Task Team Meeting - Rolling Agenda and Minutes 2018

Database Task Group Meeting – July 20, 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

• Allan indicated that the initial ICD-10 coding is almost done, with expectation to send it to Trish, Tina, Julie early next week.
  • Regarding the Bug Lists, the ICD-10 approach to coding resistant organisms is separate codes for the bug and the type of resistance. THUS, for infections we’ll need some way to link 3 codes.
  • Work (with goal of being finished by end of October 2017) on making new Wiki articles for each code. We will begin an inservicing process as this work proceeds.
  • Tina to create the interface for inputting the new coding schema.
  • Data collectors to begin “shadow entry” of the new coding on 11/1/2017
  • Cease entering the current coding on 1/1/2018
• Regarding identifying diagnoses for which there are specific definitions, Tina created a list of longer Wiki entries, under the presumption that such diagnoses will be included there. https://ccmdb.kuality.ca/index.php?title=Diagnoses_that_likely_have_criteria_based_on_article_size
• 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).

• Allan reported that he has left messages and emails for the WRHA IT lead, Leona Lane (204-926-8086) who said she would set up a meeting including herself, the current WRHA Privacy Officer (Christina Von Schindler), Allan, Tina. Allan will follow-up with Leona, who is on vacation until July 31.

3. Follow-up on seeking collectors having eChart access. Trish is continuing to look into this.

4. New data collection issues:

• Laura raised the question of how to code the “prior service” for a patient who makes a stop in a procedure area (e.g. cath lab, interventional radiology) on the way from ED to ICU or ward. After discussion, we agreed that: (a) when the patient has actually been admitted to a service (e.g. Neurology for a stroke patient) that the prior service will be that service, (b) when this doesn’t occur, and the proceduralist (e.g. cardiologist, invasive radiologist) is merely doing a procedure, we agreed that such individuals will be coded as coming from the Emergency Department service.
• Regarding how to code MAID (medically assistance in dying): We agreed that until we switch to ICD10/CCI, we will assign it a new “diagnosis” code, similar to what we now do for Palliative Care. Allan researched how this should be done in CCI. He found that:
  • starting in 2018 there will be new codes, in both ICD10 and CCI codes for MAID. But until then the recommendation from CIHI is: (i) code the underlying ICD10 diagnoses, and (ii) use the following procedure code: 1.ZZ.35.HA = Pharmacotherapy, total body, percutaneous approach, nervous system, using hypnotic and sedative agents
• Question arose as to how to code carbapenem-resistant organisms. In CCI there is a code for this type of resistance.
• Question arose as to how to code medical isolation. It is a procedure, with CCI code: 7.SC.70.SA.

5. Trish asked if it was possible to obtain from MCHP a list of all publications written using the ICU or Medicine databases. Allan indicated he’d ask --> Answer: It’s not easy to obtain publications, but it is easy to obtain projects which requested use of either of the databases. Allan asked Charles Burchill and he’ll do so yearly for us (though we probably will need to remember to ask him yearly). Allan obtained the list going back 1 year from July 2017, and forwarded it to Tina.

6. Julie asked how we should calculate avoidable days in a unit. The question is whether to count all days spent in that unit after initially identified as transfer ready, regardless of the level to which they eventually go, or only to count such days if the person goes to a LOWER level. Since the answer depends on the use to which the information is put, we agreed, to put this on the agenda for the next Database Steering Committee meeting.

Next Task Group Meeting: Wednesday August 30, 2017 at 11:00 am