounters o Name of attending physician o Health record number Disease and Operation Index Each patients diagnosis is converted from a description to a numerical code Disease o Listing in diagnosis code number order ◦ Patients discharged during specified period ◦ Contains o Health record number o Diagnosis codes o Attending physicians name o Date of discharge Operation o Similar to disease index o Numerical order by procedure code o May also include surgeon’s name Physician Index Can retrieve information about a particular physician Example: the number of cases seen during a particular time frame Registries ❑Purpose: to collect data from health records and to make them available for users ❑Registries contains more extensive information than indexes. ❑Index reports created using data from existing facility databases. ❑Registries contain more extensive data from the patient record. ❑Each registry must define the cases that will be included: case definition ❑Case finding used to identify the patients who have been treated in a facility for a particular disease Cancer Registries Facility-based registries: o Provide information for improved understanding of cancer (diagnosis, treatment) Population-based registries: o Identifying trends and changes in the new cases of cancer within the area covered by the registry Registry required to collect data such as: o Demographic info about each cancer case o Occupational history of individual o Pathological data about the cancer (site, stage, type of treatment) Data Collection for the Cancer Registry When a case is first entered in the registry, an accession number is assigned. o Made up of year the patient was seen and remaining numbers assigned sequential throughout the year o Assigned manually or be assigned automatically Accession registry: can be kept manually or generated by the database Collaborative Stage Data Set: uses algorithms to describe how far the cancer has spread Trauma Registries Traumatic injuries Data used for performance improvement and research Case definition and case finding for trauma registries o Usually involves trauma diagnosis codes Data Collection for Trauma Registries Data elements may include: o Demographics o Information on injury o Care received before hospitalization o Status of patient at time of admission o Patient’s course in the hospital o Diagnosis and procedure codes o Abbreviated Injury Scale (AIS) – nature of injury, threat to life o Injury Severity Scale (ISS) – overall severity measurement calculated from AIS score Birth Defects Registries Collect information on newborns with birth defects Usually population-based Provide information on incidence of birth defects and monitor trends Case definition: o Varies by facility o May be limited to those found in first year of life Data Collection for Birth Defects Registries Demographic information Diagnosis codes Birth weight Status at birth (live-born) Autopsy Cytogenetics results Single or multiple birth Mother’s use of alcohol, tobacco, or illicit drugs Father’s use of drugs and alcohol Family history of birth defects Diabetes Registries Used in managing care and research Case definition: o May be limited by type of diabetes Case findings: o Diagnosis codes o Billing data o Medication lists o Physician identification o Health plans Diabetes Registries May be found in hospital or physician office Data collection: o Demographic information o Laboratory values o May track patients Reporting and follow-up: o Laboratory monitoring o Patient’s not seen in a year Implant Registry Tracks performance of implants Safe Medical Devices Act of 1990 Medical Device Amendments of 1992 Must report deaths and severe complications Case Definition o May be all implants or a specified type Implant Registry Data Collection User facility report number Name and address of device manufacturer Device brand name and common name Product model, catalog, serial, and lot numbers Brief description of the event reported to manufacturer and/or the FDA Where report was submitted Transplant Registry May track who needs organ o United Network for Organ Sharing o National Marrow Donor Program Data may be used for: o Research o Policy analysis o Quality control Transplant Registry Case definition and case finding for transplant registries o Patients who need transplants Data Collection for Transplant Registries o Type of data varies Immunization Registries Purpose is to increase number of infants and children to receive required immunizations at the proper intervals Case Definition o All children in population area Case Finding o Frequently entered in registry at birth Data Collection for Immunization Registries Patient name Birth data Sex, race, ethnicity Birth order Birth state/country Mother’s name Vaccine type Vaccination date Vaccine lot number National Practitioner Data Bank Database of medical malpractice payments, adverse licensure actions and certain professional review actions Required reporting: o Information on practitioner o The reporting entity Penalties for non-reporting Data used in credentialing process http://www.npdb-hipdb.hrsa.gov/ Healthcare Integrity and Protection Data Bank Mandated by HIPAA to report healthcare fraud and abuse Final adverse actions are reported: o Federal or state licensing and certification actions o Exclusions from participation in federal or state healthcare programs o Any other adjudicated actions or decisions defined in the HIPDB regulations National, State, and County Public Health Databases Public health o Surveillance of health state of population o Monitors: ◦ incidence and prevalence of disease ◦ Possible high-risk populations ◦ Survival statistics ◦ Trends over time o Data collected by interview, physical exams and health records National Health Care Survey Public health survey Made up of multiple surveys: o National Hospital Discharge Survey o National Ambulatory Medical Care Survey o National Survey of Ambulatory Care o National Nursing Home Survey o National Home and Hospice Care Survey Uses health record data Vital Statistics Data on births, deaths, fetal deaths, marriages, and divorces Collected by state Information shared with National Center for Health Statistics Linked Birth and Infant Death Data Set Clinical Trials Research project in which new treatments and tests are investigated Protocols ClinicalTrials.gov: o Information includes summary of purpose of study, recruiting status, criteria for participation, location of trial and contact information Tasks for this Week 1. Discussion 2. Assignment 3. Seminar Assignment Instruction Review the following website: Source: Healthcare Cost and Utilization Project: United States Department of Health and Human Services. Retrieved from http://www.ahrq.gov/research/data/hcup/ Create an informational flyer for the Healthcare Cost and Utilization Project. You should use Microsoft Word or Microsoft Publisher to create your advertisement. Include the following information: • What is the HCUP Program? • There are several different database tools used in this program. Name at least four database tools and give a summary for each. • Indicate on the advertisement if your state participates in the HCUP program. If your state does participate in the program, provide the contact information for the person listed. Requirements: The Assignment should be a 1 page flyer created using either Microsoft Word or Microsoft Publisher. This Assignment should follow the conventions of Standard American English (correct grammar, punctuation, etc.). Your writing should be well ordered, logical, and unified, as well as original and insightful. The resources used (including your text) should be properly cited. Your work should display superior content, organization, style, and mechanics. Submitting your work: Submit your Assignment to the appropriate Dropbox. Please be sure to download the file “Writing Center Resources” from Course Documents to assist you with meeting APA expectations for written Assignments. A look ahead to Unit 7 Discussion Post – ◦ Determine why information security is so important in healthcare by analyzing at least two different types of safeguards for data and elaborate on what standards are looked at for each. Also, identify the types of facilities these safeguards can be used in and what are the expectations. Please try not to duplicate your classmates’ answers. There may be several different standards for each safeguard but you are required to mention at least two. ◦ Administrative safeguards ◦ Access safeguards ◦ Physical safeguards ◦ Administrative safeguards ◦ Network safeguards Unit 7 Assignment Instructions: Create a security plan for a medium sized health care facility. In your security plan, evaluate how you would approach security threats from both inside and outside the organization. Be sure that you address the following items in your security plan: ◦ physical and administrative safeguards: employee education, health information archival and retrieval systems, disaster recovery, storage media ◦ access safeguards: authentication, password management ◦ network safeguards: cloud computing, firewalls, encryption / decryption and using mobile devices to deliver healthcare Critique the plan you have written, identifying its strengths, elements that were not covered in the text, and any additional omissions or weaknesses of the plan. As a reference, you may want to visit the following website: Source: HIPAA Privacy, Security, and Breach Notification Audit Program: United States Department of Health & Human Services. Retrieved from http://www.hhs.gov/ocr/privacy/hipaa/enforcement/audit/index.html QUESTIONS?
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