Thanks Nathan for the clarification. This is helpful.
Thanks Supreet Sent from my iPhone > On Jan 8, 2015, at 3:56 PM, Nathan Graham <[email protected]> wrote: > > Supreet/Debbie, > > I used “Active Patients” as for covered patients in part A. I also used > “Active Patents” for the denominator in part B. > > As for part C, I would think that answers would differ for each site. For > example, versions of SAS might differ, databases used (I know some use > SQLServer), etc. I would recommend that you review them and if your site > deviates at all from what Russ sent that you make the appropriate changes. > Otherwise, say “same as KU” or something like that and we’ll sort it out from > there. Does that sound reasonable? > > Regards, > > Nathan > > From: [email protected] > [mailto:[email protected]] On Behalf Of Fothergill, Rita, R > Sent: Thursday, January 08, 2015 3:46 PM > To: 'Debbie Yoshihara'; Supreet Kathpalia > Cc: [email protected] > Subject: RE: Due Monday, January 12th: Population characterization (parts A > and B) for PCORNet LOI > > Supreet, > > Yes, I used “Active patients” for “number of patients covered by insurance > plan”. > > Thanks, > Rita > > From: Debbie Yoshihara [mailto:[email protected]] > Sent: Thursday, January 08, 2015 2:42 PM > To: Supreet Kathpalia; Fothergill, Rita, R > Cc: [email protected] > Subject: Re: Due Monday, January 12th: Population characterization (parts A > and B) for PCORNet LOI > > Supreet, > > For section A, Number of patients covered by insurance plan - I did not limit > it to active patients, just used > all patients. But like you, for Part B, I used active patients only. > > ---- Debbie Yoshihara > University of Wisconsin > > > On 1/8/2015 2:13 PM, Supreet Kathpalia wrote: > Hi Rita, > > As we are preparing the counts at UMN I have a quick question: > > For section A our interpretation for the "Number of patients covered by > insurance plan" is that this number would be derived from the 'Number of > active patients with data in EMR', is that how CMH did it? > > Since we used "active patients" to get the percentages for part B.. > > Thanks, > Supreet > > On Thu, Jan 8, 2015 at 11:03 AM, Fothergill, Rita, R <[email protected]> > wrote: > Hi All! > > Here are the numbers for CMH for part A and part B. Does each site need to > fill out part C? > · For “active patients”, used the formula: “2 visits in the 3 years > where the visits are separated by greater than 30 days”. > > > > CMH > Site Name > Site Name > Site Name > Site Name > Site Name > Site Name > Number of active patients with data in EMR > 227,120 > > > > > > > Number of patients covered by insurance plan > 219,959 > > > > > > > Number of patients for which both EMR and insurance claims data are available > 219,959 > > > > > > > Count of distinct patients with at least one encounter or record in the system > 1,444,273 > > > > > > > > Part B: Insurance Coverage Overview > > · No distinction in our system whether insurance is "group" coverage > or “individual”. > > · Used “active patients” to get percentages > > · Medicaid insurance includes out of state Medicaid coverage as well > > > > CMH > Site Name > Site Name > Site Name > Site Name > Site Name > Site Name > Percent group > UNKNOWN > > > > > > > Percent individual > UNKNOWN > > > > > > > Percent commercial > 43.51% > > > > > > > Percent Medicaid > 47.45% > > > > > > > Percent Medicare > 0.08% > > > > > > > > Percent other public payer > 2.46% > > > > > > > Percent self-pay or uninsured > 6.17% > > > > > > > Percent with unknown payer > 0% > > > > > > > > > Thanks, > Rita Fothergill| Software Architect | Phone: 816.701.4881 | Children's Mercy > Hospitals and Clinics > > > From: [email protected] > [mailto:[email protected]] On Behalf Of Russ Waitman > Sent: Wednesday, January 07, 2015 4:54 PM > To: 'Thomas F Mish'; [email protected] > Subject: RE: Due Monday, January 12th: Population characterization (parts A > and B) for PCORNet LOI > > Required Table to Accompany LOI for PCORnet Clinical Data Research Networks > (CDRNs) > > This table (Parts A – C) must be completed for each CDRN applicant. For Parts > A and B, provide the requested information by each site participating in the > CDRN. Insert additional columns for participating site as needed. > > Part A: Population Overview > Interpretation notes for KUMC discussion: > · For “active patients”, we applied the same criteria used to > characterize enrollment for PCORI milestone 1.1: “2 visits in the 3 years > where the visits are separated by greater than 30 days”. > > · For the number of patients covered by insurance plan, we counted > patients that had had an insurance payer recorded in the EMR. We don’t > appear to have payer information for all patients in our system. > > · KUMC doesn’t have claims data as far as I know. > > · The count of patients with at least one visit encompasses all > patients we pull in to our i2b2 system without restricting the types of > encounter. > > > > KUMC > Site Name > Site Name > Site Name > Site Name > Site Name > Site Name > Number of active patients with data in EMR > 331,177 > > > > > > > Number of patients covered by insurance plan > 234,556 > > > > > > > Number of patients for which both EMR and insurance claims data are available > 0 > > > > > > > Count of distinct patients with at least one encounter or record in the system > 2,077,184 > > > > > > > > Part B: Insurance Coverage Overview > Interpretation notes for KUMC discussion: > · We don’t seem to have payer information for everyone in the system. > The percentages below were calculated two different ways – both querying > Clarity directly. We don't know how to determine if the insurance is "group" > coverage or individual. > > · Over all patients in the system (note that most are unknown) > > · Using the same method that we used for the original proposal – > calculate percentages based on patients who have payer information recorded > (parenthesis) > > > > KUMC > Site Name > Site Name > Site Name > Site Name > Site Name > Site Name > Percent group > Unknown > > > > > > > Percent individual > Unknown > > > > > > > Percent commercial > 5.38% (46.61%) > > > > > > > Percent Medicaid > 0.97% (8.41%) > > > > > > > Percent Medicare > 4.95% (42.88%) > > > > > > > Percent other public payer > 0.03% (0.28%) > > > > > > > Percent self-pay or uninsured > 0.01% (0.10%) > > > > > > > Percent with unknown payer > 88.47 > > > > > > > > Part C. Data Description > > 1. Has the site data that will be queried been de-identified or > obfuscated in any way? If yes, please describe the > de-identification/obfuscation process. > > Yes. KUMC uses the Safe Harbor definition and removes all 18 HIPAA > Identifiers. Dates for every patient are shifted back in time by a random > number of days between 0 and 365. Patient IDs, encounter IDs, and Order > numbers are replaced by a sequence number. For patients over 90, their age > is capped at 90 and their de-identified birth date is moved forward in time > to match the capped age. Identifiers such as name, address, phone number, > etc. are removed. Zip codes are reduced to a sufficiently non-specific > "distance from KUMC" (radius) in 5-mile increments. > > For IRB approved studies we can link back to fully identified data. > > See also approaches to securely de-identify and re-identify patient data, > De-identification Plan and KUMC De-Identification Strategy. > 2. Does the source data, (i.e., raw data from your legacy data systems) > consist of data from multiple sources? If yes, please describe the sources > and the combination process. > > All patients are from University of Kansas Medical Center and affiliated > clinics. EPIC EMR, KUH Cancer Registry (linked by MRN), GE IDX clinic > billing system (linked by MRN), University HealthSystem Consortium (linked by > MRN), Social Security Death Master File (linked by SSN/birth date), KUMC > Biospecimen repository (linked on MRN). > 3. Does your network impose eligibility restrictions for inclusion in > PCORnet, or otherwise have members, populations, or records that are > intentionally and routinely excluded? > > GPC data agreement specifies: “Participants will not include alcohol and drug > abuse patient records, or data derived from such records, that are maintained > in connection with the performance of any federally assisted alcohol and drug > abuse program which are protected from disclosure by 42 C.F.R. Part 2, > psychotherapy notes as defined by 45 C.F.R. § 164.501, or where otherwise > protected by state or Federal law.” > > 4. Is the patient identification number (i.e., medical record number) in > the electronic health record consistent across time, or might a new > identifier be generated for the same individual? If so, please explain the > circumstances when a new patient identification number would be generated > (e.g., change in insurance policy)? > > Yes for identified medical record number. The de-identified patient > identification number may change every month when new data is loaded as part > of the ETL process into i2b2 from the various sources. The PCORI CDM tables > are built from the de-identified i2b2 tables. > 5. What operating system(s) (e.g., Unix, Linux, Windows, Mac) is/are > used at your site? > > Linux, Windows, Mac (LINUX for servers) > 6. What database system (e.g., Oracle, Postgres, MySQL, etc.) is used to > host and extract the PCORnet data at your site? > > Oracle (i2b2, Epic EMR, CDM), PostgreSQL (cross-GPC terms-only i2b2), MySQL > (REDCap). > 7. What SAS version and modules are available at your site? > > SAS v9.4 though use is mostly limited to the Statistics department. In the > medical informatics department, we primarily use R. > > > > > > From: [email protected] > [mailto:[email protected]] On Behalf Of Thomas F Mish > Sent: Wednesday, January 07, 2015 4:54 PM > To: [email protected] > Subject: Re: Due Monday, January 12th: Population characterization (parts A > and B) for PCORNet LOI > > On the GPC Global call (that's going on right now) Russ showed us KUMC's > answers to Table C. Is there any chance we could get a copy of KUMC's > answers, I'd like to model mine after what Russ showed on the phone call a > few minutes ago. > > -TM > > On 1/7/2015 1:07 PM, Nadkarni, Prakash wrote: > Maybe Debbie’s solution is OK – I don’t see any language in the template to > the effect that the numbers must add up to 100 percent, and multiple > insurance is a fact of life in the real world. A footnote to the effect that > the numbers are > 100 because of multiple insurance per patient may resolve > the issue. > > From: Nathan Graham [mailto:[email protected]] > Sent: Wednesday, January 07, 2015 12:02 PM > To: 'Debbie Yoshihara'; [email protected]; Nadkarni, Prakash; > '[email protected]' ([email protected]); '[email protected]' > ([email protected]); Alex Bokov ([email protected]); > Fothergill, Rita, R <[email protected]> ([email protected]); 'Jason > Lebsack ([email protected])' ([email protected]); Mish Thomas F > ([email protected]); [email protected]; Justin Dale > ([email protected]) > Cc: Steve Fennel > Subject: RE: Due Monday, January 12th: Population characterization (parts A > and B) for PCORNet LOI > > Debbie, > > That’s a good question – I somewhat arbitrarily picked one of the groups per > patient (Oracle min() function on the ID number associated with the group). > Maybe that’s not a good approach - I’m open to other ideas. > > -- > Nathan > > From: Debbie Yoshihara [mailto:[email protected]] > Sent: Wednesday, January 07, 2015 10:56 AM > To: Nathan Graham; [email protected]; '[email protected]' > ([email protected]); '[email protected]' ([email protected]); > '[email protected]' ([email protected]); Alex > Bokov ([email protected]); Fothergill, Rita, R <[email protected]> > ([email protected]); 'Jason Lebsack ([email protected])' > ([email protected]); Mish Thomas F ([email protected]); > [email protected]; Justin Dale ([email protected]) > Cc: Steve Fennel > Subject: Re: Due Monday, January 12th: Population characterization (parts A > and B) for PCORNet LOI > > Hi, > > When I do my query for Part B: Insurance Coverage Overview, there are > patients (25%) which are in multiple > groups: for example, Commercial and Medicare FFS. How are other groups > marking this? I will get > 100% > if I mark these individuals in both groups. The effective date is the same, > so I have no choice but to use both. > > --- Debbie > > > On 1/7/2015 8:58 AM, Nathan Graham wrote: > All, > > As we discussed in the GPC-dev call yesterday, we’re working on PCORnet Phase > 2 letter of intent (LOI). Much like the quarterly updates we’ve provided to > PCORI, the LOI document template has a couple of sections with tables devoted > to population characteristics: > · Part A: Population Overview > > · Part B: Insurance Coverage Overview > > > Brittany sent out an e-mail to the site PIs on Friday (January 02, 2015) > asking that each site fill in these sections (among others) by Tuesday, > January 6th. However, as per GPC-dev meeting notes for January 6, 2015, Dr. > Waitman has extended the requested deadline to Monday January 12th (for the > tables in sections A and B at least). > > Please let us know right away who from each site will be the primary contact > for providing numbers for the tables in parts A and B. For the PCORI > quarterly updates, I believe I got population numbers from the following > people: > · University of Iowa: Prakash Nadkarni > > · Medical College of Wisconsin: Brad Taylor > > · Marshfield Clinic: Laurel Verhagen > > · San Antonio: Alex Bokov > > · Children's Mercy Hospital: Rita Fothergill > > · University of Nebraska: Jason Lebsack > > · University of Wisconsin – Madison: Tom Mish > > · University of Texas Southwestern: Phillip Reeder > > · University of Minnesota: Justin Dale > > > There’s been some discussion regarding what “Number of active patients with > data in the EMR” means. After talking with Dr. Waitman yesterday I plan to > use the same method we used to characterize enrollment for PCORI milestone > 1.1: > > “The GPC will use a refined definition of enrollment based upon the criteria > we used in our proposal...2 visits in the 3 years where the visits are > separated by greater than 30 days” > > I also plan to use that number for “active patients” as the denominator for > part B. > > Thanks for your help! > > Regards, > > Nathan > > > > _______________________________________________ > Gpc-dev mailing list > [email protected] > http://listserv.kumc.edu/mailman/listinfo/gpc-dev > > > > -- > Debbie Yoshihara Informatics Specialist > SMPH-IT, Biomedical Informatics Services > School of Medicine and Public Health, UW-Madison > [email protected] > Tel:(608)263-5643 > > > Notice: This UI Health Care e-mail (including attachments) is covered by the > Electronic Communications Privacy Act, 18 U.S.C. 2510-2521, is confidential > and may be legally privileged. If you are not the intended recipient, you > are hereby notified that any retention, dissemination, distribution, or > copying of this communication is strictly prohibited. Please reply to the > sender that you have received the message in error, then delete it. Thank > you. > > > > _______________________________________________ > Gpc-dev mailing list > [email protected] > http://listserv.kumc.edu/mailman/listinfo/gpc-dev > > > Electronic mail from Children's Mercy Hospitals and Clinics. This > communication is intended only for the use of the addressee. It may contain > information that is privileged or confidential under applicable law. If you > are not the intended recipient or the agent of the recipient, you are hereby > notified that any dissemination, copy or disclosure of this communication is > strictly prohibited. If you have received this communication in error, please > immediately forward the message to Children's Mercy Hospital’s Information > Security Officer via return electronic mail at > [email protected] and expunge this communication without > making any copies. Thank you for your cooperation. > > _______________________________________________ > Gpc-dev mailing list > [email protected] > http://listserv.kumc.edu/mailman/listinfo/gpc-dev > > > > > -- > Regards, > Supreet Kathpalia > Clinical Data Analyst > Research Development & Support > AHC Information Systems, U of MN > Ph. 612.624.5848 > [email protected] > > > > _______________________________________________ > Gpc-dev mailing list > [email protected] > http://listserv.kumc.edu/mailman/listinfo/gpc-dev > > > > -- > Debbie Yoshihara Informatics Specialist > SMPH-IT, Biomedical Informatics Services > School of Medicine and Public Health, UW-Madison > [email protected] > Tel:(608)263-5643
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