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HEALTH INITIATIVES CONSULTING,
INC.
Healthcare Transformation, Redesigned!
Your Partner in Data Stewardship
Maintaining Data Mapping in i2iTracks
Data Stewardship is a process of establishing and maintaining the validity and reliability of data used to
drive your business. This document will help you maintain the appropriate data mapping in i2iTracks, as
part of your data stewardship process. Health center teams are encouraged to do an initial “deep dive”
into all the data elements in i2iTracks. After the initial comprehensive process, it is best practice to
review and update data on a quarterly basis to include:
1. Linked Visit Types
2. Allergies
3. Educations
4. Immunizations
5. Medications
6. Problems
7. Procedures
8. Self-Management Goals
9. Treatment Plans
10. Other Profile Items
11. Labs
12. Custom Data Integrator
(CDI)
pg. 2 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
Allergies, Problems, and Medications are displayed in a patient’s profile.
Items with the i2i
logo are Tracks
profile items that
are mapped and
active. Items with
the blue “leaves”
are external
items and come
over as-is from
the EHR.
In general, it is best practice to “enable” only the patient profile items that you are currently using on a population level.
If you determine that you need to add a new profile item, always click “Show Disabled Items” and check to see if the item
exists in the “disabled” library. If it does, simply enable and map that item. As you complete mapping, already mapped
data from the EHR/PM systems will disappear from the available library. If your search yields no results when you do
your quarterly review, it means that no new items have been added to the EHR/PM libraries. If this result is unexpected
the mapping should be reviewed for completeness.
Linked Visit Types:
ICD and CPT codes come from the Practice Management System. Linked Visit Types are a collection of CPT/ICD codes
that all mean the same thing. They should be unique and specific to the concept that is mapped. Review all of the code
mappings for the enabled Linked Visit Types during your initial Data Stewardship set-up process. Items that use Linked
Visit Types are one of the only items in i2iTracks that are not “self-healing” in the event of incorrect mapping. This
means that if an ICD or CPT code is incorrectly mapped in a linked visit type that drives a Procedure, Education or
Immunization and you identify that you can make the correction of future data by correcting the Linked Visit Type
mapping. However, in order for historical Procedures, Educations or Immunizations to be removed, you must open a
support case with i2i Population Health to have them remove the incorrect profile items that were populated by the
linked visit type.
Unless new codes are
introduced, linked visit
type mappings do not
need to be maintained
on a quarterly basis.
pg. 3 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
In this example, all Procedure and Diagnosis codes
mean a preventive care exam was done. There is
an “OR” relationship between the Procedure and
Diagnosis codes. Any one of the codes attributed
to a patient will bring that patient up in search
using this linked visit type. Patients do NOT need
to have BOTH a mapped procedure AND
Diagnosis code.
Allergies:
Review Allergy mapping (Setup > Patient Profile Items > Allergies) for all enabled allergies. Note that you only need to
enable and map allergies that you are concerned with on a population basis, or allergies that are relevant for quality
measures.
Select the Allergy, and click Edit. Then in the
new window, click Add to select from the
External Allergy library. External Allergies are
interfaced directly from your EHR (just like
External Problems). Filter items based on your
search criteria and select all that apply, then click
OK. Repeat this search on a quarterly basis to
identify mappings that need to be added,
especially if there are new allergies being added
to the EHR allergy library on a regular basis.
Educations:
Review Education mappings (Setup > Patient Profile Items > Educations) for all enabled Educations.
pg. 4 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
Select the Education, and click Edit. You will note that
Educations can be created through a Linked Visit Type. It is
also helpful to put “CDI” in the description if this item is
linked to Custom Data. Review the Custom Data mappings
in the External Data Diagnostics tool (EDD).
Verify that the
alert schedule is
still appropriate
for the practice.
External Data Diagnostics Tool (EDD):
File > Tools > External Data Diagnostics
Enter the name of the Profile Item in the search field as shown below. All mapped items will display with information
that will be helpful in determining if the mapping is appropriate. You can also search with appropriate terms to identify
potential data that are not currently mapped. Changing mapping in the Custom Data Integrator (CDI) is reviewed later in
this document.
Immunizations:
Most immunizations are populated via hard-coded behind-the-scenes programming linking the EMR immunization table
CVX codes to the Childhood Immunization elements in i2iTracks. “Childhood” immunizations capture ALL immunizations,
in spite of the nomenclature. Although immunizations can be mapped as part of the Profile Items using Linked Visit
Types, best practice is to rely on Immunization Type mappings. Rarely there are immunization types entered into the
EMR immunization table that are not associated with a CVX code. When this happens, these outliers must be mapped in
“Vaccine Type Mappings.”
Setup > Tracking > Childhood Immunizations > Vaccine Type Mappings
pg. 5 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
Note how this FLU VACC QUADRAVALENT is not
mapped. Select the unmapped item, click “Map”
and find the related vaccine type to map to. If the
specific vaccine type is not known, use the “NOS”
version.
If your organization does use the Immunization
Profile Items then go to:
Setup > Patient Profile Items > Immunizations >
Select Immunization to Validate
Go to the Vaccine Types tab and verify that all appropriate vaccine types
are linked. Using this method will bring in immunizations administered
at your clinic AND elsewhere that are documented in the EMR
immunization template.
Check the schedule to be sure it reflects current practice.
Caution: Using a Linked Visit Type is NOT self-healing and can create
duplicate immunizations based on the link to billing as well as the EMR
immunization template.
For each immunization, you can set custom schedules based on selected
patient characteristics. If a patient does not meet the established
schedule, you will see a notification on your Morning Huddle report. If you
need to set a schedule that is more complicated than the standard
schedule tool will allow, you can create a Protocol Search to display on the
Morning Huddle report. Schedules for Childhood Immunizations are
automatically loaded based off of the standard CDC guidelines. However,
children “of age” for Childhood Immunizations must be added to
Childhood Immunization Tracking in order for alerts to appear on the
huddle report or patient visit summaries.
Review each Immunization in your library on a quarterly basis.
Medications:
i2iTracks automatically maps a specific set of medications and updates the mapping on a regular basis.
The following i2iTracks medications are automatically mapped:
• ACE Inhibitor, Unspecified (i2i)
• ADHD Medications
• AG Inhibitor, Unspecified (i2i)
• Amylin Agonists
• Anti-depressant, Unspecified (i2i)
• Antibiotic
• Antihypertensive Pharmacological Therapy
• Antithrombotic Therapy (NQF) (Note: Some aspirins may not map to this and may require manual update)
• ARB, Unspecified (i2i)
pg. 6 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
• Aspirin (i2i)
• Asthma Controller Medication
• Asthma Rescue Medication
• Biguanides
• Contraceptives (NQF)
• Diabetes Medications (NQF)
• DPP 4 Inhibitors
• Glitazones, Unspecified (i2i)
• GLP 1 Analog (Byetta)
• Insulin (i2i)
• Lipid Lowerer (NQF)
• Meglitinides
• PCP Prophylaxis (Note: Bactrim and related medications are not auto-mapped and will need to be manually added as appropriate for your practice)
• Smoking Cessation (NQF)
• Sulfonylurea, Unspecified (i2i)
• Warfarin (NQF) (Note: Jantoven is not included auto-mapping and will need to be manually added as appropriate for your practice)
Medications that are auto-mapped but not used by your practice can be disabled to remove them from the visible pick
list. However they will continue to populate on the patient level based on their maping to EMR medications. DO NOT
change the names of any of the auto-mapped medications as this will interfere with the appropriate function of the
auto-map routine.
If you need a medication that is not listed on the
medication list, such as Hepatitis C Meds, it will need to be
manually created and mapped. First, ensure that the
medication is enabled (Setup > Patient Profile Items >
Medications > Medications). Once it is enabled (or
created), review the mapping (Setup > Patient Profile Items
> Medications > Medication Mapping). Select the
medication, and then Edit.
If there are no medications listed, you will need to Add
them manually. This is a labor intensive set-up process, but
only needs to be maintained on a quarterly basis for
enabled medications moving forward.
First, search the medication library for the root word of the
generic medication. In some EMRs the generic name is
included with the brand name of the drug. If not, you’ll
also need to do a search for all the brand named drugs
within the broader category.
pg. 7 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
Select OK to add the medication mappings.
On a quarterly basis, review the mapping for all
medications that are NOT auto-mapped by doing a
search for all the names that have already been
mapped (this will identify if a new dosage was
prescribed for the first time, for instance). Search
for new medications in the class of medications
that are being mapped. Is there a new brand name
or generic that has been released recently that is
now in use at your clinic?
Problems:
Review Problem mapping (Setup > Patient Profile Items > Problems) for all enabled problems. Note that you only need
to enable and map problems that you are relevant to a population or for quality measures. You do not need to replicate
your entire EHR problem list.
Problems can be mapped to diagnosis codes, procedure codes,
external problems, or custom data. If a problem is mapped to
custom data (CDI) exclusively or in addition to External Problems,
best practice is to write “CDI Mapping” in the Description to
prevent confusion.
It is best practice to map Problems to External Problems with
or without CDI mappings as these are both self-healing and
allow the problem in Tracks to resolve when the
corresponding problem in the EMR is resolved. Any mapping
changes in linked billing ICD codes will only change the
problem attribution in i2iTrakcs from that moment forward.
As with Procedures, Immunizations or Educations that are
created by linked visit types, past errors will need to be cleared by i2i Population Health by submitting a support ticket.
pg. 8 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
The “Related Profile Items” tab in Problem setup is where you
designate profile items of interest to patients that have that
particular problem (e.g. comorbidities). These Related Profile
Items will populate on the Patient Visit Summary for patients
with the i2iTracks problem(s), which is particularly useful if you
are using a generic “Preventive Care” patient visit summary.
This is a setup for the “i2i Preventive Care Template”
Patient Visit Summary. Check the “Include profile items
that are related to the patient’s problems” radio button
to have the visit summary personalize for each patient
based on their i2iTracks problems.
Procedures:
Review Procedure mappings (Setup > Patient Profile Items >
Procedures) for all enabled Procedures.
Select the Procedure, and click Edit. You will note that
Procedures can be created through a Linked Visit Type. It is
also helpful to put “CDI” in the description if this item is linked
to Custom Data. Review the Custom Data mappings in the
External Data Diagnostics tool (EDD).
Verify that the alert schedule is still appropriate for the
practice.
See the CDI mapping section at the end of this document for
more information on updating CDI mappings.
pg. 9 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
Self-Management Goals, Treatment Plans and Other Profile Items:
Setup > Patient Profile Items > Self Management Goals
Setup > Patient Profile Items > Treatment Plans
Setup > Patient Profile Items > Other
Self-Management Goals, Treatment Plans and Other Profile Items
can only be driven by the CDI. Review their mapping quarterly. See
the CDI section in this document.
Labs:
Review lab mappings quarterly or when sudden shifts in report outcomes are observed. Labs can change result codes
without your knowledge and EMR mappings can change. Either one of these events can change the lab result mapping
needed in i2iTracks.
As with all data elements, only enable the Labs that you will be
using to manage or report on the population. Labs are enabled
and disabled in “Labs”. Once you have a clean list of labs that
you will be using, lab mappings can be reviewed in “Lab
Mappings.” Note: The other functions in this menu are legacy
functions from a time before lab interfaces. These functions can
be ignored.
pg. 10 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
You will have a tab across the top for each of your lab sources.
Labs need to be mapped separately under each tab.
Prior to mapping it is a good practice to drill down on the
various results in the External Data Diagnostics tool to validate
appropriate results. Numeric results, like the HbA1c do not
require additional steps beyond mapping the results codes.
Qualitative and list values have additional mapping requirements. HIV screening is an example of a qualitative lab. HCV
Fibrosis stage is an example of a list value. Use the “Set” button to map the results.
Custom Data Integrator:
Mapping for custom data occurs in the Custom Data Integrator (CDI).
Items in the CDI are mapped on an as-needed basis. Depending on your
EHR interface, you may have thousands of items in this library. You only
need to maintain mappings (i.e. look for unmapped values) for items
that have equivalent i2iTracks items. Items that have unmapped values
will be highlighted in red UNLESS the “Ignore Unmapped Values” radio
button has been selected in the setup of that item. The selection of this
radio button is indicated by a “Yes” in the “Ignore Unmapped Values”
column of the CDI.
pg. 11 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
If you identify an item in the CDI that needs to be mapped and an equivalent i2iTracks item does not exist, the setup of
that item can be done right from the CDI. For example, you might want to also map this item to a Procedure of “Tobacco
Use Assessment.”
Click on “Add Another Mapping.” Choose the Category of item that you want to create. Then click on “Setup Items…”
1
2 3
pg. 12 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
Then create the required data element. Remember
to always check the disabled items before potentially
creating a duplicate data element. Add “CDI” to the
description for clarification. Once the item has been
created you can map it.
If you are creating a new Problem, you can map the
External Diagnoses from the setup within the CDI,
rather than having to go back through profile items
setup when done in the CDI.
When a new rule is added, you must determine how the rule will treat the EHR data.
Other Profile Items that are numeric values will give you the following mapping options:
Any date value (Use as event date
Any numeric value “As Is”
Any of the following values
Any value
When there are many text values, rules can be applied to simplify mapping maintenance.
Validation should be thorough
to be sure that the data is being
interpreted appropriately.
pg. 13 – HIC Maintaining Data Mapping in i2iTracks 2017 ©
CDI Data Validation
Depending on the EMR interface with i2iTracks, there may not be a capability of drilling down on custom data in
the External Data Diagnostics tool prior to mapping that data element. Prior to mapping something to
production, when the data interpretation is not clear, you can map the data element to a Test List Value item in
Other Profile Items.
CDI mappings are self-healing. Once a mapping is cleared and auto-update has occurred (generally overnight for
most installations of i2iTracks) then the data that had been mapped to the i2iTracks items is removed from the
patient level. This allows you to repurpose any of the test list values for testing additional data elements. Simply
edit the name of the item and map it to the data that you want to validate. Wait for auto-update and then you
can drill down within the EDD or create searches and reports to validate the data.