Indices, Registries, And Databases

1. Indices, Registries, and Databases Lori Powers HIM 241 – Data Quality Standards Jonathan Eastabrooks Monday, March 19, 2012

2. Indices: Master Patient Index, Disease index, Physician Index The MPI is an index that lists all the patient’s seen at a facility. Specific patients Previous visits Find health record number/avoid duplicates Access to MPI: Facility specific Monitor Hardcopy Master Patient Index (MPI ) Patient-identifiable data Name DOB Address Hospitalizations Attending physician Number of health record About Use Access

3. Disease Index Includes: Procedures Number of health record Gender Physician name Service Result Encounter dates Used for: F inding patient records S pecific disease’s Q uality improvement, R esearch studies M onitoring quality of care Access: Entering in criteria Compiling/aggregating data into a report, View on screen or On hardcopy/print out HIM Standard : The integrity of a disease index is maintained. Disease indexes are used to provide cross-reference for locating health records of all patient types for the purposes of epidemiological and biomedical studies; health services research; and statistical research on occurrence rates, ages, sex, complications, and associated conditions; as well as continuous quality improvement/total quality management activities . (AHIMA)

4. Procedure Index types of procedure done and coded by the facility Used to find patients who had a certain procedure, for quality improvement research studies and monitoring quality of care Access the procedure indices by assembling the data into a report then you can either view it on a monitor or on a printout

5. Indices: Physician Index Types: Physician Indices are equivalent to Disease and Procedure indices. About: List of physicians Uses: Find physicians Access: Facility specific View on screen Printout (hardcopy)

6. Registries: Admission, Discharge, Birth, Death, Cancer, Trauma, Other. “A chronological listing of data” (Johns) Admission Registries: About; or census register, lists chronologically all admissions by date. Includes; Admission date Resident name Medical record number Where admitted from Use; Compiling statistical information/reports for a facility Access; Facility Specific View on screen Hardcopy

7. Registries: Discharge Registry About: List of all patients discharged from a facility Includes : Discharge Date Patient Name Medical Record Number Where Discharged/Disposition Optional Information Transfer/return date Length of Stay Attending Physician Access: Facility Specific View on screen Hardcopy “Listing in diagnosis code number order for patients discharged from the facility during a particular time period” (Johns )

8. Registries: Birth Registry About: A birth registry is a listing of all births for a given time frame. It is used for research, epidemiology studies and other public health programs. There is also a birth defects registry. Includes: Information on child Information on parents Mother’s pregnancy Access: Facility specific Quality of care Performance Improvement The national vital statistics system

9. Registries: Death Registry About: A list of all deaths that happen within a certain time frame. This registry is kept by the national vital statistics. Includes: Decedent information Place of death Medical certification Disposition information Access: Facility specific The national vital statistics system

10. Registries: Cancer Registry About: The cancer registry is a group of facts about the manifestation of cancer, the types of cancer, the location inside the body, the disease stage of the cancer the kinds of treatments. Accession number Monitor Cancer trends Determine cancer patterns Guide Planning and Evaluation Set Priorities allocating health resources Research National database of cancer incidence Includes: Aggregated data Type of cancer Gender Age Ethnic group Access: CDC and the National Cancer Institute (NCI) have combined their data sources to publish annual federal cancer statistics in the United States Cancer Statistics: Incidence and Mortality report. http://www.cdc.gov/cancer/npcr/about.htm

11. Registries: Trauma Registry About: Is the database on patients with severe traumatic injuries. Includes: Demographic information Injury information Patient care Patient status Patient’s course Diagnosis and procedure code Abbreviated injury scale Injury severity score Access: Trauma codes Death Neurosurgery Orthopedics Plastic surgery

12. Registries: Washington Nurse Aide Registry About: organization in care of preserving a record of skilled persons who have met the state and federal requirements to deliver nurse aide services in long-term care and skilled nursing facilities all over the state of Washington Includes: identifying data, the nurse aide work records, eligibility for employment in a long term care facility, and any instances of abuse, neglect , or misappropriation of client property Access: on-line , accessed by nurse aides or nurse aide employers, to confirm the standing of an individual http://www.cnatips.com/registry/nurse-aide-wa.php

13. Database : Healthcare Cost and Utilization Project (HCUP) About : This organization uses data composed at the state level from either claims data or discharge-abstracted data. Includes: Nationwide inpatient sample State inpatient ambulatory surgery database State emergency department database Abstracts for visits that do not result in hospitalization Kids inpatient database Access: http://www.hcup-us.ahrq.gov/

14. Database : Health Effectiveness Data and Information Set (HEDIS) About: to measure performance on important dimensions of care and service Includes: identifying the clinical area to evaluate; conducting an extensive literature review; developing the measure with the appropriate MAP and other panels; vetting it with various stakeholders; and performing a field-test that looks at feasibility, reliability and validity . Access : this report can be accessed through NCQA who has an on-line reporting tool called Quality Compass that for a fee of several thousand dollars.

15. Database : National Ambulatory Medical Care Survey (NAMCS) http://www.cdc.gov/nchs/ahcd/ahcd_questionnaires.htm

16. Database : National Hospital Ambulatory Medical Care Survey ( NHAMCS)

17. Database : National Nursing Home Survey (NNHS) About: Offers data on curren t residents, and discharged residents . Includes: Ownership Size Certification Admissions Services Full-time staff charges Access: http:// www.cdc.gov/nchs/nnhs.htm

18. Database : National Home and Hospice Care Survey About : Data gathered on the home health or hospice agency as well as on their current and discharged patients. Includes: Referral Length of services Diagnoses Number of visits Patient charges Health status Reason for discharge Types of services Access: http:// www.cdc.gov/nchs/nhhcs.htm

19. Database : National Electronic Disease Surveillance Systems (NEDSS) About: Internet-based arrangement for public health shadowing data transfer that uses precise PHIN (Public Health Information Network) and NEDSS Data Standards Includes: System of interoperable subsystems, components and systems modules. Access: http://www.cdc.gov/phin/tools/NEDSS/index.html

20. Database : Washington State Vital Statistics About: Washington State Vital Statistics is where they have certificates of; Includes: birth, death, marriage, fetal death, divorce. Access: Vital Records Homepage - Order Birth, Death, Marriage and Divorce Certificates - Center for Health Statistics - Washington State Department of Health

21. Database : Clinical Trials Database About: registry and results database of federally and privately maintained clinical trials lead in the United States and around the world. Includes: purpose, who may participate, locations , phone numbers for more details Access : http://clinicaltrials.gov/

22. Database : National Practitioners Databank (NPDB) About: collects information regarding sanctions taken by State licensing authorities against all health care practitioners and entities . (Taken directly from the website listed below) Includes: unprofessional behavior; to report medical malpractice payments; and to restrict the ability of incompetent physicians, dentists, and other health care practitioners to move from State to State Adverse actions can involve licensure, clinical privileges, professional society membership, exclusions from Medicare and Medicaid. Access : All Information included in the NPDB NOT available to the general public. Access to information in the NPDB is limited to those entities specified by Law (Taken from the website below) http://www.npdb-hipdb.hrsa.gov/

23. Database : Healthcare Integrity and Protection Databank (HIPDB) About: A federal data bank that has been formed to serve as repositories of information about health care providers in the United States. Includes: unprofessional behavior; to report medical malpractice payments; and to restrict the ability of incompetent physicians, dentists, and other health care practitioners to move from State to State Adverse actions can involve licensure, clinical privileges, professional society membership, exclusions from Medicare and Medicaid. Access: All Information included in the NPDB and HIPDB is NOT available to the general public. Access to information in the NPDB and HIPDB is limited to those entities specified by law (Taken from the website below) http://www.npdb-hipdb.hrsa.gov/

24. Database: Medicare Provider and Analysis Review ( MEDPAR) About: Data from claims for services provided to beneficiaries admitted to Medicare certified inpatient hospitals and skilled nursing facilities ( SNF). (Taken from the website below) Includes: Demographic data on patient Data on provider Information on Medicare coverage Total charges Charges broken down by service ICD and CPT codes MS-DRGs Access: http://www.cms.gov/IdentifiableDataFiles/05_MedicareProviderAnalysisandReviewFile.asp

25. Summary Indices: Master Patient Index, Disease indexes, Procedure indexes, Physician indexes Registries: Admission, Discharge , Birth , Death , Cancer trauma Databases: Healthcare Cost and utilization project, health effectiveness data and information, national ambulatory care survey, national hospital ambulatory medical care survey, national nursing home survey , national home and hospice care survey, national electronic disease surveillance system clinical trials database, national practitioners databank, clinical trials database, national practitioners databank, healthcare integrity and protection databank, Medicare provider and analysis review