Re: [gpc-informatics] #155: Define Encounter type terms and Epic ETL
#155: Define Encounter type terms and Epic ETL --+-- Reporter: lv| Owner: huhickman Type: design-issue | Status: assigned Priority: major | Milestone: drn-basic-query Component: data-stds | Resolution: Keywords:| Blocked By: Blocking: 160, 178 | --+-- Changes (by dconnolly): * milestone: data-domains3 = drn-basic-query Comment: encounter type is needed for CDM ETL -- Ticket URL: http://informatics.gpcnetwork.org/trac/Project/ticket/155#comment:8 gpc-informatics http://informatics.gpcnetwork.org/ Greater Plains Network - Informatics ___ Gpc-dev mailing list Gpc-dev@listserv.kumc.edu http://listserv.kumc.edu/mailman/listinfo/gpc-dev
Re: [gpc-informatics] #155: Define Encounter type terms and Epic ETL
#155: Define Encounter type terms and Epic ETL --+ Reporter: lv| Owner: huhickman Type: design-issue | Status: assigned Priority: major | Milestone: data-domains3 Component: data-stds | Resolution: Keywords:| Blocked By: Blocking: 160, 178 | --+ Changes (by dconnolly): * owner: campbell = huhickman * status: reopened = assigned Comment: Hubert, Thanks for sharing the details of UNMC's approach to encounter types (attachment:pcori_encounters.sql:ticket:178 and ticket:178#comment:6). It's reasonably clear how that query lets you compute PCORNet CDM summary stats on encounter type. But we still have to decide what encounter terms GPC will use. The UNMC metadata on babel (as of Nov 6 ticket:64#comment:26) doesn't seem to include the results under UNMC: Encounters. Do you plan to continue working in that direction? -- Ticket URL: http://informatics.gpcnetwork.org/trac/Project/ticket/155#comment:7 gpc-informatics http://informatics.gpcnetwork.org/ Greater Plains Network - Informatics ___ Gpc-dev mailing list Gpc-dev@listserv.kumc.edu http://listserv.kumc.edu/mailman/listinfo/gpc-dev
Re: [gpc-informatics] #155: Define Encounter type terms and Epic ETL (was: Define Encounter)
#155: Define Encounter type terms and Epic ETL --+- Reporter: lv| Owner: campbell Type: design-issue | Status: reopened Priority: major | Milestone: data-stds-gov-plan Component: data-stds | Resolution: Keywords:| Blocked By: Blocking: 160 | --+- Changes (by dconnolly): * status: closed = reopened * resolution: invalid = * blocking: = 160 Old description: Create a GPC definition for Encounter; may be based upon input from DSSNI or unique to the network. Discussed on the dev call 9/16/14. New description: Create a GPC definition for Encounter; may be based upon input from DSSNI or unique to the network. - SQL queries to classify Epic CLARITY encounters according to type - ''Cattails, Cerner design should follow straightforwardly'' - term hierarchy (names, paths) for - aggregated counts on babel - federated queries initially discussed on the dev call 9/16/14. -- Comment: Looks like next step could be to get details on this: Epic has provided an unfortunate excess of encounters such that administrative, billing and non-patient care events are all assigned as encounters. Segregating between ED and hospitalizations as well as ambulatory surgery is a bit convoluted but we have sorted out the Clarity data structures necessary to do so. - [http://listserv.kumc.edu/pipermail/gpc-dev/2014q3/000373.html Campbell 15 Aug] -- Ticket URL: http://informatics.gpcnetwork.org/trac/Project/ticket/155#comment:3 gpc-informatics http://informatics.gpcnetwork.org/ Greater Plains Network - Informatics ___ Gpc-dev mailing list Gpc-dev@listserv.kumc.edu http://listserv.kumc.edu/mailman/listinfo/gpc-dev
Re: [gpc-informatics] #155: Define Encounter
The linked definition doesn't preclude redundant entries resulting from multiple encounters taking place on the same day (and these are not rare, at least at the two GPC sites I've worked with so far). This is deeper than terminology. The pragmatic question is: what should be in each row of the analysis-ready result-set: patient, patient-encounter, or patient-day? Perhaps a study that delves deeply into the timing and ordering of individual specialist visits would treat each encounter as a separate collection of observations, even if those encounters were on the same day. Presumably someone with enough domain knowledge to do a study like that will also know how to resolve redundancies and discrepancies. I don't. If the research question is more general, like is vital sign X different between patients with diagnosis A and diagnosis B? or does the prevalence of diagnosis Y increase in patients from demographic group C compared to patients from demographic group D?, I would start to worry about whether I sufficiently understand if it's possible and what it means for A, B, C, D, X, and Y to show up on /multiple encounters that are really administrative abstractions representing the same physical visit to the clinic or hospital/. I too want to hear from clinicians about any universal rules governing uniqueness of observations from different encounters on the same day. Until then, when preparing data for analysis, I play it safe by collapsing visits into one row per patient-day. Codes of a given scheme (after being filtered for any applicable modifiers) get concatenated into comma- or semicolon-delimited strings (resulting in one column each for distinct diagnoses, procedure orders, medications, etc.) /except/ specific codes that the researcher has singled out for individual attention. Each of those gets a separate column, however many columns that takes. Numeric values (e.g. each type of lab result) also get individual columns. I'm not advocating that the definition of encounter should or shouldn't be changed. Only that encounters as our systems define them aren't always the right thing to count for power analysis or feasibility studies. On 09/29/2014 09:04 AM, Dan Connolly wrote: I asked for clarification on this issue and haven't gotten any. Would somebody please give a specific technical reason why, for example, this Wikipedia definition of encounter doesn't suffice? Within the medical record, individual medical encounters are marked by discrete summations of a patient's medical history by a physician, nurse practitioner, or physician assistant and can take several forms. -- http://en.wikipedia.org/wiki/Medical_record#Medical_encounters ___ Gpc-dev mailing list Gpc-dev@listserv.kumc.edu http://listserv.kumc.edu/mailman/listinfo/gpc-dev
Re: [gpc-informatics] #155: Define Encounter
#155: Define Encounter --+- Reporter: lv| Owner: campbell Type: design-issue | Status: new Priority: major | Milestone: data-stds-gov-plan Component: data-stds | Resolution: Keywords:| Blocked By: Blocking:| --+- Changes (by dconnolly): * cc: gpc-dev (removed) * cc: gpc-dev@… (added) Comment: This looks like #120; how is it different? -- Ticket URL: http://informatics.gpcnetwork.org/trac/Project/ticket/155#comment:1 gpc-informatics http://informatics.gpcnetwork.org/ Greater Plains Network - Informatics ___ Gpc-dev mailing list Gpc-dev@listserv.kumc.edu http://listserv.kumc.edu/mailman/listinfo/gpc-dev
