The National Committee on Vital and Health Statistics has been a sentinel organization in the area of uniform data efforts. 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. 8. 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 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. Health Insurance Association of America, John I. Gallin, M.D. For the first 12 elements, with the exception of unique identifier, information may not need to be collected at each encounter. Mayo Medical School, F. Lawrence Clare, M.D., M.P.H. An example of this could be NAHDO which could undertake to work with its members. It will do so by assigning a unique identifier to each provider. However, in the three remaining areas of health plans/insurers, government, and data standards organizations, the vast majority supplied data sets. HHS, NID, Division of Epikdemiology and Prevention Research, William J. Sobaski, M.B.A. Paul L. Grimaldi, Ph.D. These same data bases are being used to provide input to Federal surveys such as the National Hospital Discharge Survey (NCHS) and the Hospital Cost and Utilization Project (AHCPR). National Institutes of Health, Stanley C. Garnett But time is short; decisions are being made by organizations now. 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. Much of the required information can be located on the patients face sheet. In recent years, the focus of health care has been shifting to hospital outpatient and other outpatient care, including clinic, hospice and home care, sites for which standardized data collection had not been developed. Sex Male or female 04. Biometrics, Center for Devices and Radiological Health, Food and Drug Adm. Elizabeth Grossman Operating Clinician Identification (inpatient) 1/, 23. In addition, there are some disabilities, such as severe mental illness or blindness, where ADLs and IADLs are not sufficient measures. At the very minimum, there need to be "place holders" provided to standards organizations to inform them that certain data elements are critical elements, even when the specific format of the items is currently undecided. Standardized coding schemes, such as the Census Bureau's Alphabetical Listing of Occupation and Industry and the Standardized Occupation and Industry Coding (SOIC) software developed by the National Institute for Occupational Safety and Health, should be reviewed. Indian Health Service, Robert Davis What clinical information is collected in the Uhdds? (9 days ago) What does uacds mean or stand for?UACDS means Uniform Ambulatory Care Data Set. A second study is currently underway, one which will investigate core data elements in common use in data sets on persons with disability and/or persons receiving long term care. Together with marital status, this element provides a picture of potential formal/informal resources available to the person. Operating Clinician Identification - The unique national identification number assigned to the clinician who performed the principal procedure, as recommended by the UHDDS. California Health Information for Policy Project, Nancy J. Kennedy, Dr.P.H. Participants in the various meetings had discussed ways to disseminate new data items, seek input, and inform data collectors of recommended elements and definitions. Massachusetts General Hospital, Harvard Medical School, Jonathan M. Ellen, M.D. ABLES Project Opfficer, NIOSH, Steven Rosenberg, Ph.D. 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. 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 [] Regenstrief Institute, Dora A. McDonald There has been substantial agreement on data elements in these sets, but less agreement on data definitions. The UHDDS and UACDS have recommended the collection of all charges for procedures and services rendered to the patient during a hospitalization or encounter. HHS, Health Care Financing Administration, Kim Streit No EP studies. 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). Health Care Practitioner Identification (outpatient) 1/, 20. Patient's Relationship to Subscriber/Person Eligible for Entitlement, 12. 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. Several organizations have volunteered to facilitate dissemination and feedback of the core data elements project. 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. Kaiser Foundation Health Plan, Matthew McKearn 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. NCQA (National Committee for Quality Assurance). State of Kansas Department of Health and Evironment, Renate E. Pore For children under the age of 18, the mother's highest grade of schooling completed should be obtained. Currently there is little or no input from the public health field for several reasons. 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. The UHDDS guidelines are used by hospitals to report inpatient data elements in a standardized manner. 1. Work on this topic is currently ongoing in the NCVHS Disability and Long-Term Care Statistics Subcommittee. American Association of Health Plans, Louis H. Diamond, M.B.Ch.B. Currently, data are often shared within a facility in an identifiable format. Patient's Relationship to Subscriber/person eligible for entitlement -, A.Self Diagnosis Chiefly Responsible for Services Provided (outpatient), 38. Several states, including California, Oklahoma, and New York presented findings on using a combination of key data items to perform probabilistic matches. Date of Birth - Year, month and day - As recommended by the UHDDS and the Uniform Ambulatory Care Data Set (UACDS). 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. Emily Friedman Health Policy Analysis, Del Fulgencio States have varying laws to protect the confidentiality of these data, and often the laws do not protect data that have crossed state lines. All have significant value and could result in the collection of four separate data elements. 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. HHS, Public Health Service, Health Resources Services Administration, Steven Clauser These elements apply to persons seen in both ambulatory and inpatient settings, unless otherwise specified. Where can I watch the entire Dragon Ball series for free. 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. The Committee recognizes the importance of having both data items and identical definitions in order to compare and analyze data elements. While reviewing the draft list of data elements, respondents indicated a number of additional data elements that they felt were important core elements. Type of Encounter - This element is critical to the placement of an encounter of care within its correct location, i.e., hospital inpatient , outpatient, emergency department, observation, etc. Oklahoma Department of MH and SA Services, Don Eugene Detmer, M.D. To measure the current state of the use of various data sets, the Committee contracted with the Center for Health Policy Studies (CHPS) in Columbia, MD to begin identifying major data sets already in existence, especially in the private field. Commonwealth of Virginia, Department of Medical Assistance Services, William R. Taylor, M.D., M.P.H. A significant procedure is one that is: Surgery includes incision, excision, amputation, introduction, endoscopy, repair, destruction, suture, and manipulation. The Minimum Data Set for long term care (MDS) was published by the Department of Health & Human Services in 2013 and modified in 2016. Agency for Health Care Policy and Research, Center for Cost and Finance Sudies, Marc A. Weisblatt, M.P.H. FACEP University of Missouri, Kansas City, School of Dentistry, David K. Henderson, M.D. 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. Future projects may undertake to seek consensus among some of these items. The complete address of the providers office. ICD-9-CM Vol. 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. Operating Clinician Identification (inpatient), 40. 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. Race and Ethnicity - The collection of race and ethnicity have been recommended by the UHDDS and the UACDS, and these elements have a required definition for Federal data collection in Office of Management and Budget (OMB) Directive 15. National Institute on Drug Abuse, Cille Kennedy 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. However, there was no clear-cut listing of mutually exclusive encounter locations or definitions to draw upon. North Carolina Department of Human Resources, Division of Medical Assistance, Robert W. Mayes Health Care Practitioner Identification (outpatient), 21. OMB is currently investigating the possibility of changes to this classification, and the Committee will await the OMB recommendations. 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. However, the activities envisioned by many participants go much farther than an advisory committee can handle. 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. Dept. The Committee has appointed a liaison to participate in selected meetings of the American National Standards Institute (ANSI) Accredited Standards Committee (ASC) X-12, a private sector coalition that is developing transmission standards for health data. Children's Memorial Hospital, Ernest J. Sessa Currently, such a staff does not exist. Office of Statewide Health Planning and Development. Department of Veterans Affairs, Assistant Secretary for Policy and Planning, Mary Dufour Philippine Nurses Association of America, Lisa L. Culver, PT, MBA Agency for Health Care Policy and Research, Rachel M. Schwartz, M.P.H. Type of admission C. Gender D. Reason for encounter D. Reason for encounter What is the purpose of data mapping A. 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. Consideration of these various issues and additional study and evaluation are needed before recommendations can be made for standardizing functional status measurement. External Cause of Injury - This item should be completed whenever there is a diagnosis of an injury, poisoning, or adverse effect. Molly A. Anthony, Ph.D. Patient's Expected Sources of Payment - The following categories are recommended for primary and secondary sources of payment: 40A. Current or Most Recent Occupation and Industry, 28. B.The health care practitioner for each clinical service received by the patient, including ambulatory procedures. 200 Independence Avenue, SW The process for these specialized areas is ongoing and final recommendations for specific elements have not yet been submitted to the full Committee. E.Discharged/transferred to another type of institution for inpatient care or referred for outpatient services to another institution 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. University of California--San Francisco, Marlene M. Lugg In some instances, lists of items were received with many basic data items not included. Which data is collected on Medicare and Medicaid patients? 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. ), particularly when used alone, and impediments (legal and otherwise) to its use. 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. 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. College of American Pathologists, Division of Government and Prof. Affairs. This element is currently collected on the HCFA 1500 form. More than 150 responses to this second request were received, including responses from the leaders in the health care and health care information fields. The NCVHS recognizes the vital importance of maintaining confidentiality and emphasizes that any public use of a unique identifier should be in an encrypted form. In addition to the presentations at the meetings, more than 100 written responses to the solicitation letter were reviewed and considered. 22. 2. Birch & Davis Health Management Corporation, Inc. George F. Grob State of Washington Department of Health, Maria Rey A. Race and ethnicity B. 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. Health Care Financing Administration, Emily Friedman Living/Residential Arrangement - The following definitions are recommended by the NCVHS: Multiple responses to this item are possible. Additionally, includes optional data elements to describe the patients living arrangements and marital status. Health Resources & Services Administration, Office of Policy Coordination, Nancy Moss, Ph.D. The latter element, which describes all conditions requiring evaluation and/or treatment or management at the time of the encounter as designated by the health care practitioner, has been divided into two elements: 1) the diagnosis chiefly responsible for services provided, and 2) other diagnoses. National Center for Health Statistics. The Committee has chosen to include these elements because it believes that the need for the type of information they contain will continue to increase. The HCFA Common Procedure Coding System (HCPCS), based on CPT-4, is required for physician (ambulatory and inpatient), hospital outpatient department, and free-standing ambulatory surgical facility bills; however, NCVHS strongly advocates a single procedure classification for inpatient and ambulatory care. 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. In addition, a number of elements for which consensus is close, must be field tested to confirm their definitions and collectibility. Gender As recommended by the UHDDS and the UACDS. 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. 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. American Hospital Association, Edward W. Bacon [Uniform Ambulatory Care Data Set (UACDS)]: A core set of data elements used to report ambulatory data elements in standardized manner. However, there is some evidence that the number of interracial marriages is accelerating. 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). Michigan Department of Social Services, Interagency Coordination Program, Stephen W. Wyatt, D.M.D., M.P.H. Development of a unique identifier does not necessarily mean that the individual is identifiable to users. New York State Office of Mental Health, James T. Howell, MD 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. If a reporting entity is using a different element or definition, explain why their current usage is preferable. The University of Illinois at Chicago, Eunice Chee The definition has been expanded slightly from the OMB requirement: It is recommended that this item be self-reported, not based on visual judgment or surnames. Which of the following data elements is unique to UACDS? To transmit electronic data C. To create a process for transmitting data to external users D. Describe each data set . A qualifier element is recommended to indicate the type of coding structure used, i.e., ICD, CPT, etc. However, AHCPR is in the process of publishing findings indicating definitional discrepancies even within the organizations collecting the UHDDS. United States Department of Agriculture, Food and Nurtrition Service. Years of Schooling - Highest grade of schooling completed by the enrollee/patient. It also includes data elements specific to ambulatory care, such as the reason for the encounter with the healthcare provider. The Committee has recognized that data confidentiality is a major concern in the collection of health data from an increasing number of sites, and the Committee has long been concerned with personal privacy and data confidentiality issues. 18. 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. American Foundation for the Blind, Harvey A. Schwartz, Ph.D. Virginia Health Information, Charles MacKay If you continue to use this site we will assume that you are happy with it. The National Association of Health Data Organizations has also opposed such an inclusion. IPRO - Corporate Headquarters, Nancy G. Stetson, B.S.N., M.A. Total Billed Charges - All charges for procedures and services rendered to the patient during a hospitalization or encounter. Another issue was the role of the National Committee itself as the source of information on common data elements. Health Care Practitioner Identification (outpatient) - The unique national identification number assigned to the health care practitioner of record for each encounter. On that same day NCVHS submitted to the DHHS Data Council its recommendations for standardizing 42 core health data elements, including demographic, socioeconomic, and health status information about a person and data specific to a person's encounter with the healthcare system on either an inpatient or outpatient basis. White, M.P.H., Ph.D. D.Discharged/transferred to an intermediate care facility (ICF) No decisions have been made by the Department on any of these recommended revisions of either the UHDDS or the UACDS. Other Procedures (inpatient) - All other procedures that meet the criteria described in element 33. 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. 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. American Medical Association, Mark Epstein, Sc.D. Information is collected by a wide range of users and in a myriad of different formats. 21. UACDS differs from UHDDS with data elements specific to ambulatory . 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. What does ambulatory care include? Circulate the report within the Department for review and constructive criticism. Illinois Department of Public Aid, Amanda Attridge Henson 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. College of Nursing, East Tennessee State University, Jimmy Thomas Efird Connecticut Children's Medical Center, Geraldine Oliva Personal/Unique Identifier - the unique name or numeric identifier that will set apart information for an individual person for research and administrative purposes. As highlighted earlier, the Committee has identified a number of areas that should be considered for implementation by the HHS Data Council. Where can the Uhdds data elements be found? 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. 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. Each encounter generates a date of service that can be used to link encounters for the same patient over time. Congress of the United States, Emilie Schmeidler, Ph.D. Mactas In recent years, the Committee has recognized the importance of electronic standardization efforts which are taking place in the business community. A lack of footnote indicates that these elements are ready for implementation. Deborah Lieberman, MHSA, OTR/L, PAOTA Attending Physician Identification (inpatient) 1/, 22. For the first 12 elements, with the exception of unique identifier, information may not need to be collected at each encounter. Centers for Disease Control and Prevention, Lynn E. Jensen, Ph.D. The Committee recognizes the importance and desirability of linking services with diagnoses, wherever feasible. Office of Personnel Management, Jacqueline Darroch Forrest, Ph.D. Health Resources and Services Administration, Lorne A. Phillips, Ph.D. New York, using the last 4 digits of the Social Security Number, with other characteristics (such as date of birth), indicated a match rate exceeding 99 percent. It will also serve as a quality check as the date of birth approaches the new century mark. The Alan Guttmacher Institute, Kathleen A. Frawley However, income questions are often considered intrusive, whereas years of schooling are more acceptable to respondents. 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