Value-Add Field Logic

Overview

To compensate for potential data gaps, anomalies, or inconsistencies in participants' data feeds, HealthInfoNet employs value-add logic to a few key fields used throughout the reporting dashboards. In order to ensure transparency in the data transformation activities performed, the following sections outline the methodology used for each value-add field.

Address Information

The Address History dashboard includes all iterations of patients' address information as reported by participating organizations. In all other reporting dashboards, patients' most recently reported sets of Street Address, City/Town, State, ZIP Code, and Telephone Number values are used in related filter options, metrics, charts, and tables. Previously reported addresses are used only when patients' most recently reported set of address information contains only State, or only Telephone Number, or only State and Telephone Number values.

Diagnosis Type

The ICD-10 diagnosis codes that have been identified by the Office of MaineCare Services under “Section 45 Non-Emergent Use of Emergency Department: ICD-10 Codes," effective October 1, 2015, as "Non-Emergent" diagnosis codes. This reference table is used to identify 'Non-Emergent' diagnosis codes based on the values contained in each encounter's Primary Diagnosis Code field. Review the full value set by downloading the following reference document.

HealthInfoNet - Diagnosis Type Reference Table.xlsx

Encounter Payer

On some encounter records, participants supply a free-text description of the health insurance plans reported by patients at the point of care. Because those descriptions can vary greatly within/across participants' ADT data feeds, HealthInfoNet categorizes the values into higher-level groupings. When insurance information is available on encounter records, valid values include Commercial, Medicaid, Medicare, Government, Free Care - Self Pay, Worker’s Compensation, Other; when insurance information is not available on encounter records, the field will remain null.

Encounter Status

Valid values for the Inpatient and Emergency Department encounter types include:

• Discharge disposition codes when valid values are available, including the following groupings:

  • Cancer Center/Children’s Hospital: 05, 85

  • Court/Law Enforcement: 21, 87

  • Expired: 20, 41, 42

  • Facility: 04, 84

  • Federal Health Care Facility: 43

  • Health Care Institution: 70, 95

  • Home - Against Medical Advice: 07

  • Home - Home Health Services: 06, 86

  • Home - Routine: 01, 81

  • Hospice - Facility: 51

  • Hospice - Home: 50

  • Hospital: 65, 66, 93, 94

  • Hospital - Inpatient: 02, 82

  • Hospital - Long-Term Care: 63, 91

  • Hospital - Swing Bed: 61, 89

  • Inpatient Rehab Unit: 62, 90

  • Nursing Facility: 64, 92

  • Other: 08, 68

  • Skilled Nursing Facility: 03, 83

  • Still Patient: 30

  • This Hospital - Inpatient: 09

• Presumed Discharged - Added to encounter records that are 30 days past the admission date and do not have a discharge date or discharge disposition code. If encounter records are later updated with a discharge disposition code, the reporting will update with the latest source value.

• Currently Hospitalized - Added to encounter records that do not have a discharge date or discharge disposition code and are within 30 days of the admission date. If the encounter records are later updated with a discharge disposition code, the reporting will update with the latest source value; if the encounter records are not updated with a discharge date or discharge disposition code within 30 days of the admission date, the records will be presumed as discharged.

Valid values for the Long-Term Care encounter type include the above discharge disposition code groupings when valid values are available; if not available, the field will remain null (i.e., blank).

Race, Ethnicity, Sex, & Date of Birth Information

In all reporting dashboards, patients' most recently reported non-null values for race, ethnicity, sex, and date of birth information is used in related filter options, metrics, charts, and tables. Only when patients' most recently reported values are null are their previously reported non-null values used (when available).