Task Team Meeting - Rolling Agenda and Minutes 2018

ICU Database Task Group Meeting – April 28, 2017

Present: Allan Garland, Con Marks, Julie Mojica, Laura Kolesar, Tina Tenbergen, Trish Ostryzniuk

Absent: none Minutes prepared by: AG

Action items in BOLD

1. Switching over to ICD-10 and CCI - nothing new to report at this meeting.

• There are just a few finishing touches needed to finalize the ICD-10 and CCI framework. These include: (a) to optimize word searching, we will decide upon and implement a common schema for wording (e.g. “liver failure, acute” instead of “acute liver failure”), (b) map the current “buglist” with the ICD-10 schema, (c) figure out how to to implement combining diagnostic codes together as part of the same entity. Allan will work on these.
• We should create crosschecks at this early phase of development (e.g. every metastatic dz code must also have a primary source of cancer code).

2. Update on seeking data on PHIN validation data, hospitalization data, and mortality data from WRHA (Phil Jarman).

• After the April 3 meeting, Allan and Julie spoke by phone with Phil Jarman who was supportive of our updated request for data. Phil sent an email to Trevor Strome to that effect, but we have not heard from him. Next Wednesday, Julie will join Tina's meeting with Trevor (at Seven Oaks) to try and move this along.

3. Update on working on updating the databases given to MCHP.

• It was reported that we are ready to send this to on to MCHP (via Manitoba Health, for de-identification). Julie/Tina will try to get to this next week.
• It was agreed that this new version of the file we send will contain all the old "legacy" data, to be contained in linked (or linkable) ACCESS files.
• There was discussion about our documentation of the new relational database in ACCESS. In effect, ALL documentation is contained on our wiki, but it seems likely that MCHP will insist on having documentation on their online data dictionary. Allan spoke to Dave Towns at MCHP, and he would like to receive the EXCEL file Julie has that describes the tables and data fields, and also the figure of table/query Relationships.

4. New Collector issues:

• We agreed that the TroponinI_wb (whole blood) test counts will simply be combined with the usual, serum TroponinI.
• We agreed with Laura's idea to occasionally include wiki entries containing additional details about specific entities. For example, a chart indicating the cutoff values of FEV1 which in Pulmonary Function Tests represent mild vs. mild vs. severe obstruction. Laura will send such items/questions to Allan for vetting.
• Question was raised of how to code hemorrhagic transformation of ischemic stroke. In ICD-10 Allan found that:

 There is no specific code for this
 So, in the absence of anticoagulation or thrombolysis --- we should code both cerebral infarction AND nontraumatic intracerebral hemorrhage --- linked together
 If the bleed occurred after introduction of anticoagulation or thrombolysis, then code cerebral infarction AND hemorrhage due to anticoagulants -- linked together
 In light of this, we will discuss at the next meeting if/how to change the current coding

• Question of coding long-term mechanical ventilation out of an acute hospital.

Next Task Group Meeting: Thursday May 25, 2017 at 10:00 am