1. Chapter 7: Indexes, Registers, and Health Data Collection

2. Indexes Master Patient Index (MPI)
The MPI is used administratively for continuity of care internally and externally.
Purpose of the MPI - Links a patient’s medical record number with common identification data elements
Automated MPI - Consist of an electronic database of the patient’s identification data
Manual MPI - Requires typing or handwritten posting of the patient’s identification information
Avoiding duplicate MPI records
The Master Patient Index (MPI) is the key to locating patient record in
numeric identification system. It identifies all patients who have been
treated by the facility and lists the number associated with the name. The
MPI is maintained permanently. It must contain enough information to
identify that you have the correct patient. While the minimum information
is the name and number, it really should contain enough information to
identify the patient

3. Disease, procedure, and physicians indexes
Disease Index - Organized according to ICD CM codes
Procedure Index - Organized according to ICD CM and/or CPT-4/HCPCS codes
Physician Index - Organized according to the numbers assigned by the facility to the physicians who treat inpatients and outpatients
Every facility must maintain different indices for data collection, research and process improvement

4. Registers and Registries
Registers and registries contain information about a disease e.g. cancer or an event e.g. a birth
Maintained by each healthcare facilities, federal and state government and private organizations.
Registers and registries represent a secondary source of information
Registries provide surveillance (collection,
collation, analysis and dissemination of data). A
registry can be established for any disease and can
vary by location or type of facility.

5. Types of Registers and Registries
Case report forms
Vital statistics
Birth certificates
Death certificates
Operation of registers and registries
Register and Registries are operated by a variety
of entities including but not limited to:
-Federal government agencies (e.g. CDC)
-Adoption Registry
-Birth defects Registry
-Alzheimer Registry

6. Case Abstracting Case abstracting - an automated or manual process
performed by HIM department to collect patient
information to determine prospective payment
system (PPS) used to report data to quality
improvement organizations and state and federal
agencies.
The following are the processes:
Case mix analysis
Automated case abstracting systems
Manual case abstracting systems
Data set
Data dictionary
Generally with abstracting, a set of predetermined data is obtained
from the patient record and related sources. These data items are
collected because of their relevance to the disease or condition addressed in
the registry. This data provide information such as demographic
information, diagnostic information, treatment data, outcomes of treatment,
And follow-up.

7. Health Care Data Sets Before the case abstracting process
can begin, standards for collecting
and reporting the individual data
elements must be established to
provide uniformity and easy data
interpretation.

8. Health Care Data Sets Types of Data Sets:
Data Elements for Emergency Department Systems (DEEDS)
Essential Medical Data Set (EMDS)
Health Plan Employer Data and Information Set (HEDIS)
Minimum Data Set (MDS)
National Cancer Data Base (NCDB)

9. Health Care Data Sets (Cont’d)
Outcome and Assessment Information Set (OASIS)
JCAHO ORYX Initiative
Uniform Ambulatory Care Data Set (UACDS)
Uniform Clinical Data Set (UCDS)
Uniform Hospital Discharge Data Set

10. Health Care Data Sets (Continued)
Medical Information Bureau (MIB)
Clearinghouse of medical and avocation information
National Practitioner Data Bank (NPDB)
Legislated by the Health Care Quality and Improvement Act of 1986

11. Health Care Collection
Health data collection is performed by health care facilities for administrative planning and to report statistics to state and federal government agencies.
The primary purpose of the health care data is for the
care of the patient.
Health care data is created by health-related events
and are used by many different people, organizations,
and agencies for multiple purposes. Users of health
data range from the individual patient, the health care
providers, and organizations to epidemiologist,
researchers, health care payers, grant funding
organizations, politicians and public agencies.

12. Health Care Collection
The following are health data collection concepts:
Descriptive health care statistics - Summarizes a set of data using graphs, charts and tables.
The following are types of descriptive data:
Aggregate data
Comparative data
Patient-centric data
Transformed-based data
Hospital-based statistics
Admission data
Length of stay (LOS)
Discharge data

13. Health Care Collection (cont’d)
Health care statistics are useful only if
developed from quality data
General data quality includes:
Data integrity
Data reliability
Data validity
The term “data quality” suggests the
correctness of the data. As patient records are
migrating from paper-based to the HER systems,
the characteristics of data quality continue to be
refined.

14. Question Data quality includes: Data integrity Data reliability
Data validity
All of the above

15. AHIMA Data Quality Management
AHIMA has developed a data quality management model that outlines the characteristics of data quality. The four areas of data quality management are defined by AHIMA as follows:
Data Application
Data Collection
Data Warehousing
Data Analysis
The AHIMA has published guides on the content of the
patient records and professional practice standards for a
number of clinical settings. It has also supported the formal
development of voluntary standards for EHRs by working with
the ASTM, a national standards development body.

16. QUESTIONS?????