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.
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)
    CCI Volumes 2019There have been concerns about the volume of work generated by CCI entries. Since we had already reduced certain entries earlier in 2019, the numbers referenced here are only for pts admitted during the third quarter of 2019.
    CTECTU vs NTU
    Centralized data front end.accdbStill has old name, need to update. Also, isn't really documented here yet
    Centralized data front end.accdb Change Request_dev_CFE
  • add button for link suspect queries to patient list, then update Correcting suspect links with change in steps
  • 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
    _dev_CFE
  • Linked pairs, better storage
    Charlson Comorbid Score query_dev_CFE
    • the query needs to be cleared out of CFE once we are done. Possibly sooner, I sort of doubt it is used.
    Check Inf Potential Infection must have pathogen or alt combined code_dev_CCMDB
  • Discussed on Agarland 09:56, 2019 August 22 (CDT) - we should implement this. At least for a while. If too much extra work, we can take it out.
  • Check TISS Intubation consistent_Dev_CFE
  • 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.
    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
    DSM Labs Consistency check.accdb_DEV_DSM
    • Next version:
      • lock out sending of request if any sent but not vetted records are present to make sure they are not missed; or send all <> incomplete?
      • fix auto email it says "Hi, \n \n here is a new data request file for the CCMDB export. Could you please generate the lab export and let us know when done? \n \n Thanks!"
        • why would I change it and to what?
      • Add a debug.stop after the new-lab-finding part so the import can just continue.
      • the error it gives for there already existing a file needs more helpful text.
      • automate reconnecting; I thought this was done but it's not.
    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.
    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.
  • Exporting and sorting an admission list from EPR
  • Val, you went through the process of exporting this with me there last time. Could you write up how we exported the list to .xls?
    • we just discussed that we don't need to save that file, just generate it and copy from it.

  • Building this now, more info to come.
    FinalCheck field_DEV_CCMDB_data
    Guideline for coding organ donation after death_dev_CFE

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

    ICD/CCI remove once old pt goneICD/CCI remove once old pt gone 1
    Instructions for importing a batch of DSM Data_dev_DSM 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)
    LOS Medicine per hospital admission and LOS Medicine per ward stay may duplicate content above. Do they? If we ever split these out into reporting documentation indicator pages we will need to make sure these are not duplicated.
    Lab and culture reportsyou wanted to remove stuff from here that's already in the infection guidelines instead.
    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)
  • Multiple encounter consistency checksThe task is currently done by the Statistician and we'd like to get it off her plate.
    Newsflashneeds troubleshooting
    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.
    PL 2Phin Fake or Blank_dev_CFE As per meeting with Allan, Julie and Pagasa: (1) only if complete AND (2) only do links in incomplete if have PHIN.
    PL SamePHIN Site Diff chart_dev_CFE 1 this query has reached the 2GB limit, must see if I can lean it out or otherwise reduce the size
    PL missing L Tables contentHave there been more since?
    Confirm this only deals with complete records
    • Pagasa, could you please log here when this query lists errors, and what was found to be the problem (ie whether there was data in CCMDB.accdb that didn't make it, or no data in first place.
    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?
    Previous Location field
    • In the instructions above it says to select "other - known but not listed" this is not in the dropdown as an option.
    • Turns out location missing/unknown wasn't implemented either. Is there any concern if we implement this now?
    • Implement both now
    Processing errors in patient data


    _dev_CFE

    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 Please removePTorres 11:48, 2019 July 24 (CDT)
    Query NDC CLI No AcqDX but CLI DateinTMPV2ICD/CCI Please removePTorres 11:49, 2019 July 24 (CDT)
    Query NDC CLI unacceptable dateICD/CCI remove once old pt gone
    Query NDC Dialysis TISS CCI_dev_CFE change to wait till complete
    Query NDC Dxs vs TISS Dialysis_DEV_CFE Discussed 10:00, 2019 August 22 (CDT) - list looks like a good start, ready to implement.
    Query NDC TISS Extubation only on TISS Intubated days_DEV_CFE
    • implement check
    Query NDC TISS vs pharmacy_Dev_CFE
  • Have all info now, Allan confirmed drug list. Once implemented let Julie know so she can not do this in SAS any longer
  • Query NDC Trach Dx TISS_DEV_CFE ready to implement
    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 NDC zCRRT TISS no tmp_dev_CFE - remove this and *old
    Query NDC zCRRT tmp no TISS_dev_CFE - remove this and *old
    Query TISS Errors missing dayswhich report/s are these actually included in?
    _Dev_TISS28 change to wait till complete
    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 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 only 1 stage of renal failureq

    According to our collection instructions for Admit Diagnosis and Comorbid Diagnosis, and the instructions for these codes (e.g. Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90, the diagnoses could be coded as both an Admit Diagnosis and Comorbid Diagnosis. Right now this cross check prevents that.

    • Do we want to be able to code these as both admit and como?
    • Would both need to be the same code?
      • allow this duplication in different bins
    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
    REDCapJust need a place to jot down some thoughts, need to clean them out later.
    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.accdb.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)
    TISS28 Form Scanning
    • 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.
        • Do we want to make this change then, Pagasa? You would be the only one who would be affected, so mostly up to you. Maybe confirm with Trish.


    _dev_TISS

    • 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)
    Testneeds troubleshooting

    with sort

    Count: 70 List:

     
    TISS28 Form Scanning
    Previous Location field
    Processing errors in patient data
    PL missing L Tables content
    Exporting and sorting an admission list from EPR
    Awaiting/delayed transfer to other care facility NOS
    Completeness of TISS records
    List of diagnoses affecting Overstay Project (pre-ICD10)
    CTE
    Eliminating distinction between different ward types
    Non-standard ICD10 Diagnoses
    APACHE Comorbidities in ICD10 codes
    APACHE Comorbid Diagnoses
    Reconnect CFE and initial error checks
    Automatic updating of MS Access Databases using scheduled tasks
    Query NDC CLI AcqDX but NoCLI DateinTMPV2
    Query NDC CLI No AcqDX but CLI DateinTMPV2
    R Filter Field
    Query NDC VAP unacceptable date
    Query NDC VAP AcqDX but NoVAP DateinTMPV2
    Query NDC CLI unacceptable date
    Query NDC VAP No AcqDX but VAP DateinTMPV2
    ICD/CCI remove once old pt gone
    "almost same patient" check
    S dispo.loc type
    Bed holds
    REDCap
    S ICD10 Chapter block pattern table
    ApLab Complete
    Query check CCI must have entry
    Centralized data front end.accdb
    S TISS Report table
    Multiple encounter consistency checks
    Searching the wiki
    Pre-linking checks
    Query Import request matcher
    LOS
    FinalCheck field
    Query NDC TISS Extubation only on TISS Intubated days
    Query NDC Dxs vs TISS Dialysis
    Query NDC Trach Dx TISS
    DSM Labs Consistency check.accdb
    Query NDC TISS vs pharmacy
    Check TISS Intubation consistent
    Query TISS Errors missing days
    Check Inf Potential Infection must have pathogen or alt combined code
    Centralized data front end.accdb Change Request
    Guideline for coding organ donation after death
    Charlson Comorbid Score query
    PL 2Phin Fake or Blank
    Query NDC Dialysis TISS CCI
    Query NDC zCRRT TISS no tmp
    Query NDC zCRRT tmp no TISS
    PL SamePHIN Site Diff chart
    Instructions for importing a batch of DSM Data
    Potential Change
    Repeat clicks being needed when entering CCI PX Type
    Data Processor
    Room nr
    Pharm Flow Complete
    APACHE Acute Diagnoses
    Newsflash
    Test
    Query check ICD10 only 1 stage of renal failure
    L Hospitalization table
    Query check ICD10 duplicates
    Adding a CCI or ICD10 entry in CFE
    CCI Volumes 2019
    Lab and culture reports
    Questioning data back to collectors