VIReC Database and Methods Cyber Seminar Series

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Presentation transcript:

2009-2010 VIReC Database and Methods Cyber Seminar Series MB: Is there a problem with having Intranet links on the presentation as non-VA staff and people at non-VA locations will be viewing the presentation? MB: Joanne stated that this item is up for discussion at the next week’s leadership meeting. Other seminars have provided an inactive link or removed from presentation.

2009-2010 VIReC Database and Methods Cyber Seminar Series Overview of VA Data, Information Systems, National Databases and Research Uses Session 1 April 6, 2009 Presented by: Denise M. Hynes, PhD, RN Center Principal Investigator, VIReC

Provide brief overview of VA data sources Session Objectives Introduce Series Provide brief overview of VA data sources April 6, 2009

Upcoming Lectures May 4, 2009 June 1, 2009 July 6, 2009 Assessing VA Health Care Use: Inpatient Denise Hynes, PhD, RN June 1, 2009 Assessing VA Health Care Use: Outpatient Kevin Stroupe, PhD July 6, 2009 Measuring Outpatient Pharmacy Use in the VA using VA Pharmacy Data Todd Lee, PhD April 6, 2009

Overview of VA Databases for Research Databases Addressed by Series Topics for Today Overview of VA Databases for Research Databases Addressed by Series Policies Governing Researchers’ Access to Data Obtaining Help KDG and RP: Perhaps switch order of policies and databases addressed by series. Policies explain how to request data, but haven’t yet discussed what data to request. April 6, 2009

Overview of VA Databases for Research Databases Addressed by Series Topics for Today Overview of VA Databases for Research Databases Addressed by Series Policies Governing Researchers’ Access to Data Obtaining Help April 6, 2009

Administrative/operations data Clinical Financial Many Sources of VA Data Administrative/operations data Clinical Financial Data from other agencies Veteran Population Surveys RP: NPCD is not a data source, remove. Add Telehealth, VACCR, NSQIP MMB: Incorporated suggestions April 6, 2009

Levels of Data Local Facility Level VA Network Level: VISN Warehouses Information may reside only at local facility VA Network Level: VISN Warehouses Specific to VISN; scope varies Corporate (National) Level Mandate for some local data may include uploading a standardized component to a central location April 6, 2009

VHA Corporate Databases Monograph Produced by OI National Data Systems http://vawww.va.gov/NDS/CorporateDatabasesMonograph/Monograph_2008.pdf Includes 106 databases and information systems Revised to show 2008 version April 6, 2009

Introduction to VA Data VIReC website: http://www.virec.research.va.gov/Support/Training-NewUsersToolkit/IntroToVAData.htm April 6, 2009

Overview of VA Databases for Research Databases Addressed by Series Topics for Today Overview of VA Databases for Research Databases Addressed by Series Policies Governing Researchers’ Access to Data Obtaining Help April 6, 2009

Databases addressed by series VA Inpatient Data VA Outpatient Data VA Pharmacy Data VA DSS National Laboratory Data VA Rehabilitation Data Centers for Medicare and Medicaid Services (CMS) Data Acquired by VA VA Corporate Data Warehouse (CDW) VA Vital Status Dataset KDG: Revise so titles match slide titles MB: Revised as suggested April 6, 2009

VA Inpatient Data General Description: Inpatient services are recorded in the MedSAS Inpatient datasets Common dataset structure, generally stable over time Maintained at the Austin Information Technology Center (AITC) The Medical SAS Inpatient Datasets cover four main categories of care: Acute, Extended, Observation, and Non-VA. Four datasets within each: Main, Bed Section, Procedure, and Surgery KDG: MedSAS Datasets only?, Revise Data Steward from John Quinn to NDS, Add inpatient RUG under website/where to go to find more. Mention IE file? April 6, 2009

VA Inpatient Data Data element examples Data Steward: Patient demographics Primary/Secondary Diagnosis Length of Stay ICD-9 Procedure and Surgery Codes Data Steward: National Data Systems (NDS) (John Quinn) Website/Where to go to find more: http://vaww.virec.research.va.gov/References/RUG/RUG-Inpatient06.pdf http://vaww.va.gov/nds/ April 6, 2009

VA Outpatient Data General Description: Outpatient services recorded in the MedSAS Outpatient datasets: Visit datasets (SF) files and the Event (SE) datasets. Data element examples: Patient identifier (SCRSSN) Patient demographics (Age, date of birth, race, marital status) Date of encounter Means Test Indicator Patient eligibility code Procedure (CPT4) codes & Diagnoses (ICD9) codes Type of provider April 6, 2009

VA Outpatient Data Data Steward: National Data Systems (NDS) (John Quinn) Website/Where to go to find more information http://vaww.va.gov/nds/ http://vaww.virec.research.va.gov/References/RUG/RUG-Outpatient06.pdf April 6, 2009

VA Pharmacy Data General Description: Data on medications dispensed from VA pharmacies Data element examples: Drug name, VA class, quantity, days supply, dispensing date, costs Data Steward PBM: Fran Cunningham DSS: VHA Decision Support Office Website/Where to go to find more information PBM: www.pbm.va.gov DSS: http://vaww.dss.med.va.gov/ April 6, 2009

VA DSS National Laboratory Data General Description: The VHA Decision Support System (DSS) is the designated Managerial Cost Accounting (MCA) System of the Department of Veterans Affairs. Includes Four DSS Clinical National Data Extracts (NDE) Lab (Fact of) Lab Results Pharmacy—Prescription Data Radiology April 6, 2009

VA DSS National Laboratory Data Data Element Examples: Actual Total Cost Laboratory fixed direct, variable direct, and indirect costs Dates Ordering provider Laboratory test results (71) Data Steward: VHA Decision Support Office Website/Where to go to find more information http://vaww.dss.med.va.gov/ April 6, 2009

VA DSS National Laboratory Data Lab test examples: HDLC LDLC Total Cholesterol Serum Creatinine Hemoglobin Hemoglobin A 1C HIV Antibody HIV Viral Load Arterial blood gases Post dialysis levels Some drug levels (Lithium, Digoxin, Theophylline) April 6, 2009

VA Rehabilitation Data: FSOD General Description: Functional Status Outcomes Database (FSOD) includes inpatient rehab events Housed at the AITC in Austin TX Data Element Examples: Demographic information and evaluations using the Functional Independence Measure (FIM) Rehabilitative services Treatment location Bed section variable ICD-9 procedure codes Diagnostic fields April 6, 2009

VA Rehabilitation Data Data Steward: VA Physical Medicine and Rehabilitation Service (Doug Bidelspach) Website/Where to go to find more information: http://vaww1.va.gov/rehab4veterans/page.cfm?pg=12 April 6, 2009

Center for Medicare and Medicaid Services (CMS) Data Acquired by VA General Description: CMS data are available about veterans who are enrolled in, eligible for, or have used VHA care. Select non-veteran data are also available. Data Available Include: Medicare Enrollment and Claims Data Medicaid Medicare Current Beneficiary Survey (MCBS) U.S. Renal Data System (USRDS) Long Term Care Minimum Data Set (MDS) Home Health Outcome & Assessment Information Set (OASIS) KDG: Revisions needed MB: Incorporated Linda’s revisions April 6, 2009

Center for Medicare and Medicaid Services (CMS) Data Acquired by VA Data Element Examples: Demographics Admission and discharge dates Diagnosis and procedure codes Billing data Data Steward: VA/CMS Data Merge Initiative Project at VIReC Status Since January 2007, VIReC has been working closely with CMS, ADUSH-PP, Office of Privacy Compliance Assurance, OGC, ORD, and a Research Advisory Board (RAB) to resume distribution of CMS data for research VIReC is currently unable to process requests for CMS data. Currently, VA researchers cannot obtain CMS data directly from CMS Website/Where to go to find more information www.virec.research.va.gov April 6, 2009

VA Corporate Data Warehouse (CDW) General Description: Data from VA clinical and administrative systems. Data Element Examples (Sources): Patient and Staff demographics (VistA; All time) Prosthetics (VistA; All time) Outpatient encounters (NPCD;10/1/1999 and forward) All ICD9 and CPT Codes Vital Signs (HDR; 10/1/1999 and forward) Data Steward: Jack Bates (Jack.Bates@va.gov ) Website/Where to go to find more information: http://vhacdwa09.vha.med.va.gov:8080/. April 6, 2009

VA Vital Status General Description: Provides multiple sources of mortality information. Contains one record for every SCRSSN-DOB-gender combination found in the VA utilization, enrollment and compensation and pension files. Sources include BIRLS death file, the SSA death master file, the PTF file, and the Medicare Vital Status Data element examples: date of death, date of birth, gender, veteran status April 6, 2009

VA Vital Status Data Steward: National Data Systems Website/Where to go to find more information Access information: http://vaww.va.gov/NDS/DataAccess/VitalStatus.asp Documentation: http://www.virec.research.va.gov/DataSourcesName/VitalStatus/VitalStatus.htm April 6, 2009

Overview of VA Databases for Research Databases Addressed by Series Topics for Today Overview of VA Databases for Research Databases Addressed by Series Policies Governing Researchers Access to Data Obtaining Help April 6, 2009

Who Can Use VA Data For Research? Employment status Purpose Ownership/Management/ Authorizations Physical Location/Format Sensitivity of the information KDG: Expand details as these slides will be posted on the internet April 6, 2009

Requirements for Research Data Access are Multi-Departmental VHA Office of Research and Development Brenda Cuccherini, Ph.D., reviews all requests for national real SSN data. VHA Privacy Office Reviews request packet re: HIPAA and Privacy Act requirements VHA Security Liaison Office Reviews Data Use Agreements for technical details VA OI&T, Information Security Officer Reviews for technical data transfer/storage VHA Local Management Director, VISN Director, etc Data Custodian Examples: NDS, VIReC, Local KDG: Remove: VHA National Data Systems and VHA Local Management as these are dependent on which dataset are requested. Add a bullet for Information Custodian and sub-bullets for NDS, Local, & VIReC April 6, 2009

Required Documents: National Data Systems (NDS) Data Example Research Study Protocol Research and Development (R&D) Committee Approval Letter(s) Original one and Current one Research Study Institutional Review Board (IRB) Approval Letter(s) Original one and Current one Sample Informed Consent and HIPAA Authorization, if applicable to the Research Study IRB Approval of Waiver of HIPAA-compliant Authorization and Waiver of Informed Consent is required for the Research Study Signed Privacy Statements DSS Non-Disclosure (if applicable) Vital Status Rules of Behavior (if applicable) Data Use Agreement Approved 9957 forms for each individual accessing/using the data KDG: May be confusing as a new researcher does not know what data are contained at NDS RP: Revise #5 so that HIPAA waiver and Informed Consent are two distinct documents MB: Made revisions to #5 April 6, 2009

Approval Process for Researcher Access to NDS Real SSN Data 5)Notification to Researcher 1) Submission of Research Package Researcher Data Custodian NDS 4) Approval of Data Use Agreement and Notification to the Data Custodian NDS 2) Review of Research Package VHA Privacy/ Security Office ORD 3) Review and Approval of Research Package April 6, 2009

ORD Review What data access requests require ORD review/approval? Real SSN data For specific dataset requests indicated by specific functional task codes VistAWeb Generally includes real SSN KDG: Move slides 17-20 in front of slide 15 April 6, 2009

More ORD Review What is reviewed? Research protocol to ensure that access is really needed.  IRB and R&D approvals -- ensuring they are valid and current.   HIPAA authorization (or waiver) to ensure that, if granted, the waiver is documented in accordance with HIPAA requirements. For multi-site studies the IRB and R&D approvals should be from all sites if the researchers at the other sites will have access to the SSNs or will also request VistAWeb access. April 6, 2009

Policies governing researchers access to data VHA Handbook 1200.12 (March 9,2009) Use of Data and Data Repositories in VHA Research http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1851 RP: Include link to new handbook April 6, 2009

Overview of VA Databases for Research Databases Addressed by Series Topics for Today Overview of VA Databases for Research Databases Addressed by Series Policies Governing Researchers Access to Data Obtaining Help April 6, 2009

Helpful E-mail Addresses in GAL VHA Real SSN Access Requests Mailbox for requesting Data VHA Vital Status Access Mailbox for requesting Vital Status File Access only, must have approved protocol and complete Research Documentation Package VHA Real SSN Access Recertification Mailbox to be used only if you receive a Recertification Notice KDG: This may be helpful in the access to data section April 6, 2009

Obtaining Help HSRData Listserv Join at VIReC’s Intranet Web site Exchange of current information, ideas, questions, and answers about data and informatics issues affecting VA research Discussion among 380+ VA only researchers, data stewards, managers and other users Searchable archive of past discussions KDG: Add “intranet” JS: provided updated information April 6, 2009

Obtaining Help April 6, 2009

Obtaining Help VIReC Help Desk http://www.virec.research.va.gov Research User Guides (RUG) Variable-level information about VA databases Technical Reports Web-site “Toolkit for New Users of VA Data” Monthly Data Issue Briefs virec@va.gov (708) 202-2413 April 6, 2009

Questions? April 6, 2009

Assessing VA Health Care Use: Inpatient Denise M Hynes, PhD, RN Next session: Assessing VA Health Care Use: Inpatient Denise M Hynes, PhD, RN Monday May 4, 2009 12:00pm CST