Hello, my name is Lori Powers. I want to thank you for coming, today I will be going over the different indices, registries, and databases. Indexes are a guide that is used as a pointer, or indicator to locate information on disease, physicians, and procedures/operations.Registries are data listed in chronological order, registries hold information on cancer, and trauma’s.Databases is a collection of organized data saved in a binary-type file. Databases need a database management system to read what is stored in these databases.
The Master Patient Index (MPI) can also be called the master population index, or the master person index. The MPI is an index that lists all the patients that have been seen in a facility, it contains patient identifiable data which includes name, address, date of birth, date of hospitalizations or encounters, attending physicians name, and the number of the health record. The MPI is used to quickly find patients for any given query the HIM office person enters. The MPI is facility specific and can only be accessed by specific query information into the system, such as name, SS#, etc. this will bring up the information if the patient has been seen before by the facility. If nothing comes up then this patient has probably never been seen by that facility.
The disease index comprised of those patients who have specific diseases. In other words the index is made up of all the diseases that have been coded by the facilityDisease indices are used for finding patient records with specific disease’s for quality improvement, research studies, and for monitoring quality of care.You access the disease indices by compiling or aggregating the data into a report, which is then viewed either on the workstation or printed.
The procedure index is pretty much the same as the previous indexes, because these indexes include the same information coded in the facility the information contained in each is the same. The only difference is what the HIM professional is looking for, so they will put in certain criteria to find the information they want.The procedure index is the type of procedures done and coded by the facility, it is used to find patient health records who had certain procedures, it is also used for quality improvement, research studies and monitoring the quality of care. Access is facility specific, so it is only accessible by entering the required criteria into the system, then you are able to view or printout a hardcopy to look at.
Just like a disease or operation index, a physician index is a guide to identifying medical cases associated with a specific physician. Essentially, the datarequired in these indexes include the physician's name and code; the health record number; the diagnoses, operation(s), and disposition of patients treated; dates of the patient's admission and discharge; and the patient's gender and age. Often, depending on the application of the information, other demographic items could be included.
The admission register, also known as census register, is a list of patients admitted to the facility organized by date, it is in a chronological format. This register can be either manually entered and managed or by a computer system/program.Includes:At a minimum, the admission/discharge register should contain the following information:Admissions:Admission dateResident nameMedical record numberWhere admitted fromUse and access“Unless required by state law, facilities can determine the format and content of the admission/discharge register to meet their needs.” (AHIMA) The admission register that helps to compile statistical information, and reports for the facilities use. It is a list that is in a chronological format, sequenced by date. For each month, list chronologically all activity integrating admissions and discharges and sequencing them in date and time order. This method gives you a picture of the activity each day whether it was an admission or a discharge.
“Unless required by state law, facilities can determine the format and content of the admission/discharge register to meet their needs.” (AHIMA) The discharge register is similar to the admission register, but instead of admission information it has to do with the all patients discharged from the facility. This register can be either manually entered and managed or by a computer system/program. This register also is helpful in compiling statistical information, and reports for the facility. Includes:Discharge dateResident nameMedical record numberWhere discharged to/discharge disposition Optional Information:Transfer and return dates (bed-hold information)Pay source (on admission and on discharge)Discharge length of stayAttending physician Access:Accessing the discharge registry is the HIM professional gets the patient’s health record, and then compares it to the results of a the search criteria entered into the system. Once all patient’s have been verified as discharged the HIM department does a record reconciliation, if this is not reconciled, the HIM professional must find the patient health record.
A registry of all births for a given time frame. It is used for research, epidemiology studies and other public health programs. This registry includes information on the parents and child, and on the mother’s pregnancy. This registry is facility specific and it can be accessed via the national vital statistic system.
This is a list of all deaths that happen within a certain time frame. This registry is maintained by the national vial statistics.This registry includes Decedent information, place of death, medical certification, disposition information. To access this information can be facility specific, and it can also be accessed through the national vital statistics system.
The cancer registry is a collection of information about the occurrence of cancer, the types of cancer, the location inside the body, the disease stage of the cancer the kinds of treatments. This data is reported to a central statewide registry from various medical facilities, this includes hospitals, physician offices, therapeutic radiation facilities, freestanding surgical centers, and pathology laboratories. The data collected helps the public health professional to understand and address the cancer burden, the critical data for targeting programs focused on risk – related behaviors, or environmental risk factors. This information is crucial for ascertaining when and where cancer screening should be improved and for observing the treatments delivered to cancer patients. Includes:Monitor cancer trends over time. Determine cancer patterns in various populations. Guide planning and evaluation of cancer control programs (eg, determine whether prevention, screening, and treatment efforts are making a difference). Help set priorities for allocating health resources. Advance clinical, epidemiologic, and health services research. Provide information for a national database of cancer incidence.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.
Is the database on patients with severe traumatic injuries. A traumatic injury includes wounds, or injuries from an outside physical force such as an automobile accident, a shooting, stabbing ,or fall. This registry is used for performance improvement and research in trauma care. Trauma registries could be facility-based or could include data for a region or stateIncludes:Demographic informationInjury informationPatient care Patient statusPatient’s courseDiagnosis and procedure codeAbbreviated injury scaleInjury severity scoreAccess:Trauma codesDeathNeurosurgeryOrthopedicsPlastic surgerySome hospitals report trauma data to the national trauma database
This organization uses data collected at the state level from either claims data or discharge-abstracted data.Includes:Nationwide inpatient sampleState inpatient ambulatory surgery databaseState emergency department databaseAbstracts for visits that do not result in hospitalizationKids inpatient databaseAccess:
The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital emergency and outpatient departments. Findings are based on a national sample of visits to the emergency departments and outpatient departments of non-institutional general and short-stay hospitals.
NEDSS (National Electronic Disease Surveillance System) is an Internet-based infrastructure for public health surveillance data exchange that uses specific PHIN (Public Health Information Network) and NEDSS Data Standards. NEDSS also relies heavily on industry standards (including: standard vocabulary code sets such as LOINC, SNOMED, and HL7), policy-level agreements on data access, and the protection of confidentiality. NEDSS represents an ongoing close collaboration between the CDC and its public health partners. NEDSS is not a single, monolithic application, but a system of interoperable subsystems, components and systems modules that include software applications developed and implemented by the CDC; those developed and implemented by State and Local health departments and those created by commercial services and vendors.
intended to improve the quality of health care by encouraging State licensing boards, hospitals, professional societies, and other health care organizations to identify and discipline those who engage in 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 without disclosure or discovery of previous medical malpractice payment and adverse action history. Adverse actions can involve licensure, clinical privileges, professional society membership, and exclusions from Medicare and Medicaid.
The Healthcare Integrity and Protection Data Bank (HIPDB) is a federal data banks that have been created to serve as repositories of information about health care providers in the United States. Federal law requires that adverse actions taken against a health care professional's license be reported to these data banks. Information about nursing discipline actions is reported to the HIPDB by the board taking action. 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 as listed below.
In summary, indices, registries, and databases are all important for quality management, research, and quality of care for each facility. To recap the different indices, registries and databases there are:Master Patient Index, Disease indexes, Procedure indexes, and Physician indexes. Each of these are similar to the others as far as content, use and access. Each of these are facility specific, so there is no set rule to follow.Registries include, Admission, Discharge, Birth, Death, Cancer and trauma, there are others besides these that are listed. Each of these registries are similar in some extent to indexes, although these have rules and standards that must be followed since like the Cancer registry is not facility specific so it has a set format, and entry requirements.The databases are numerous and each one is vital in it’s own way. The use of databases helps to have all data that a facility will need for quality improvements, quality of care checks, and for research.The following are 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.
Indices, Registries, And Databases
About • The MPI is an index that lists all the patient’s seen at a facility.Master Patient Index (MPI)• Patient-identifiable • Specific patients data Use • Previous visits • Name • DOB • Find health record number/avoid • Address duplicates • Hospitalizations • Attending physician Access to MPI: • Number of Access health record • Facility specific • Monitor • Hardcopy
Access:Includes: Used for: • Entering in criteria • Procedures • Finding patient records • Compiling/aggregating • Number of health record • Specific disease’s data into a report, • Gender • Quality improvement, • View on screen or • Physician name • Research studies • On hardcopy/print out • Service • Monitoring quality of care • Result • Encounter dates
Access the procedure indices by Used to find assembling the patients who had a certain data into a procedure, for report then you quality can either viewtypes ofprocedure done improvement it on a monitorand coded by the research studies or on a printoutfacility and monitoring quality of care
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)
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
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
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
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
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
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
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
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/
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.
One of the main public health surveys in the national health care survey. State discharge databases. Office- Office-based Data on the based physician physician patient and the records. practice visit The data is abstractedhttp://www.cdc.gov/nchs/ahcd/ahcd_questionnaires.htm
meet the need for objective, reliable information about the provisionand use of ambulatory medical care services in the United States.Data are obtained on patients symptoms, physicians diagnoses, andmedications ordered or provided. This survey also offers statisticson the demographic characteristics of patients and servicesprovided, as well as information on diagnostic procedures, patientmanagement, and planned future treatmenthttp://www.cdc.gov/nchs/ahcd/ahcd_questionnaires.htm
About: Offers data on current residents, and discharged residents. Includes: Ownership Size Certification Admissions Services Full-time staff charges Access: http://www.cdc.gov/nchs/nnhs.htm
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
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.h tml
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 D ivorce Certificates - Center for Health Statistics - Washington State Department of Health
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/
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 he alth care practitioners to move from State to State Adverse actions can involve licensure, clinical privileges, professional socie ty 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/
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 practi tioners 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/
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_MedicareProviderA nalysisandReviewFile.asp
Databases: Indices: Healthcare Cost and utilization project, Master Patient Index, health effectiveness data and information, national ambulatory care survey, Disease indexes, national hospital ambulatory medical care survey, Procedure indexes, national nursing home survey, national home and hospice care survey, Physician indexes national electronic disease surveillance system Registries: clinical trials database, national practitioners databank, Admission, clinical trials database, Discharge, national practitioners databank, healthcare integrity and protection databank, Birth, Medicare provider and analysis review Death, Cancer trauma