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''For Critical Care, see [[Definition of an ICU_admission]]''
This page defines what would be a profile in the [[Medicine program]] portion of the database (see also [[Definition of a Critical Care Program Admission]]); it is relevant for [[Using Cognos2 to keep track of patients]] general data use. There are some differences in CC and Med collection, see [[ICU Curriculum]]/[[Medicine Curriculum]].


The definition of a "Medicine patient" for the Regional Medicine Database is:
Each Medicine profile constitutes all care in ''any'' Internal Medicine location (see [[Boarding Loc]]) or Service (see [[Service tmp entry]]) at a given hospital with certain exceptions (see [[#Excluded patients]] further below in this article). Thus once a patient is admitted to an Internal Medicine service at a given hospital (regardless of where they are physically), a profile begins -- and the same profile includes all continuous direct transfers among Internal Medicine services and locations while under Medicine at that same hospital. For a transfer between hospitals a new database profile is started.
*admitted under a Medicine service attending physician.  If patient doesn't meet this definition then we don't collect data and enter into the Medicine database.


Collection for internal medicine patients starts at [[Accept DtTm]] ie [[Accept_DtTm_field#Direct_Admissions.2FTransfers|possibly while in ER]], regardless of where they are, including if they are still in the ER (i.e. [[EMIP]]).
== Included patients ==
* Collection starts at [[Service tmp entry]] DtTm, ie possibly while still in ER.


{{DT | Med and ICU will be same definition and can then be collapsed. This is also discussed in [[Change to start collection at accept rather than arrive time]].
* The following situations '''ARE''' included for the Regional Medicine Database.
Ttenbergen 11:48, 2020 October 27 (CDT) }}


{{DT | Clear out or reconcile [[EPR Reports]], [[Discharge Register]], [[Transfer Register]], [[Definition of a Medicine Service admission]], [[Definition of an ICU admission]]}}
=== Inclusion based on service ===
__TOC__ 
*Admitted under a Medicine service attending physician anywhere in the hospital (including, for example, if they are remaining in ED because there is no medicine ward bed yet). (see [[#excluded patients]])
** includes "HSC Oncology / Medicine"


=== Special cases - Inclusion of extra patients ===
=== Inclusion based on location ===
{{DA |
*Admitted to a core Medicine ward '''location''' but rather than being cared for by the regular ward team, the primary care service is
* Allan to ask Nick Hajidiacos what he wants and why.
** Nephrology
}}
** Neurology (includes "HSC Internal Med / Neurology" patients admitted to [[HSC HOBS]])
This is about the inclusion of some pt not attended by Internal Medicine Attendings. Generally we only include pts under Internal Medicine Service, but the following are exceptions where we collect even though pt is under other physician:
** Oncology -- ''EXCEPT'' if admitted ONLY for chemotherapy (if complications occur and Medicine service takes over, admit the pt starting at medicine service acceptance)
* all '''"HSC Internal Med / Neurology" patients that are admitted to [[HSC HOBS]]''', once they are discharged/transferred out of HOBS, we no longer follow the patient. (per Dan Roberts, see also [[HSC Medicine Collection Guide]])  
*When you enter such a patient into the Medicine Database, you should include the time in ED when they were on that service (Nephro, Neuro, Onc).
* all '''nephrology patients'''
*For these inclusions based on location, once pt is transferred out of the Medicine ward location, we no longer follow the patient. (see [[#excluded patients]])
{{Discuss |
 
* many to D5 (Low [[Level of care hierarchy]]) under service of nephrology, neurology, oncology (ward being a non-teaching medicine but those services continue to care for their patient unless accepted by Dr Dowhanic or Arneja(who won't handle the HD population))
{{Discuss | JALT
** ''not sure what that line means now with the new model; would collectors need to include any non-med-service patients for this? If not, what are we actually saying with it?
* heard that some beds at STB may have been "given" to Nephro, so we may be collecting them? Made me do a quick query to get rough numbers, sent off to JALT. '''. Is there anything we want to update in our definition based on this?'''[[User:Ttenbergen|Ttenbergen]] 18:55, 8 December 2025 (CST)
}}
{{Discuss |
*At STB patients admitted under '''SBGH Internal Med/Nephrology''' are collected and included in the database.
** ''not sure what that line means now with the new model; would collectors need to include any non-med-service patients for this? If not, what are we actually saying with it? Does the above answer this question?
}}
}}


=== Special cases - Exclusion of medicine service patients ===
== Excluded patients ==
We don't collect the following as medicine patients
* The following situations '''ARE NOT''' included for the Regional Medicine Database:
* patients at any site '''admitted under the oncology service''', e.g.  
** Oncology patients admitted only for chemotherapy. These are short stay patients with only nursing IPN entries.  
** [[STB_Med]] - E6 Occasionally Medicine-Oncology service patients are admitted to receive Chemo treatments, these patients are not included in the data base
** Nephrology, Oncology or Neurology patients whose primary care service is (respectively) nephrology, oncology or neurology -- who are NOT on a core Medicine ward location, ie they are admitted to an overflow medicine location
{{Discuss |
** Patients admitted to HSC_H6 or HSC_H7S (High OBs) under "HSC Internal Med / Respiratory"
* If I excluded all "SBGH Internal Med / Oncology", "HSC Oncology / Radiation", "HSC Oncology / Medicine", would we miss any that we care about? Somewhere else this was described as "who are here only for chemo" - are any of them here for reasons other than chemo that we would want to collect? Ttenbergen 16:39, 2020 November 2 (CST)
** Patients who use a ward bed for a procedure but are NOT admitted to the Medicine service, and indeed these patients are usually not formally inpatients at all.  Examples include a patient who is using a ward bed for: insertion of a central line; diagnostic endoscopy; dialysis.
}}
**  "HSC Internal Med / Neurology" -- on HSC_H6, actually this fits into the above rules, as HSC_H6 is not a Medicine ward location.
* patients admitted to HSC_H6  under respiratory service, or neurology service
** Interventional radiology pts admitted for an overnight procedure (not on [[Cognos EPR Report]] so easy to exclude)
{{Discuss |
** Exclude "HSC Oncology / Radiation"
* I think we just don't collect any H6, right? Is the service relevant to that? Or do we board non-res-non-neuro pts on H6 and collect them?
** Exclude "IV infusion Administration"
** H6 is also a medicine contingency ward, so we do follow some patients on H6 [[User:Lkaita|Lisa Kaita]] 10:59, 2020 November 4 (CST)
** Exclude patients admitted to STB Internal Medicine/Respiratory service
}}
 
* [[STB_Med]] - interventional radiology will admit a patient for an overnight procedure, we are not following these
=== Excluded service admissions can lead to missed records ===
{{Discuss |
There are scenarios in which a legitimate admission may be missed when [[Using Cognos2 to keep track of patients]]. If a patient's first location upon admission is one where we don't collect, the patient would be excluded from [[CSS]]. If the patient then moves to a location where we would collect them without changing services, this change will not show up in Cogonos since we already excluded the service admission. We have occasionally found these records when looking for other things, but some are likely getting through. We discussed this and could not think of a way to overcome this, so this is only to document that this can happen.
* In Cognos I don't see a service that makes me think interventional radiology, but it might just be a service not included in the dump. Do these patients show up in Cognos, and if so, how do you decide that this is what they are and they should be excluded? Ttenbergen 16:39, 2020 November 2 (CST)
 
== End of a database profile ==
=== Bed holds ===
To see when a profile should continue vs new profile, see [[Bed holds]].
 
== Definitions relevant for historical data ==
Definitions over time are available at
* [[Special:History/{{PAGENAME}}]]
 
{{Discuss |  
* We need to extract a summary of the definition details from the page history.
* We should set up a [[Record definition query in CFE]] to provide a clear way in [[CFE]] to treat historical, pre [[PatientFollow Project]], records in a way that is consistent with our current definition.
}}
}}


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{{Related Articles}}
{{Related Articles}}


[[Category: Admit/Discharge | *]]
[[Category:Admit/Discharge | *]]
[[Category: Overflow]]
[[Category:Overflow]]
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