User:Ttenbergen/questions for tina

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 DiscussQuestion
"almost same patient" checkIf we need this page at all it needs to be integrated better.
ALERT Scaleneed tie-it-together page.
APACHE Acute Diagnosesneed here some general info what these are, links to wiki articles they are actually related to under old coding scheme, etc. I need help with this because I don't know if any of this is on the wiki, or else what it is about. Ttenbergen 17:20, 2018 February 23 (CST)
APACHE Comorbid DiagnosesDx grouping
  • either need details or need to revise this when we re-group dxs; meeting booked with Julie and Allan 2019-01-20 Ttenbergen 15:42, 2019 January 3 (CST)
APACHE Comorbidities in ICD10 codesDx grouping
  • Need to update from Allan's email 2018-11-26, but he said he would need to review this in light of the changes that had been made to ICD10 and CCI since he and Julie discussed. Ttenbergen 00:36, 2018 November 27 (CST)
  • Adding a CCI or ICD10 entry in CFEwe need a better solution, I need to make that ID field populate automatically.
    ApLab CompleteLegacy field cleanup.
    Automatic updating of MS Access Databases using scheduled tasksI think PHI copy automation uses this. It might accomplish this in a different way...
    Awaiting/delayed transfer to other care facility NOS
  • We probably don't need this code from a data use perspective (as confirmed by AG 2018-11-30) but we might need it for cross checks like Query check ICD10 needs awaiting if TR Dt and Dispo Dt on diff days or similar; will keep this code until we have worked out if those checks will be possible.
  • Bed holdsJulie seems to set the limit at 1 day - emailed Julie Ttenbergen 10:07, 2016 November 10 (CST)
    duplication on wiki needs to be cleaned up once we are on same page
    Laura and Tina discussed this and there clearly are different understandings about this. Need to review. LKolesar 14:43, 2017 March 1 (CST)
    CFE Data Integrity Checks
    CTECTU vs NTU
    Can't check ICD10 ARF vs APACHE ARFdefinition is changing so it might become possible soon to cross-check this.
    Centralized data front end.accdbStill has old name, need to update. Also, isn't really documented here yet
    Centralized data front end.accdb Change RequestPostal Code vs Pre-acute
    Linked pairs, better storage
  • 2019 March 01 - move priority number column for ICD10 to be after the primary type column. This would make it the same as CCMDB.
  • add TDI column to query L_CCI_Combined
  • fix dc treatment box that isn't showing up in form Ttenbergen 15:52, 2018 April 11 (CDT)
  • fix table reconnector to not look for L_Labs_DSM any longer, since it's now elsewhere. Ttenbergen 15:52, 2018 April 11 (CDT)
  • CCI and ICD10 make button for Pagasa

    • clean up the form (whatever that meant)
    • add button for link suspect queries to patient list
    • update Correcting suspect links
    Charlson Comorbid Score query
    • the query needs to be cleared out of CFE once we are done. Possibly sooner, I sort of doubt it is used.
    Check CCI CXR vs LOSwould we not use Accept DtTm here? Because we could have CXRs on days before arrival...
    started implementation but had question for Julie, added below
    Check TISS Intubation consistent
    • this cross check would not know the difference between (on one day, intubated, extubated, and reintubated) vs (intubated and then extubated); while this hopefully not too common of a thing, would it cause false positives for Pagasa to run after? Ttenbergen 11:33, 2018 October 29 (CDT)
      • yes that is correct because both have a difference of zero. Using the cut off GTE Abs(2) will get true negatives and not false positives. This query considers only the counts and not the dates which will have numerous scenarios and too complicated to define. For those having a difference of -1,0,1 , there are also the possibility for incorrect sequence of dates of intubation or extubation - this is not captured in the query. If you have other suggestions, let us know.--JMojica 12:19, 2018 October 29 (CDT)
        • What I was trying to say is that I am worried this would be a false positive, which will then create work load for Pagasa and/or Collectors to confirm. Do we really want cross checks that bring up potential errors? We have talked about this before, but never really come up with a general answer. Should we take it to task meeting? Ttenbergen 23:45, 2018 October 29 (CDT)
        • Are you saying I should use "difference between A and B can be -2, -1, 0, 1, 2. Other values will be questionable?
          • The basic scenarios are
            • 1. no new insert and no extubation (0-0=0) ,
            • 2. no new insert and then extubated - this assumes currently with tube and then extubated (0-1=-1),
            • 3. insert new tube and no extubation(1-0=1),
            • 4) insert new tube and then extubated (1-1=0). When there are 2 insertions, the valid number of extubations =1,2,3 even if occurring at same or different days as insertion day, the difference will either be -1,0,1. Same holds true with 3 insertions or 4 insertions. there will be definite errors if the difference is >= 2 or <= -2. Having 1 insertion and 3 extubations or 3 insertions and 1 extubation are not possible and are errors.
              • Scenario: Pt arrives intubated. On day 1, they are extubated. On day 2 they are intubated, extubated and then intubated again on the same day, which will look on TISS as one insertion on that day and one removal. If you then had a removal the next day you will have an error because you have a count of 3 extubations with only 1 intubation.
              • yes, this scenario if indeed correct has to be checked with the dates and also not that frequent. I found a case of 3 days extubations and 1 day insertion which is questionable because the 2nd day extubation (4/18/2018) is not the same day as the insertion day (4/16/2018) and the 3rd extubation day is 4/23/2018 - is there a missing insertion before 4/23 or an extra extubation 4/18 or 4/23? Actually, the most common cases are either extubations >= 2 and zero intubations or zero extubation and intubations >= 2 which we assume as missed bubble that is why -2 and 2 are not included in the acceptable values. When I discussed with Trish the scenario you have cited, she said we still need an audit so we are aware and clear about the cases of two insertions done in a day.--JMojica 10:19, 2018 November 21 (CST)

    I will have to sit down with this and work through it.

    Check drugs vs TISSHave all info now, Allan confirmed drug list. Once implemented let Julie know so she can not do this in SAS any longer
    Check pre acute consistentwhat exactly do we want to check for? Please also have a look at the stuff below that doesn't specifically have your name. This requested check ties into a bunch of things and if we want the check we need to be sure that instructions stay consistent and lose ends are tied up.
    There was a previous attempt to address some of this in Care levels in the community; this page and it need to be consistent, and consistently linked from the relevant field definitions. If we can get it short enough we might make a template to apply the instructions to each of the field pages.
    How does Chronic Health Facility fit into this?
    There was talk about comparing Postal Codes to known PCH Postal Codes. Since these might Include other buildings at the same site that are not PCHs, this check can at best be a soft check. Please add the list of these postal codes here.
    • from a data perspective, what do you mean by "admitted directly"? If I were to build a check, where would I find that? OR maybe I don't need to know, but then I need to have a definition of what combination of data would be an error.

    Integrity check


    • ... unless they are discharged somewhere else entirely, like another ward. So what do we really mean with this? That they can't come from one PCH and go to another or maybe "home" after all?
      • I realize this maybe hard to do. what I mean here is that if one is already a PCH resident, when leaving the hospital, the dispo location must be a PCH location too. or is a patient is already in CHF, the destination when leaving the hospital must either be a CHF or another PCH.


    • Need to look at the PCH Postal code data.

    It may be relevant to this check that we have ICD10 Imprisonment/incarceration and other info in Prison / Jail / Correctional Institution.
    Chronic Health APACHEDx grouping
    • AG REPLY -- Tina I don't know what the question is here.
      • just flagging it to sort with the others so we can deal with it when we address them.
    Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1
    Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5
    Chronic kidney disease, NOS (stage unspecified)
    Collector dictionarysomething went wrong with this query and it has no data
    CollectorDictionaryQuerysomething went wrong with this query and it has no data
    Colonized with organism (not infected)make sure this is consistent with Lab and culture reports
  • Are all of these actually things that can colonize without infection? We should only list those here that can. I started adding in links but then decided to hold off in case a lot of them drop off this list. Ttenbergen 15:34, 2018 November 28 (CST)
  • The above list is those organisms that require isolation. You may want to move this list to the Isolation, infectious section.--LKolesar 07:06, 2018 December 24 (CST)
  • Completeness of TISS records
    • we will track the TISS outstanding status in the L_PHI.notes field
    • that field will be made available in CFE underneath notes field
    • email button will be changed to store in L_PHI.notes
    • Pagasa will clear notes field when done
    • update definition for "vetted" to reflect it does not include TISS
    • move all TISS queries into CFE
    Contingency locations
    Continuous Stayneed to integrate Julie's definition pasted here into this page
    Controlling Dx Type for ICD10 codesnot needed at go-live; Need to export the list and plan process that includes the extra items below. To export, see S_ICD10_table#Query_to_populate_s_ICD10_table_from_wiki.
    Como Admit Acquired Primary Limits / Dx grouping - this is part of both of those discussion
    • I have emailed Allan the table with all Dxs to set them as Como_allowed, Admit_allowed, Acquired_allowed. Will set up infrastructure to contain this once I have data. Ttenbergen 12:31, 2019 February 13 (CST)
      • Ignore until at least April.
    Conversion from our old diagnosis schema to ICD10/CCItransition plan to CCI/ICD10 details...
    need to confirm this is documented, as in tied together and interlinked from relevant places
    Correcting suspect linksupdate when the button has been added: When done, click the ... button to confirm all link_suspects queries are clean.
    Data Processorleave these for now, Tina will go over these and take those that are not really data processing out of the category before we try to address the rest.
    Data dictionarysomething went wrong with this query and it has no data
    Attempt at a easier to follow data dictionary. Is this what you had in mind?
     Yes, this is what I have in  mind. Thanks.  Some suggestions: 
    
    • I just notice some start dates are not the actual start dates - It is important for the users to know how far back the data are available so they can decide the covered period of their study. is it possible to change the date to actual earliest collection start date (not 1 Jan 1900). --JMojica 10:05, 2019 January 3 (CST)
      • The start and end dates are stored on the individual pages. If the list shows 1900 then they were not filled in. If you know what they are and fill them in then this page will list them. I can also change the default if-not-filled value in templates to something other than 1900-01-01. I just needed a value for ranges and filters to work. Ttenbergen 14:49, 2019 January 3 (CST)
    • add a column for program (Critical care only or Medicine only or both).
      • I can do that, but the table is already getting quite wide for a web page. Can we lose any of the columns we currently have? The info you mean is always visible in the pages themselves as well, in case that's sufficient. But, yes, we can tweak what the tables should show. It is done in Template:DataDictionaryQuery (details visible once you edit it...) and removing fields would be easy enough. I can show you how to add fields. Or I can add them once we confirm what we want.

    Tina has changed the ICD10 and CCI templates to use a startdate of 2019-01-01 and will change other default dates as I receive dates Julie wants me to use.
    DataDictionaryQuerysomething went wrong with this query and it has no data
    Deceased patients
    Eliminating distinction between different ward typesany of Julie's Reporting that use this concept?
    CTU vs NTU - we decided at task that we wanted to eliminate the distinction. A lot of things are part of their network of information, so we will need to work out the details above before we can move ahead.
    • I believe it was only related to transfer ready DtTm between CTU and NTU not eliminate the concept. Medicine program would have to weigh in. Trish Ostryzniuk 16:11, 2018 July 30 (CDT)
      • I seem to remember the reason to stop doing this also involved that we have more and more locations that don't fall into a clean place. For now we pretend we can give medicine this data, but is it true and meaningful? Ttenbergen 15:51, 2018 July 31 (CDT)
        • Allan will contact the medicine stakeholders about eliminating this distinction. Will email Mary-Ann Lynch, VanAmeyde, Griffin. Ttenbergen 12:18, 2019 January 24 (CST)
          • pinged again for Allan to Follow-up. Ttenbergen 13:44, 2019 February 25 (CST)
    • AG REPLY: DONE. NOBODY is using or seeking this info. So let's stop collecting it.
    Guideline for coding organ donation after death
  • which of the many LOS? Will the same apply to the other Diagnosis implying death?

    • People have expressed concern about the that there might be significant interventions listed on TISS in the time between Brain death and pt leaving the unit; will we continue to do TISS for this, and how will TISS scores for this time affect any reporting? If we exclude the time from LOS it will mess with the N for this.



    The following in Correcting suspect links will need to be updated for this:


    • Re-admission - based on how just plain transfers are exempted from this, it might be affected. Please see and fix page for more.


    • As per Allan, "It’s necessary to avoid double counting the death for patients who transfer after brain death".
    • Mortality and readmission report - that page has very limited information. Is this report still done? If so, can we update that and make sure this change won't mess with it?
    • Are there other reports that count death rates or mortality? If so we should make a page for it and add it to Category:End-of-life related data and make sure it records how we will address this scenario. Ttenbergen 16:04, 2019 May 21 (CDT)


    • transfer delays (Transfer Delay - currently says it's only for survivors. Is that still true? If so it will need to be adjusted. Is that actually right, to exclude deceased pt? They were still delayed while alive. Excluding them may be inconsistent with our definition of Transfer Ready as the first time they are ready.


    • Julie, which reports and what linking will be affected by this, so we can update the related wiki pages?
      • Firstly, Medicine is the only one which report linked admissions during a hospitalization. If a medicine patient happens to go to an ICU, died, an organ donor and move to another ICU , this rule is saying do not consider the second ICU. what will be the LOS of that hospitalization - I presume this rule will exclude the second ICU stay, is that correct?


    • I had one patient where they withdrew care in the unit then went directly to the OR to harvest the organs. What do we do in this case?--LKolesar 08:03, 2019 June 5 (CDT)
    ICD/CCI remove once old pt goneICD/CCI remove once old pt gone 1
    Instructions for importing a batch of DSM Data1 I have to make/fix a connector module for this.
    There is a newly found and new added query for each; why are there two and can I delete one set?
    L Hospitalization tablez
    • implementation was never finalized, and it wasn't tested and isn't used.
      still need to figure out if I need an s_table for this.
    LOSthis article has evil twins, need to reconcile, search for LOS Ttenbergen 21:13, 2014 October 23 (CDT)
    Are LOS Medicine per hospital admission and LOS Medicine per ward stay evil twins of one of the below? If so pls move the link under that section.Ttenbergen 15:34, 2016 April 18 (CDT)
    Lab and culture reportsyou wanted to remove stuff from here that's already in the infection guidelines instead.
    Legacy eHealthany suggestion where to put this old instruction under? Seem like new folks don't know her in eHealth as she is in another group there now.
    List of ICD10 Diagnoses we don't code
    List of diagnoses affecting Overstay Project (pre-ICD10)
  • in reconciling these, a lot are based on Charlson Comorbidities in ICD10 codes, so whatever we use there should be consistent with here.
    • Allan was OK with these at list meet today Ttenbergen 14:58, 2019 February 25 (CST)
  • Non-standard ICD10 DiagnosesDx grouping
    • With our addition of codes, collectors may use one of our codes rather than the closest standard ICD10 code. In that case, the dx would not show up in the range. How should we address this? The most likely candidates above seem Bronchiolitis obliterans organizing pneumonia (BOOP, cryptogenic organizing pneumonia (COP)) and SARS (severe acute respiratory syndrome)
      • AG REPLY -- for this nonstd BOOP code, there are no existing issues regarding any of the comorbid groups (e.g. Charlson)
        • Allan, could you confirm that that this is what we found when we looked into BOOP.
    • AG REPLY --- so far Tina the only 2 U-codes that would ever be a primary dx are U04 and U14.68 -- which belong respectively to ICD10 chapters J and E. But whenever we add a new U-code we need to remember to decide which chapter (if any) it needs to be included under. Tina to add to template.
    PHI Loader.accdb
  • Don't know what to solution is yet as Tina hot sure why to problem is occurring.>
  • PL SamePHIN Site Diff chart1 this query has reached the 2GB limit, must see if I can lean it out or otherwise reduce the size
    Past history, transplanted kidney
    Pharm Flow Completelegacy data field
    Potential Changegot lost
    Pre-linking checksnot working right now due to PL_SamePHIN_Site_Diff_chart size limit
    This automatic list includes an PL missing L Tables content - where does it fit in into the order in which you run these above? It is likely a very first thing, right?
    Preparatory care (incl preop optimization)needs to go elsewhere
    Processing errors in patient data


    Automate the populating of notes so button just does it.

    • raise an input box for a summary, if gets content put data and content into Notes, else put nothing.
    Query Import request matcherThis part of the cross-check is now well understood and ready to program.
    This one is fairly easy, Pagasa will try to make it.
    Query NDC CLI AcqDX but NoCLI DateinTMPV2ICD/CCI remove once old pt gone
    Query NDC CLI No AcqDX but CLI DateinTMPV2ICD/CCI remove once old pt gone
    Query NDC CLI unacceptable dateICD/CCI remove once old pt gone
    Query NDC CLI vs DX but no TISS17 CentralLineICD/CCI remove once old pt gone
    Query NDC VAP AcqDX but NoVAP DateinTMPV2ICD/CCI remove once old pt gone
    Query NDC VAP No AcqDX but VAP DateinTMPV2ICD/CCI remove once old pt gone
    Query NDC VAP unacceptable dateICD/CCI remove once old pt gone
    Query TISS Errors NrTISSDays NE LOSTina to break out this standard check information to a different page to link to... and clean up duplication
    Query check CCI must have entryPatients without CCI entries are slipping through and found by PL missing L Tables content , must fix PTorres 09:42, 2019 February 7 (CST)
    Query check ICD10 ESRD vs AP ARF
  • some of these give false positives for transplants, review what's up.
    • I have heard nothing else about these false positives I think - are they still an issue? Ttenbergen 15:19, 2019 June 18 (CDT)
  • Query check ICD10 ESRD vs ARF
    • some of these give false positives for transplants, review what's up.
      • I have heard nothing else about these false positives I think - are they still an issue? Ttenbergen 15:19, 2019 June 18 (CDT)
    Query check ICD10 duplicatesthe count is wrong, there wasn't a quick fix, so disabling the query for now. Ttenbergen 15:56, 2019 March 27 (CDT)
    Query check ICD10 mechanism vs traumasee DA above if this has not been addressed before Task.
    The outcome of this might cause a change to Template:ICD10 Guideline Iatrogenic and/or Template:ICD10 Guideline Trauma w mechanism
    Query check ICD10 only 1 stage of renal failure
    Questioning data back to collectorsz
    • Possible future scenario: The data processor puts the concern into the Notes field and sets the RecordStatus field to "questioned". Next time the collector sends, the record is returned to the laptop by a series of queries. The collector updates the record, sets it to "complete" and sends it in with the next round of sends, at which time it will be processed like any other record.

    This process is more automated and would need to be validated before we could implement. It would be the least work for all involved, though, I think.

    We keep discussing this, talked about it again today. Ttenbergen 17:44, 2016 December 1 (CST)
    R Filter Fieldmove into dx and eliminate this field
    ICD/CCI remove once old pt gone
    Reconnect CFE and initial error checksre-name these so not PL any more
    Fix why it gives this error as part of fixing DSM process.
    Tina will fix Query check CCI must have entry so those are caught going forward.
    Repeat clicks being needed when entering CCI PX Typeinvestigate and fix
    Room nrlegacy data
    S ICD10 Chapter block pattern tableJust storing this here for now, it should really be integrated into the SMW like the Charlson and Apache ones. Generated by query CCMDB.mdb.s_ICD10_Chapter_block_pattern_wikimaker.
    S TISS Report tableTISS: not really sure where and how this is used, will need to update
    S dispo.loc typeThis value is not yet encoded on the wiki as Property:Collection Location Location Type for locations that have their own article, but maybe it should be. Should it be? Ttenbergen 09:46, 2017 November 9 (CST)
    Indeed, what is the description? Especially in contrast to S dispo.service type; when you give the answer, please put it behind "element_description" above and delete this question.
    Searching the wikiThere are ongoing problems searching the wiki. Better search functionality would be nice
    planning to try ElasticSearch when I next update the wiki software via elastica or CirrusSearch - timeframe: next 2 months Ttenbergen 13:53, 2019 February 13 (CST)
    Standard error messagesmore informative error messages requested
    System resource exceededQuery tweaked and wifi disabled; let's see if this does it. Ttenbergen 13:20, 2019 March 13 (CDT)
    As of Wednesday Apr 17 is this still a problem? Ttenbergen
    TISS28 Form Scanning
    • Put the queries in a drop down list or accessible through a button in TISS.mdb, similar to way queries are set up in CFE. Trish Ostryzniuk 11:21, 2019 February 7 (CST)


    • If a frozen version is kept available during TISS scanning anyways then there is no reason to not do these checks in CFE, is there? Or rather, collectors sending would not be the reason. Pagasa, let's talk about this. Maybe we can make this more convenient for you. Or write down the actual reason why it can't be done. Ttenbergen 00:34, 2017 November 12 (CST)
      • Discussed this with Pagasa. It would mean doing scanning during send time, and likely doing all fixes during pull time, so all checks could actually be done form CFE. Discussed also w Pagasaa that we would delete the error checks from TISS so there is no duplicates getting out of sync
    Tracheostomy care

    with sort

    Count: 84 List:

     
    Colonized with organism (not infected)
    Check pre acute consistent
    Centralized data front end.accdb Change Request
    Guideline for coding organ donation after death
    PHI Loader.accdb
    TISS28 Form Scanning
    Processing errors in patient data
    Query check ICD10 mechanism vs trauma
    Awaiting/delayed transfer to other care facility NOS
    Data dictionary
    CFE Data Integrity Checks
    Charlson Comorbid Score query
    Check TISS Intubation consistent
    Completeness of TISS records
    List of diagnoses affecting Overstay Project (pre-ICD10)
    PL SamePHIN Site Diff chart
    Instructions for importing a batch of DSM Data
    LOS
    System resource exceeded
    CTE
    Eliminating distinction between different ward types
    Controlling Dx Type for ICD10 codes
    Non-standard ICD10 Diagnoses
    APACHE Comorbidities in ICD10 codes
    APACHE Comorbid Diagnoses
    Chronic Health APACHE
    Reconnect CFE and initial error checks
    Check drugs vs TISS
    Automatic updating of MS Access Databases using scheduled tasks
    Query NDC VAP No AcqDX but VAP DateinTMPV2
    Query NDC CLI unacceptable date
    R Filter Field
    Query NDC CLI vs DX but no TISS17 CentralLine
    Query NDC VAP unacceptable date
    Query NDC CLI AcqDX but NoCLI DateinTMPV2
    Query NDC VAP AcqDX but NoVAP DateinTMPV2
    Query NDC CLI No AcqDX but CLI DateinTMPV2
    ICD/CCI remove once old pt gone
    "almost same patient" check
    S dispo.loc type
    Bed holds
    S ICD10 Chapter block pattern table
    ApLab Complete
    Query check CCI must have entry
    Centralized data front end.accdb
    S TISS Report table
    Searching the wiki
    Pre-linking checks
    Query Import request matcher
    Query TISS Errors NrTISSDays NE LOS
    Legacy eHealth
    Can't check ICD10 ARF vs APACHE ARF
    Potential Change
    Repeat clicks being needed when entering CCI PX Type
    Data Processor
    Room nr
    Pharm Flow Complete
    Standard error messages
    APACHE Acute Diagnoses
    ALERT Scale
    Conversion from our old diagnosis schema to ICD10/CCI
    Continuous Stay
    Preparatory care (incl preop optimization)
    Chronic kidney disease, NOS (stage unspecified)
    DataDictionaryQuery
    Collector dictionary
    CollectorDictionaryQuery
    Check CCI CXR vs LOS
    L Hospitalization table
    Query check ICD10 duplicates
    Correcting suspect links
    Adding a CCI or ICD10 entry in CFE
    Lab and culture reports
    Questioning data back to collectors