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. 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. 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. Phillippine Nurses Association of America, Karen Grady National Institute on Drug Abuse, Cille Kennedy Department of veteran's Affairs (191), W. Michael Boyson, M.H.A. And now, with movement toward HMO's, PPO's, and other types of managed care, there may be a greater need to share identifiable data. Non-excision all debridement of stage three pressure ulcer of subcutaneous tissue of buttock. Together with marital status, this element provides a picture of potential formal/informal resources available to the person. Division of Adolescent Medicine, Department of Pediatrics, David W. Emmons, Ph.D. One would be through the use of a state-level or regional-level organization that already has a line of communication with other organizations. HHS, Health Care Financing Administration, Kim Streit Marital Status - The following definitions, as recommended by the NCVHS, should be used. B.The health care practitioner for each clinical service received by the patient, including ambulatory procedures. 30. It will do so by assigning a unique identifier to each provider. 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. 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. 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. The major output of this project to date has been the recommendation of core data elements, definitions, vocabulary and classifications. 15. Several organizations have volunteered to facilitate dissemination and feedback of the core data elements project. Michigan Department of Social Services, Interagency Coordination Program, Joellen Edwards 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 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. 1. HHS, CDC, NIOS&H - ALOSH, Division of Safety Research, Kris Haltmeyer The NCVHS notes that the Department of Veterans Affairs routinely collects this element, and thus approves the continued inclusion in this core list, pending a review of uses and users of this element. See Page 1. 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. The data is collected on inpatient hospital discharges for Medicare and Medicaid programs. Years of Schooling - Highest grade of schooling completed by the enrollee/patient. A key distinction to be ascertained in "residential arrangement" is whether organized care- giving services are being provided where the patient lives. 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Place holders will be set, and, in some cases data items and definitions decided on, before national and local public health agencies and organizations will be able to act. 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, a place holder for this element is recommended to the standards-setting organizations. Favorable input has been received from a wide range of experts, and these elements should be compellingly useful both to states and to provider organizations. This identifier includes hospitals, ambulatory surgery centers, nursing homes, hospices, etc. It is hoped that, as data collection evolves, certain data items, such as personal data, (i.e., date of birth, race, occupation) will only need to be collected at time of entry into a health care plan or to be updated on an annual basis, to reduce the burden of data collection. An example of this could be NAHDO which could undertake to work with its members. The Committee's intent is not to specify a data set for mandated external reporting; not every element may be needed in a specific collection effort, and these data elements do not represent all of the important data items that are collected in the field or needed for specific applications. The focus of the NCVHS effort has been on the content of the data to be transmitted, rather than the method of transmission. 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. Participation in the system will be voluntary for non-HCFA providers at first. The Committee recognizes the ongoing discussion of discrepancies between 'expected' and 'actual' sources of payment. It is the expectation of the Committee that the health care field will find these recommended data elements to be fundamentally important for any collection of person and health care encounter data and will consider these elements and standardized definitions for inclusion in their data collection efforts wherever possible. 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. To transmit electronic data C. To create a process for transmitting data to external users D. Describe each data set . Total Billed Charges - All charges for procedures and services rendered to the patient during a hospitalization or encounter. Some respondents incorrectly interpreted this item as a means of classifying primary site for cancer, utilizing ICD-O (oncology). Other recommendations will be circulated for comment at a future time. Consensus has been reached on definitions for the majority 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. Health Care Financing Administration, Steven B. Cohen What is a list of recommended data elements with uniform definitions that are relevant for a particular use? Catherine McCabe As highlighted earlier, the Committee has identified a number of areas that should be considered for implementation by the HHS Data Council. Which of the following data elements is unique to UACDS A. Mutual of Omaha Health Plans of Lincoln, Robert Koladner, M.D. HHS, HCFA, Office of Managed Care, Gordon Bonnyman The currently recommended coding instrument is the ICD-9-CM. National Committee for Quality Assurance, James S. Todd, M.D. Date of Encounter (outpatient and physician services), 18. D.Discharged/transferred to an intermediate care facility (ICF) Operating Clinician Identification - The unique national identification number assigned to the clinician who performed the principal procedure, as recommended by the UHDDS. 19. NYLCare Health Plans, Inc. Eugene Stanton 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. It will also serve as a quality check as the date of birth approaches the new century mark. Problem, Diagnosis or Assessment (outpatient). More than 150 responses to this second request were received, including responses from the leaders in the health care and health care information fields. Health Care Financial Management Association/ASC X12, Kenneth E. Roos, M.S., M.B.A. To this end, the Committee recommends that the Data Council: 3. 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. Georgia State University, Maria Redona Couper Office of Personnel Management, Jacqueline Darroch Forrest, Ph.D. prison), Principal diagnosis of an injury or poisoning. Department of Agriculture, Theresa Wulbrecht Review state-of-the-art of widely used core data sets in the United States and other countries (including coding and formatting features that allow for flexibility); ANSI (American National Standards Institute). No follow-up planned (return if needed, PRN), Referred elsewhere (including to hospital), No charge (free, charity, special research, or teaching), Mental Health and Substance Use History of Consumer and of Consumer's Family Members, Categorization and Coding of Wrap Around Services (including community-based services, housing assistance, job training, etc.). In addition, there are some disabilities, such as severe mental illness or blindness, where ADLs and IADLs are not sufficient measures. 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. 5. Expired has been added because the outpatient setting includes a wide range of sites, including Emergency Departments and ambulatory surgery centers. Columbia/HCA HealthCare Corporation, John Quinn National Association Children's Hospitals, George Arges University of Colorado Health Sciences Center, Inpatient Administration, Charles J. Rothwell However, income questions are often considered intrusive, whereas years of schooling are more acceptable to respondents. Other data items are related to a specific episode of care and will be provided at each encounter. By January 1998, all California State Department of Health data bases will contain five data items to facilitate linkage. BlueCross BlueShield of Minnesota. 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. White, M.P.H., Ph.D. Carries a procedural risk, or. Discharge Date (inpatient) - Year, month, and day of discharge as currently recommended in the UHDDS and by ANSI ASC X12. The intent is not to specify a data set for mandated external reporting; the list of recommended data elements is by no means exhaustive, and, unlike earlier activities, is not a "data set" to be used in a specific setting. The Uniform Hospital Discharge Data Set, or UHDDS, is used for reporting inpatient data in acute-care, short-term care, and long-term care hospitals. 9. https://www.health-improve.org/what-is-uacds-in-healthcare/ IPRO - Corporate Headquarters, Nancy G. Stetson, B.S.N., M.A. 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. If the recommended specifications are widely adopted, then problems--such as data incompatibility and high costs of collecting, linking, and using data--can be substantially reduced. Those present at the November and December 1995 NCVHS regional meetings agreed that the establishment of a unique identifier is the most important core data item. The continuing expansion of types of payments and the combination of payments within groups is ever changing. (Currently approximately 40 states collect health data on inpatient hospital stays.) Race and ethnicity B. Florida Hospital Association Information Services, George J. Stukenborg, Ph.D. 3 is required; however NCVHS strongly advocates a single procedure classification for inpatient and ambulatory care. Medications Prescribed - Describe all medications prescribed or provided by the health care practitioner at the encounter (for outpatients) or given on discharge to the patient (for inpatients), including, where possible, National Drug Code, dosage, strength, and total amount prescribed. (9 days ago) What does uacds mean or stand for?UACDS means Uniform Ambulatory Care Data Set. 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. Vermont Health Care Authority, Michael G. Kassis The NCVHS recommends continued monitoring of provider practices with regard to coding and revision of these recommendations if current guidelines continue to be ignored. 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 [] Other Diagnoses (outpatient) - The additional code(s) that describes any coexisting conditions (chronic conditions or all documented conditions that coexist at the time of the encounter/visit, and require or affect patient management). State Budget and Control Board. UNIFORM AMBULATORY CARE DATA SET. It was thought that this was one of the reasons why some organizations, especially private employers, declined to participate. 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. States have varying laws to protect the confidentiality of these data, and often the laws do not protect data that have crossed state lines. Health Care Financing Administration, David L. Hobson 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. National Center for Health Statistics, Walter P. Bailey Marital status is discussed in element 6. 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. 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. 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. Legal Services of Middle Tennessee, Leonard Bourget 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. 02. Oak Orchard Community Health Center, Geraldine Nicholson HCFA, however, has estimated that there are approximately 30,000 individual payers in the U.S. Most organizations were supportive in wanting to 'get on board' with standardized data elements. Which is a data element of the Uniform Ambulatory Care data set Uacds )? 40B. 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. Pennsylvania Health Care Cost Containment Council, P. John Seward, M.D. To retrieve electronic data B. UACDS and UHDDS have many similar data elements, which makes it easier to. Another issue was the role of the National Committee itself as the source of information on common data elements. 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. Throughout the meetings it became apparent that many standards-setting groups are moving ahead without broader input, for example, from those in the public health and epidemiology fields. American Hospital Association, Edward W. Bacon Secondary Source - The secondary source, if any, that will be responsible for the next largest percentage of the patient's current bill. 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