Master Facility Table Improving the Quality of Facility Data

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1 Master Facility Table Improving the Quality of Facility Data Division of Health Informa8cs and Surveillance (DHIS) Team NSSP Webinar December 3, 2015 Center for Surveillance, Epidemiology, and Laboratory Services Division of Health InformaFcs and Surveillance

2 Agenda Introduc8ons BioSense PlaBorm Update Master Facility Table Overview Facility Cleanup Process and Tools Processing Considera8ons Next Steps

3 Introduc8ons Mike ColeKa, CDC Roseanne English, CDC Cassandra Davis, CDC Max Worlund, Contractor Charlie Ishikawa, Contractor

4 BIOSENSE PLATFORM UPDATE Mike ColeIa, CDC

5 Update: BioSense PlaBorm Development Phase 1 NSSP Planning Collaborate to idenffy crifcal acfvifes Collaborate to develop requirements (Admin Tool, Master Facility Table) Set up staging environment Set up producfon environment Phase 2 BioSense Platform Development Create Baseline Master Facility Tables Document data flow Establish datamart Develop Admin Tool Research single sign-on solufon Adjust ESSENCE seungs Develop support documents Phase 3 ESSENCE Transition TransiFon 9 sites per month, beginning summer 2016 Sunset BioSense Web applicafon Fall Winter Spring Summer

6 MASTER FACILITY TABLE OVERVIEW Roseanne English, CDC

7 Master Facility Table (MFT) Overview Challenge Facility information stored in current system may be inconsistent Opportunity Standardize facility information entries across sites Collect additional facility information Enhance downstream processing Make MFT data transparent and available to sites Constraints Current process is still manual (Excel template) Goal Develop an online Facility Administration Tool to allow Site Administrators to manage facility information via a Web application

8 Master Facility Table (MFT) Key Terms Master Facility Table (MFT) Excel Template Excel version of the master facility table Master Facility Table (MFT) SQL table to be leveraged by ESSENCE application Contains ALL facility information across sites (populated from MFT Excel Templates) Sites can view their facility information stored in the MFT Cleanup Package Excel file of site-specific info to clean up MFT Excel templates Includes a crosswalk to associate related/historic facility IDs to those found in the MFT Excel Template Companion Guide Document describing the MFT, MFT Excel Template, Cleanup Package and process

9 FACILITY CLEAN-UP PROCESS Roseanne English, CDC Cassandra Davis, CDC

10 Facility Clean-up Process Ra8onale for performing facility cleanup Improves overall quality of data Supports the de-duplication of facility records Increases data standardization to enable more robust analysis Key Requirement for ESSENCE Processing Each facility must be associated with a unique facility ID to support data ingestion and processing

11 Facility Cleanup Process (con8nued) Desired Outcome 1. Clean MFT o Metadata for each facility relationship owned by a site 2. Crosswalk o Associates deprecated or incorrect facility IDs with the official facility ID registered in the MFT o Data processing rules will utilize this crosswalk to convert incoming IDs to the official ID as needed

12 Facility Cleanup Process: Outreach DHIS Liaison will schedule a kick-off call for each site Subsequent calls can be scheduled as needed Site-customized ar8facts will be provided prior to the kick-off call MFT Excel Template Cleanup Package Companion Guide (including FAQs)

13 Facility Cleanup Process: Refine MFT Excel Template Site Administrators will review MFT Excel Template Cleanup Package o Crosswalk o Summary Reports o Exception Reports Companion Guide Site Administrators will update the MFT Excel Template and return it to the DHIS liaison

14 Facility Cleanup Tools and Ar8facts

15 Master Facility Table (MFT) Template Pre-populated with legacy BioSense facility informa8on Potentially problematic records are flagged for site administrator review Includes basic informa8on about each facility (e.g., name and address), site profile, and site contacts Key fields in the MFT Facility ID o Collect Site Input o Relationship with Site ID Facility Type Primary Facility AHA Identifier

16 MFT: Facility ID A unique ID (FacilityID_UUID) is associated with each facility on the MFT to be used in later processing Historic facility IDs may be mapped to this current/unique facility ID through the crosswalk Duplicate facility IDs will be highlighted on the MFT produced for site review and clean-up Explanation Facility ID has changed over time for the SAME facility Facility ID was entered incorrectly Facility ID is the same for facilities with different facility types/addresses Solution Select the most current facility ID to include on the MFT and list historic facility IDs in the crosswalk (utilize keep/drop indicator on MFT) Correct facility ID on the MFT Ensure one record exists for each unique facility id and facility type combination; flag one facility as primary

Reference summary reports (in the cleanup package) if necessary to inform

17 MFT: Site Input (Winning MFT Entry) 1. Review entries on draft MFT Excel Template 2. Reference summary reports (in the cleanup package) if necessary to inform decision 3. Document site decision and return to DHIS liaison 4. DHIS will produce baseline MFT (reflecting site decision) and Crosswalk

18 MFT: Facility ID and Site ID Challenge Facility IDs may repeat across sites (e.g., facility ID 1111 in site 857 and facility ID 1111 in site 902) Proposed Solu8on Each facility must be associated with a Site ID A unique key will be defined for each facility using the site ID, facility ID, and facility type Site ID Facility ID Facility Name Facility Type **Key** Example Facility Emergency Care E My Facility Emergency Care E

19 MFT: Facility Type The facility type will be used in conjunc8on with the facility ID to iden8fy a unique facility Accounts for situations where the same facility ID may apply to o Multiple facility types o Multiple facilities Facility Type is a standardized value that replaces local facility types used in previous versions Emergency Care Inpatient Practice Setting Ambulatory codes o Medical Specialty o Primary Care o Urgent Care The DHIS team can map site-specific local facility types to these standardized values upon request

20 MFT: Facility Type (Example 1) Example: Mapping a local facility type to the standardized facility type

MFT: Facility Type (Example 2) Example: Multiple facility types mapped to the same facility ID Assumptions: Each unique facility ID and facility type combination will exist as a row in the MFT

21 MFT: Facility Type (Example 2) Example: Multiple facility types mapped to the same facility ID Assumptions: Each unique facility ID and facility type combination will exist as a row in the MFT spreadsheet For each unique facility ID, one row will be set to Primary The primary facility flag will come into play for downstream ESSENCE processing of messages associated with a facility ID that maps to multiple entries on the MFT

MFT: Facility Type (Example 3) Example: Multiple facilities of the same type are mapped to the same facility ID Assumptions: Each unique facility ID and facility characteristics (e.g.

22 MFT: Facility Type (Example 3) Example: Multiple facilities of the same type are mapped to the same facility ID Assumptions: Each unique facility ID and facility characteristics (e.g., name; location) will exist as a row in the MFT spreadsheet For each unique facility ID, one row will be set to Primary Where possible, sites should establish unique facility IDs; otherwise, sites should enter separate rows for each facility associated with the same ID.

23 MFT: American Hospital Associa8on (AHA) Iden8fier Each MFT Excel Template includes an AHA Matching Tab Compares AHA 2013 data to existing MFT facilities Reflects results from the NSSP Representativeness Assessment from 2014 for sites actively participating in the NSSP Goal Align AHA IDs to facility information in the MFT o Confirm/update the AHA ID mapped to each facility, where possible o Investigate facilities that do not have a matching AHA ID o Review facilities that have an AHA ID but are not included on the MFT Excel Template o May provide insight for site administrators to target new facilities for onboarding Report which facilities are actively sending data to the NSSP

24 MFT: AHA Iden8fier (Example) Review instances where a match to an AHA Iden8fier is provided Review instances where a match was not found and provide an AHA ID if possible In this example, Facility ID 1112 may truly map to AHA ID 258 Indicate if the facility is ac8vely sending data to the NSSP Indicate if the facility is ac8vely sending data to a local system

Facility Cleanup Process: Confirm and Finalize MFT Excel Template 1. Site Administrators return an updated copy of the MFT Excel Template with their input to the DHIS liaison 2.

25 Facility Cleanup Process: Confirm and Finalize MFT Excel Template 1. Site Administrators return an updated copy of the MFT Excel Template with their input to the DHIS liaison 2. DHIS Team implements the changes and updates the crosswalk (as needed) DHIS liaison returns MFT Excel Template to Site for final review Site Administrator confirms information 3. DHIS Team establishes the Baseline MFT Excel Template (for a single site)

26 Facility Cleanup Process: Upload to MFT 1. DHIS Team uploads Baseline MFT Excel Template to the MFT Current processing Inserts only new facilities Future processing (ESSENCE June 2016) Inserts all facilities from the baseline Populates the crosswalk 2. Views will be established for each site to review their baseline facility informafon

Facility Cleanup Process: Ongoing Updates Sites may change facility informa8on acer baseline is established Onboarding team will manage updates to facility informa8on

27 Facility Cleanup Process: Ongoing Updates Sites may change facility informa8on acer baseline is established Onboarding team will manage updates to facility informa8on (e.g., onboarding a new facility) Update MFT Excel Templates Update MFT and Crosswalk implementation Periodic check-ins with Site to confirm MFT Excel Template informa8on

28 PROCESSING CONSIDERATIONS Roseanne English, CDC

29 Caveat Future processing enhancements and modifica8ons to message inges8on have not yet been fully discussed, veked with the community, or implemented The following slides present Ideas about how processing might work to join facility metadata (from the MFT) to incoming messages (visit level data) Potential downstream effects of that processing

30 Processing Considera8ons During message inges8on, the facility metadata from the MFT can be matched to incoming message data to enhance downstream processing and data availability Challenge If the facility identifier in an incoming message is associated with multiple entries in the MFT, the system must choose which facility characteristics to select Processing approach under considera8on Establish a key to connect incoming data with the appropriate entry on the MFT o Key generated from the MFT - Facility Key (MFT) o Key generated from the message Facility Key (Message)

31 Construc8ng a Facility Key from the MFT Facility Key (MFT) components Site ID Facility ID Facility Type -> Inferred Patient Class Facility Type Mapping to Inferred Pa8ent Class Standard Code Standard Descrip8on Inferred Pa8ent Class 261QE0002X Emergency Care E InpaFent pracfce seung I 261QM2500X Medical Specialty O 261QP2300X Primary Care O 261QU0200X Urgent Care E Site ID Facility ID Facility Name Facility Type Primary Facility MFT Key City Center ER Emergency Care Y E City Center Inpatient Inpatient Practice Setting N I

32 Construc8ng a Facility Key from the Message Facility Key (Message) Facility ID from the message Calculated patient class from message data o Patient class reported in the message o Patient class associated with the facility type reported in the message o Patient class associated with the facility type of the primary MFT entry System can take the Facility Key (Message) and compare it to the Facility Key (MFT) to return appropriate facility informa8on

MFT Processing Example 1 Incoming Message Site ID: 123 (inferred) Facility ID: 77777 (EVN-7) Patient Class: E (PV1-2) Calculated Patient Class: E Facility Key (Message): 123-77777-E Site ID Facility

33 MFT Processing Example 1 Incoming Message Site ID: 123 (inferred) Facility ID: (EVN-7) Patient Class: E (PV1-2) Calculated Patient Class: E Facility Key (Message): E Site ID Facility ID Facility Name Facility Type Primary Facility Facility Key (MFT) City Center ER Emergency Care Y E City Center Inpatient Inpatient Practice Setting N I The facility information (e.g., facility name) can be added to the incoming message data In this example, the incoming message will be associated with City Center ER

34 Processing Example 2 Incoming Message Site ID: 123 (inferred) Facility ID: (EVN-7) Patient Class: null Facility Type: null Calculated Patient Class: E Facility Key (Message): E Calculated Patient Class (Proposed algorithm): PV1-2 OBX-5 (facility type) MFT Look-up MFT Site ID Facility ID Facility Name Facility Type Primary Facility Facility Key (MFT) City Center ER Emergency Care Y E City Center Inpatient Inpatient Practice Setting N I If the patient class and facility type in the message is null, a proposed calculated patient class field could be leveraged. In this example, the incoming message will be associated with City Center ER because that facility is registered as the PRIMARY facility in the MFT

35 Poten8al Implica8ons System can compare the Facility Key (Message) to the Facility Key (MFT) to gather and append facility metadata If a match is found, that facility information from the MFT is returned for the record If a match is not found, additional processing/decisions will be developed o For example, data coming from a facility type that is not registered on the MFT Consider registering all facili8es from which your site expects to receive data

36 NEXT STEPS Mike ColeIa, CDC

37 Next Steps DHIS Liaison will schedule a kick-off call with each site Includes DHIS Representatives familiar with the analytic process to produce draft MFT Excel Templates and Cleanup Packages as well as communications facilitators Site Administrators and their supporting personnel Prior to this call, you will receive a tailored MFT Excel Template and Cleanup Package for your site (along with the Companion Guide)

Tenta8ve Schedule We an8cipate reaching out to the following sites (in this order) between now and March, 2016, to start the Facility Cleanup Process. 1. Illinois 2. Massachusetts 3. Kentucky 4.

38 Tenta8ve Schedule We an8cipate reaching out to the following sites (in this order) between now and March, 2016, to start the Facility Cleanup Process. 1. Illinois 2. Massachusetts 3. Kentucky 4. Arizona 5. Mississippi 6. Arkansas 7. West Virginia 8. Kansas 9. Houston, TX 10. Nevada 11. Utah 12. New Mexico 13. Denver Public Health 14. Riverside, CA 15. Idaho 16. North Dakota 17. Montana 18. Alaska 19. Stanislaus, CA 20. Linn County, IA 21. Santa Clara, CA 22. Nevada, CA 23. Florida 24. Ohio 25. Pennsylvania 26. New York 27. North Carolina 28. Georgia 29. New York City 30. New Jersey 31. Indiana 32. Texas Region 2/3 (Tarrant County) 33. Missouri 34. Louisiana 35. Maryland 36. Washington 37. Oklahoma 38. Minnesota 39. Connecticut 40. South Carolina 41. Oregon 42. Maine 43. Nebraska 44. New Hampshire 45. Rhode Island 46. Boston Public Health Commission 47. County of Sacramento, CA 48. District of Columbia 49. Delaware 50. San Diego, CA 51. Hawaii 52. South Dakota 53. San Mateo, CA

39 We appreciate your involvement. Please feel free to contact Michael A. ColeKa, MPH Na8onal Syndromic Surveillance Program Manager CDC/CSELS/DHIS For more informa8on please contact Centers for Disease Control and Preven8on 1600 Cli`on Road NE, Atlanta, GA Telephone: CDC-INFO ( )/TTY: Visit: Contact CDC at: CDC-INFO or The findings and conclusions in this report are those of the authors and do not necessarily represent the official posifon of the Centers for Disease Control and PrevenFon. Center for Surveillance, Epidemiology, and Laboratory Services Division of Health InformaFcs and Surveillance

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