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March 25, 2010Ravi Pallipamu, Microbiologist, MBACDPH/LA County HDInfection [email protected]
OBJECTIVES Explore NHSN Data submission options
CDA HL7 import(E-surveillance)
CSV import
ASCII text file import(Comma delimited file)
Carpal tunnel method
Advantages/Disadvantages
Utilizing IT and the Lab
Examples of how to upload files in NHSN
3rd party surveillance software utilizing CDA
CDA HL7 and NHSN These data can be exported electronically using infection surveillance software
systems which validates data against NHSN data requirements and creates an export report that meets NHSN specifications. CDA files contain the full semantics of clinical documents. Can contain any clinical content.
But before they can be electronically transmitted to NHSN, the data must be verified, translated and transformed to meet NHSN coding requirements and “business rules.”
Vendors must work in accordance with CDA specifications and NHSN reporting requirements.
The Current NHSN Data supported by the CDA Import Tool
Central Line - Associated Bloodstream Infection (CLABSI) ICU Denominator Surgical Site Infection (SSI) Operative Procedures CLIP (in process)
CDA compliant implementers AICE - yes
Carefusion’s--Medminded – yes
Theradoc - no
Premier’s- Safety Surveillor-- no
BD’s-Protect – yes
Hospital IT staff? Perhaps, ask.
CSV vs ASCII files Comma Separated Values (commas and rows with hidden commas)
Contains same info as ASCII file…(Patient ID, Secondary ID number, First
name, Middle name, Last name, Date of Birth, Birth weight in grams, Gender, Social Security Number, Comment Custom alpha value 1, Custom alpha value 2 ,Custom alpha value 3 ,Custom alpha value 4, Custom alpha value 5, Custom alpha value 6, Custom alpha value 7, Custom alpha value 8,Custom alpha value 9, Custom alpha value 10, Custom date value 1, Custom date value 2, Custom, Ethnicity Race )
CSV is simply in table format (columns and rows) below vs the above ASCII format
Simply a different way to look at the data
ASCII text files ONLY numbers, letters and symbols.
What you see in MS Notepad.
What’s left minus all the formatting.
separated out using delimiters
…(Patient ID, Secondary ID number, First name, Middle name, Last name, Date of Birth, Birth weight in grams, Gender, Social Security Number, Comment Custom alpha value 1, Custom alpha value 2 ,Custom alpha value 3 ,Custom alpha value 4, Custom alpha value 5, Custom alpha value 6, Custom alpha value 7, Custom alpha value 8,Custom alpha value 9, Custom alpha value 10, Custom date value 1, Custom date value 2, Custom, Ethnicity Race )
Manual data entry Helps one understand CDC HAI definitions
Should know how to do by default
Understand “errors” more readily
Time consuming
Error-prone (lose working data)
Its a drag…
Workable methods of choice
CDA is the ideal method
CSV or ASCII text import
Choose manual method when all else fails.
CDA ,CSV, ASCII..?!
CSV format
ASCII
CDACSV
1st step “Importing patients” (importing/exporting menu)
Select patient records based on whatever you are reporting for time period, location(s), etc (apply “high sensitivity”) Maybe ALL ICU patients with LOS >14d
MDRO LABID? ALL MRSA, VRE Bloods, C.Diff, etc
* Event information (including MDRO LABID event) still entered manually at this time
CSV format
Importing patient data
Micro/Lab/IT prepared file for your review
Must follow field order and formatting rules
Must be imported as CSV
Importing-- MRDO LABID data?
ASCII/CSV or CDA import not available yet
However one will have at least the patient records if net is cast big enough
Have 30 days from the end of month to report
Selecting Patient data set for import (Cast large net, High sensitivity)
SSI– patients undergoing Ortho, CABG, GI surgeriesCAUTI– Foley Cath w/ positive UR, etcCLABSI- Central Line, positive bloodMDRO, C.diff- Positive bloods, positive stools
Patients: FIND
Step by step importing ASCII procedural data
• Supply IT/Surgery with NHSN template fields (previous slide, defines Rules etc).•Ask IT/Surgery for Procedural records, ICD-9s,etc in a table• Review/populate respective records• Convert/Save as ASCII comma delimited text
Patient ID, Secondary ID number, First name, Middle name, Last name, Date of Birth, Birth weight in grams, Gender, Social Security Number, Comment Custom alpha value 1, Custom alpha value 2 ,Custom alpha value 3 ,Custom alpha value 4, Custom alpha value 5, Custom alpha value 6, Custom alpha value 7, Custom alpha value 8,Custom alpha value 9, Custom alpha value 10, Custom date value 1, Custom date value 2, Custom, Ethnicity Race
Importing bad data
Suggestions: Experiment in your database with fictitious pt info
Experiment with file types, converting, uploading
If NHSN doesn’t like the file, it will tell you what it doesn’t like.
“Bad Data” can be corrected/edited.
Call, email me anytime.