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HIT 218 CH14
| Question | Answer |
|---|---|
| What is primary data? | The information contained in the actual patient record. |
| What is secondary data? | Information that is generated from the record |
| What is a registry? | It's a systematic collection of data specific to a type of disease. |
| Surveillance mechanisms | The collection collation, analysis and dissemination of data |
| Incidence measures | Occurrence |
| what is a case? | a person with a given disease or condition that will be included in the registry |
| CDC | centers for disease control and prevention |
| epidemiologic case definitions | diseases that must be reported to a public health agency |
| clinical case definition | a list of signs and symptoms that establish a clinical diagnosis |
| case finding | the method by which all the eligible cases to be included in the registry are identified, accessioned into the registry and abstracted |
| abstracting | a set of predetermined data obtained formt he patient record and related sources |
| cancer registries | the most common type of registry |
| ACS | American college of surgeons |
| SEER Program | surveillance, epidemiology and end results program |
| NCI | national cancer institute |
| Primary goal of hospital based cancer registries | to improve patient care |
| CoC | comission on cancer |
| case eligibility for most cancer registries is defined by? | all the organizations patients diagnosed (clinically or histologically) or treated for active diseases on or after the reference date or beginning of the registry are elibible for inclusion |
| accesioned into the registry means | when patientes are determined eligible and added to the registry |
| 3 types of population based cancer registries | incidence only, cancer control and research |
| incidence only registries | operated by a government health agency and designed to determine cancer rates and trends in a defined population |
| cancer control population bassed registries | serve a broader function often combining incidence, patient care and end results reporting with various other research and cancer control activities such as cancer screening and smoking cessation programs |
| etiology | the study of the causes of disease |
| cancer abstract | must permit recording of all relevant data in a logical and uniform manner |
| WHO | world health organization |
| NCRA | national cancer registrars association inc |
| topography | site |
| morphology | cell structure and form |
| grading | variotion from normal tissue |
| differentiation | another term for varioation from normal tissue |
| AJCC | american joint committee on cancer |
| NAACCR | North American Association of Central Cancer Registries, INC |
| NCDB | National Cancer Data Base |
| birth defects | the leading cause of infant mortality in the US |
| genetic diseases | account for about one half of pediatric hospital admissions |
| active case ascertainment surveillance | systems that identify cases in all hospitals clinics or other medical facilities through systematic review of patient records, surgery records disease indexes pathology reports vital records and hospital logs |
| passive case ascertainment surveillance | systems that rely on reports submitted to the registry by hospitals, clinics orother facilities, supplemented with data from vital statistics |
| MACDP | metropolitan atlanta congenital defects program |
| major birth defects | those that affect survival require substantial medical care or result in marked physiological or psychological impairment |
| types of diabetes that are monitored | IDDM, NIDDM, Gestational and maternal |
| implant registry | used to locate a person in case of a recall of the implant |
| immunization registries | collect vaccination information about children within a geographic area |
| UNOS | united network for organ sharing |
| OPTN | organ procurement and transplantataion network |
| ACSCOT | ACS committee on trauma |
| NTDB | national trauma data bank |
| AIS | abbreviated injury scale |
| APR-DRGs | All Patient Refined DRGs |
| DCG | diagnostic cost groups |
| ACGs | adjusted clinical groups |
| CCS | clinical classification software |
| health services research | an applied field that encompasses many disciplines, generation of knowledge through scientific inquiry about how resources, organization, financing and policies relate to the provision of health services |
| 2 main areas of research | 1st focuses on the organizational level and the 2nd on the policy level |
| comorbidity | a condition that is in addition to a primary condition and that affects the course or treatment of a condition |
| APACHE | acute physiology, age and chronic health evaluation |
| CODES | crash outcomes data evaluation system |
| possible bioterrorism is monitored by | surveillance systems using coded data |
| pay for performance | main goal is to improve patient safety and to increase the methods for management of chronic disease |
| outcome | the results of a process |
| NCQA | national committee for quality assurance |
| HEDIS | health plan employer data and information set |
| HIS | health care information systems |
| HIS | operational systems that work with the transactional data on a single patient at a time |
| MHCA | Mental Health Council of America |
| CPT | current procedural terminology |
| example of a universal coding scheme | the internation classification of clinical services originally developed by Stan Mendenhall at the commission on professional and hospital activities in an attempt to standardize descriptions of treatmetnes and to provide more clinical data within codes |
| Desirable outcome systems | it is desirable that data collection systems be available wherever care is rendered whethere in an office at a bedside in a home or at a remote location and that the data be entered by thte person first acquiring it |
| need for a master identifier | is just as critical for caregiver records as it is for patients |
| data sampling - | identifying the characteristics and volume of records to be included in a given analysis |
| grouping | continuing analysis requires that data be segmented into meaningful subsets |
| tabular and graphical reporting | reporting rfunctionality runs that gamut from rigid standardized reports in flat tabular formats to flexible ad hoc reports that all the user to drill through increasing layers of detail, shift, resort and present a variety of graphical formats |
| modeling | changes in treatment patterns, resource, mix, staffing and so forth |
| indicator reporting functions | performance measurement requiring the collection and dissemination of indicators both internally and to third parties |
| benchmarking / comparative reporting capabilities | should be able to operate over both detailed internal data and external comparative data |
| DCE | distributed computing environment |
| clinical decision support | a system that brings knowledge to caregivers to assist them in making decisions about patient care |
| data dictionary | critical to the EHR as the English dictionary is to other forms of communication |
| metadata | data about data |
| data element | atomic level of information; a single question that demands a singular defined response |
| field | a physical term that refers to the place ina computer system in which a data element might reside |
| entities | "subject"; represents a higher level than the data element, a subject of information that may be a thing a concept or a process |
| table | the physical representation of the entity |
| record | a row within the table, containing data elements within fields that will provide sufficient data to identify a unique instance of the entity |
| attributes | a data element that describes the entity (column) |
| domain | the type of value that is allowable for a specific element |
| value/coding | represents a more specified way that values may be returned to the data element question |
| logical data model | the structure of the relationship of data elelments and entities within an information system |
| data dictionary should include | all the elements that are required for a person or institution to make key business decisions |
| logical name | a name thta proceeds left to right from the broadest to most specific term |
| physical name | a short name given to the element limited by the size of the physical database system |
| category | categorize the elements in a broad category such as demographic, health history, symptom... |
| definition | definition of the data element |
| type | character, numerical, date, logical, calculated, free text/memo etc |
| length | the size of the field required to hold values for the data element |
| decimal | a description of the number of decimal places that might be required in a numerical field |
| domain | the description of the allowed values for the data element including the rule for exclusion of invalid data |
| coding | a description of coded values if they are required for the data element |
| reference | a reference for the source that was used to define the data element in the dictionary, if applicable |
| building the data dictionary | step 1: inventory of an existing enterprisestep 2: identifying new data content needsstep 3: consensus development |
| once standards of data capture and retention are instituted and incorporated into the enterpries data dictionary what must happen? | they must be catalogued and distributed to all users of the dictionary. |
Created by:
thompson_ks
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