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. A. Birch & Davis Health Management Corporation, Inc. George F. Grob 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. National Indian Council on Aging, Inc. Jacqueline R. Bennett There is already consensus among data collectors and users for a significant number of data elements, especially elements related to person descriptors and to selected information on inpatient and ambulatory encounters. If the HCFA system does not have separate identification numbers for parts of a hospital (i.e., Emergency Department, Outpatient Department), an additional element (such as element 13) will need to be collected along with the facility ID to differentiate these settings. The National Committee on Vital and Health Statistics (NCVHS) has undertaken a first step in bringing together leaders in the field to seek consensus on a small set of data elements that are often considered the core of many data collection efforts. 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. The study also found that with the multiracial option there was a considerable decline in percentage terms (approximately 29 percent) of respondents choosing American Indian, Eskimo or Aleut. 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. Performance monitoring and outcomes research are two additional areas that are currently hampered by the inability to link data sets from various sources due to varying data elements and definitions. Qualifier for Other Diagnoses (inpatient), 28. Operating Clinician Identification (inpatient) 1/, 23. HHS, Agency for Health Care Policy Research, Ctr for Cost and Financing Studies. More than 150 responses to this second request were received, including responses from the leaders in the health care and health care information fields. A listing of the Core Health Data Elements grouped by level of readiness for implementation is provided after the section with the definitions of each data element. Disposition of Patient (inpatient) - As recommended by the UB 92 and as an expansion of the 1992-93 UHDDS data element: A.Discharged to home or self care (routine discharge) In addition to the presentations at the meetings, more than 100 written responses to the solicitation letter were reviewed and considered. 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. 8. The American Academy of Family Physicians, Barbara Faigin "Payers" are defined as public and private entities that have contract responsibility for health care payment. However, in the three remaining areas of health plans/insurers, government, and data standards organizations, the vast majority supplied data sets. Health Resources and Service Admin. Florida Hospital Association Information Services, George J. Stukenborg, Ph.D. To retrieve electronic data B. Data sets received were assessed for their consistency with other data sets, particularly minimum data sets such as the UHDDS and the UACDS, the HCFA 1500 and the UB 92 data sets, and also with other current and future data sets under development by data standards organizations (ANSI). Center for Health Research and Communications, Inc. Craig Zwerling, M.D., Ph.D. Condition(s) should be recorded to the highest documented level of specificity. The National Committee on Vital and Health Statistics has been a sentinel organization in the area of uniform data efforts. The Committee encourages the use of the above definition, while continuing to study and evaluate other residential categories, such as those used by the Bureau of the Census. What does UACDS stand for? Data quality is a perennial issue. Dave Baldridge National Institute of Dental Research, NIH, T. J. Mathews 10. Standard electronic formats are recommended to the extent that they have been developed. Include the full name of the provider as well as the National Provider. Several states, including California, Oklahoma, and New York presented findings on using a combination of key data items to perform probabilistic matches. The response to the Committee's activities both through 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. Expired has been added because the outpatient setting includes a wide range of sites, including Emergency Departments and ambulatory surgery centers. 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. 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. 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. They currently are not developing a system of categories to accompany the IDs. It will do so by assigning a unique identifier to each provider. State of New Jersey Department of Health, Dennis Duffy Which of the following data elements is unique to UACDS A. Used in the National Health Interview Survey and many other studies, this item has been shown to be predictive of morbidity, mortality, and future health care use, when collected in a general interview type of setting. However, the activities envisioned by many participants go much farther than an advisory committee can handle. All have significant value and could result in the collection of four separate data elements. NCQA (National Committee for Quality Assurance). The Uniform Ambulatory Care Data Set (UACDS) regulates the area of ambulatory care. 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 [] It is of vital importance to participate in and/or be members of the numerous data standards groups. The Committee could recommend such an activity, but it would require departmental staff to actually design, input data, and monitor and update the site. Additional evaluation and testing are warranted for this important information. Emily Friedman Health Policy Analysis, Del Fulgencio Social Security Administration, Andrew A. Total Billed Charges - All charges for procedures and services rendered to the patient during a hospitalization or encounter. 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University System of West Virginia, Curtis O. Porter 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. Blue Cross of California, Health Policy and Analysis, William J. Hayden, DDS, MPH One major reason is the staff and dollar resources required to travel to and participate in several meetings per group per year. During the NCVHS review of core health data elements, discussion arose regarding the specificity of diagnoses reported The official national outpatient/physician coding and reporting guidelines provide instruction that a suspected or rule out condition not be reported as though it is a confirmed diagnosis. 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. It is a standardized, primary screening and assessment tool for health status that forms the foundation of the comprehensive assessment for all . 17-23. [Uniform Ambulatory Care Data Set (UACDS)]: A core set of data elements used to report ambulatory data elements in standardized manner. Also in March, a consultant to the NCVHS updated the World Health Organization on the core data element activity and returned with input to the process. UACDS Data Elements Data Element Definition/Descriptor Provider identification, address, type of practice Place of encounter Reason for encounter Diagnostic services Problem, diagnosis, or assessment Therapeutic services Preventive services Disposition Provider identification: Include the full name of the provider as well as the National Provider Identifier (NPI). 39. Place the Committee's report, elements and definitions on an appropriate departmental Home Page as guidance to the field and as a means of encouraging use and soliciting further comments and suggestions while the report is under review within the Department. There is not one agreed-upon coding system for this item; the International Classification of Primary Care, and the Reason For Visit Classification used by the National Ambulatory Medical Care Survey are two such systems. 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. 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. At a minimum, the following classification is suggested: The critical distinction here is whether followup is planned or scheduled, as an indicator of continuing health problems and continuity of care. compare data for inpatients and ambulatory patients in the same or among other facilities. 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. At present, there is no widely recognized instrument for measuring the functional status of children. FACEP National Organization of urse Practitioner Faculties, Peter M. Wheeler It is recommended that convergence of these guidelines be investigated. https://www.health-improve.org/what-is-uacds-in-healthcare/ These elements apply to persons seen in both ambulatory and inpatient settings, unless otherwise specified. Dataset Summary. 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. 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. 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. The immediate goal of the NPI/NPF project is to support HCFA's Medicare Transaction System initiative by providing a single, universal method for enumerating the providers who serve Medicare beneficiaries. Although there is agreement that "payments" or "costs" are needed, most participants agreed that it is virtually impossible to collect these items consistently across time and locations. This item attempts to define what actually motivated the patient to seek care and has utility for analyzing the demand for health care services, evaluating quality of care and performing risk adjustment. Office of Personnel Management, Jacqueline Darroch Forrest, Ph.D. James Cooney, Ph.D., former member, NCVHS, described the burden to organizations from the addition of a single data item. Joint Commission on Accrediation of Healthcare Organizations, Susan B. Cahn, M.A., M.H.S. Health Care Financing Administration. St Vincent Hospitals and Health Services, Michael L. Millman, Ph.D. 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. 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