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documentation:next_cdm:visits_microvisits [2017/05/07 16:36] gowtham_rao |
documentation:next_cdm:visits_microvisits [2017/06/06 18:05] gowtham_rao |
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* The intent of this proposal is to capture detail information about a record in visit_occurrence. Examples of detail information may be encounters, micro-visits etc., and will be collected **as is** from the source data. | * The intent of this proposal is to capture detail information about a record in visit_occurrence. Examples of detail information may be encounters, micro-visits etc., and will be collected **as is** from the source data. | ||
* We propose a new VISIT_DETAIL table with a structure that is similar to current VISIT_OCCURRENCE table. For every record in visit_occurrence there maybe 0 or more records in visit_detail. | * We propose a new VISIT_DETAIL table with a structure that is similar to current VISIT_OCCURRENCE table. For every record in visit_occurrence there maybe 0 or more records in visit_detail. | ||
- | * Records in visit_detail will be related to each other sequentially or hierarchially, AND will be related to visit_occurrence table (using chaining/sequential method or parent-child/part-of). | + | * Records in visit_detail will be related to each other sequentially or hierarchically, AND will be related to visit_occurrence table (using chaining/sequential method or parent-child/part-of). |
* All information will belong to the domain visit. | * All information will belong to the domain visit. | ||
- | * Example: an entire inpatient stay maybe on record in visit_occurrence table. This may have one or more detail information such as ER, ICU, medical floor, rehabilitation floor etc. Each of these visit_details may have different start/end date-times, different concept_id's and fact_id's - that would be separate record in visit_detail with a FK link to visit_occurrence. Each record within visit_detail maybe related to each other, sequentially --> ER leading to ICU leading to medical floor, leading to rehabilitation, or in hierarchical parent-child visit --> a visit for dialysis while in ICU. | + | * Example: an entire inpatient stay maybe one record in visit_occurrence table. This may have one or more detail information such as ER, ICU, medical floor, rehabilitation floor etc. Each of these visit_details may have different start/end date-times, different concept_id's and fact_id's - that would be separate record in visit_detail with a FK link to visit_occurrence. Each record within visit_detail maybe related to each other, sequentially --> ER leading to ICU leading to medical floor, leading to rehabilitation, or in hierarchical parent-child visit --> a visit for dialysis while in ICU. |
- | + | ====== Proposed VISIT_DETAIL table ====== | |
- | **Proposed VISIT_DETAIL table:** Will have the same structure as current VISIT_OCCURRENCE table, except for two changes: | + | This table will have the same structure as current VISIT_OCCURRENCE table, except for two changes: |
* Two new foreign keys pointing to itself (visit_detail_parent_id) and to visit_occurrence table (visit_occurrence_id) | * Two new foreign keys pointing to itself (visit_detail_parent_id) and to visit_occurrence table (visit_occurrence_id) | ||
* Removal of _date fields. | * Removal of _date fields. | ||
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| visit_detail_id| Yes| integer| A unique identifier for each Person's visit-detail at a healthcare provider.| | | visit_detail_id| Yes| integer| A unique identifier for each Person's visit-detail at a healthcare provider.| | ||
| person_id | Yes | integer | A foreign key identifier to the Person for whom the visit is recorded. The demographic details of that Person are stored in the PERSON table.| | | person_id | Yes | integer | A foreign key identifier to the Person for whom the visit is recorded. The demographic details of that Person are stored in the PERSON table.| | ||
- | | visit_concept_id| Yes | integer | A foreign key that refers to a visit Concept identifier in the Standardized Vocabularies. | | + | | visit_detail_concept_id| Yes | integer | A foreign key that refers to a visit Concept identifier in the Standardized Vocabularies. | |
| <del>visit_start_date</del>| <del>Yes</del> | <del>date </del> | <del>The start date of the visit.</del>| | | <del>visit_start_date</del>| <del>Yes</del> | <del>date </del> | <del>The start date of the visit.</del>| | ||
| visit_start_datetime | Yes | datetime | The date and time of the visit-detail started.| | | visit_start_datetime | Yes | datetime | The date and time of the visit-detail started.| | ||
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- | ====== **PROCEDURE_OCCURRENCE** ====== | + | ====== PROCEDURE_OCCURRENCE====== |
^Field^Required^Type^Description^ | ^Field^Required^Type^Description^ | ||
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|provider_id|No|integer|A foreign key to the provider in the provider table who was responsible for carrying out the procedure.| | |provider_id|No|integer|A foreign key to the provider in the provider table who was responsible for carrying out the procedure.| | ||
|visit_occurrence_id|No|integer|A foreign key to the visit in the visit table during which the Procedure was carried out.| | |visit_occurrence_id|No|integer|A foreign key to the visit in the visit table during which the Procedure was carried out.| | ||
- | |**visit_detail_id**|No|integer|A foreign key to the visit in the visit-detail table during which the Procedure was carried out.| | + | |**visit_detail_id**|**No**|**integer**|**A foreign key to the visit in the visit-detail table during which the Procedure was carried out.**| |
|procedure_source_value|No|varchar(50)|The source code for the Procedure as it appears in the source data. This code is mapped to a standard procedure Concept in the Standardized Vocabularies and the original code is, stored here for reference. Procedure source codes are typically ICD-9-Proc, CPT-4, HCPCS or OPCS-4 codes.| | |procedure_source_value|No|varchar(50)|The source code for the Procedure as it appears in the source data. This code is mapped to a standard procedure Concept in the Standardized Vocabularies and the original code is, stored here for reference. Procedure source codes are typically ICD-9-Proc, CPT-4, HCPCS or OPCS-4 codes.| | ||
|procedure_source_concept_id|No|integer|A foreign key to a Procedure Concept that refers to the code used in the source.| | |procedure_source_concept_id|No|integer|A foreign key to a Procedure Concept that refers to the code used in the source.| | ||
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- | ====== **DRUG_EXPOSURE** ====== | + | ====== DRUG_EXPOSURE ====== |
^Field^Required^Type^Description^ | ^Field^Required^Type^Description^ | ||
|drug_exposure_id|Yes|integer|A system-generated unique identifier for each Drug utilization event.| | |drug_exposure_id|Yes|integer|A system-generated unique identifier for each Drug utilization event.| | ||
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|provider_id|No|integer|A foreign key to the provider in the provider table who initiated (prescribed or administered) the Drug Exposure.| | |provider_id|No|integer|A foreign key to the provider in the provider table who initiated (prescribed or administered) the Drug Exposure.| | ||
|visit_occurrence_id|No|integer|A foreign key to the visit in the visit table during which the Drug Exposure was initiated.| | |visit_occurrence_id|No|integer|A foreign key to the visit in the visit table during which the Drug Exposure was initiated.| | ||
- | |**visit_detail_id**|No|integer|A foreign key to the visit in the visit-detail table during which the Drug Exposure was initiated.| | + | |**visit_detail_id**|**No**|**integer**|**A foreign key to the visit in the visit-detail table during which the Drug Exposure was initiated.**| |
|drug_source_value|No|varchar(50)|The source code for the Drug as it appears in the source data. This code is mapped to a Standard Drug concept in the Standardized Vocabularies and the original code is, stored here for reference.| | |drug_source_value|No|varchar(50)|The source code for the Drug as it appears in the source data. This code is mapped to a Standard Drug concept in the Standardized Vocabularies and the original code is, stored here for reference.| | ||
|drug_source_concept_id|No|integer|A foreign key to a Drug Concept that refers to the code used in the source.| | |drug_source_concept_id|No|integer|A foreign key to a Drug Concept that refers to the code used in the source.| | ||
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- | ====== **DEVICE_EXPOSURE** ====== | + | ====== DEVICE_EXPOSURE ====== |
^Field^Required^Type^Description^ | ^Field^Required^Type^Description^ | ||
|device_exposure_id|Yes|integer|A system-generated unique identifier for each Device Exposure.| | |device_exposure_id|Yes|integer|A system-generated unique identifier for each Device Exposure.| | ||
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|provider_id|No|integer|A foreign key to the provider in the PROVIDER table who initiated of administered the Device.| | |provider_id|No|integer|A foreign key to the provider in the PROVIDER table who initiated of administered the Device.| | ||
|visit_occurrence_id|No|integer|A foreign key to the visit in the VISIT table during which the device was used.| | |visit_occurrence_id|No|integer|A foreign key to the visit in the VISIT table during which the device was used.| | ||
- | |visit_detail_id|No|integer|A foreign key to the visit in the VISIT_DETAIL table during which the device was used.| | + | |**visit_detail_id**|**No**|**integer**|**A foreign key to the visit in the VISIT_DETAIL table during which the device was used.**| |
|device_source_value|No|varchar(50)|The source code for the Device as it appears in the source data. This code is mapped to a standard Device Concept in the Standardized Vocabularies and the original code is stored here for reference.| | |device_source_value|No|varchar(50)|The source code for the Device as it appears in the source data. This code is mapped to a standard Device Concept in the Standardized Vocabularies and the original code is stored here for reference.| | ||
|device_source_ concept_id|No|integer|A foreign key to a Device Concept that refers to the code used in the source.| | |device_source_ concept_id|No|integer|A foreign key to a Device Concept that refers to the code used in the source.| | ||
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- | ====== **CONDITION_OCCURRENCE** ====== | + | ====== CONDITION_OCCURRENCE ====== |
^ Field ^ Required ^ Type ^ Description ^ | ^ Field ^ Required ^ Type ^ Description ^ | ||
| condition_occurrence_id | Yes | integer | A unique identifier for each Condition Occurrence event. | | | condition_occurrence_id | Yes | integer | A unique identifier for each Condition Occurrence event. | | ||
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| provider_id | No | integer | A foreign key to the Provider in the PROVIDER table who was responsible for capturing (diagnosing) the Condition. | | | provider_id | No | integer | A foreign key to the Provider in the PROVIDER table who was responsible for capturing (diagnosing) the Condition. | | ||
| visit_occurrence_id | No | integer | A foreign key to the visit in the VISIT table during which the Condition was determined (diagnosed). | | | visit_occurrence_id | No | integer | A foreign key to the visit in the VISIT table during which the Condition was determined (diagnosed). | | ||
- | | **visit_detail_id ** | No | integer | A foreign key to the visit in the VISIT_DETAIL table during which the Condition was determined (diagnosed). | | + | | **visit_detail_id ** | **No ** | **integer ** | **A foreign key to the visit in the VISIT_DETAIL table during which the Condition was determined (diagnosed).** | |
| condition_status_concept_id | No | integer | A foreign key to the predefined concept in the standard vocabulary reflecting the condition status. | | | condition_status_concept_id | No | integer | A foreign key to the predefined concept in the standard vocabulary reflecting the condition status. | | ||
| condition_source_concept_id | No | integer | A foreign key to a Condition Concept that refers to the code used in the source. | | | condition_source_concept_id | No | integer | A foreign key to a Condition Concept that refers to the code used in the source. | | ||
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- | ====== **MEASUREMENT** ====== | + | ====== MEASUREMENT ====== |
^Field^Required^Type^Description^ | ^Field^Required^Type^Description^ | ||
|measurement_id|Yes|integer|A unique identifier for each Measurement.| | |measurement_id|Yes|integer|A unique identifier for each Measurement.| | ||
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|provider_id|No|integer|A foreign key to the provider in the PROVIDER table who was responsible for initiating or obtaining the measurement.| | |provider_id|No|integer|A foreign key to the provider in the PROVIDER table who was responsible for initiating or obtaining the measurement.| | ||
|visit_occurrence_id|No|integer|A foreign key to the Visit in the VISIT_OCCURRENCE table during which the Measurement was recorded.| | |visit_occurrence_id|No|integer|A foreign key to the Visit in the VISIT_OCCURRENCE table during which the Measurement was recorded.| | ||
- | |visit_detail_id|No|integer|A foreign key to the Visit in the VISIT_DETAIL table during which the Measurement was recorded.| | + | |**visit_detail_id**|**No**|**integer**|**A foreign key to the Visit in the VISIT_DETAIL table during which the Measurement was recorded.**| |
|measurement_source_value|No|varchar(50)|The Measurement name as it appears in the source data. This code is mapped to a Standard Concept in the Standardized Vocabularies and the original code is stored here for reference.| | |measurement_source_value|No|varchar(50)|The Measurement name as it appears in the source data. This code is mapped to a Standard Concept in the Standardized Vocabularies and the original code is stored here for reference.| | ||
|measurement_source_concept_id|No|integer|A foreign key to a Concept in the Standard Vocabularies that refers to the code used in the source.| | |measurement_source_concept_id|No|integer|A foreign key to a Concept in the Standard Vocabularies that refers to the code used in the source.| | ||
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- | ====== **NOTE** ====== | + | ====== NOTE ====== |
^Field^Required^Type^Description^ | ^Field^Required^Type^Description^ | ||
|note_id|Yes|integer|A unique identifier for each note.| | |note_id|Yes|integer|A unique identifier for each note.| | ||
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|provider_id|No|integer|A foreign key to the Provider in the PROVIDER table who took the Note.| | |provider_id|No|integer|A foreign key to the Provider in the PROVIDER table who took the Note.| | ||
|visit_occurrence_id|No|integer|Foreign key to the Visit in the VISIT_OCCURRENCE table when the Note was taken.| | |visit_occurrence_id|No|integer|Foreign key to the Visit in the VISIT_OCCURRENCE table when the Note was taken.| | ||
- | |visit_detail_id|No|integer|Foreign key to the Visit in the VISIT_DETAIL table when the Note was taken.| | + | |**visit_detail_id**|**No**|**integer**|**Foreign key to the Visit in the VISIT_DETAIL table when the Note was taken.**| |
- | ====== **OBSERVATION** ====== | + | ====== OBSERVATION ====== |
^Field^Required^Type^Description^ | ^Field^Required^Type^Description^ | ||
|observation_id|Yes|integer|A unique identifier for each observation.| | |observation_id|Yes|integer|A unique identifier for each observation.| | ||
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|provider_id|No|integer|A foreign key to the provider in the PROVIDER table who was responsible for making the observation.| | |provider_id|No|integer|A foreign key to the provider in the PROVIDER table who was responsible for making the observation.| | ||
|visit_occurrence_id|No|integer|A foreign key to the visit in the VISIT_OCCURRENCE table during which the observation was recorded.| | |visit_occurrence_id|No|integer|A foreign key to the visit in the VISIT_OCCURRENCE table during which the observation was recorded.| | ||
- | |**visit_detail_id**|No|integer|A foreign key to the visit in the VISIT_DETAIL table during which the observation was recorded.| | + | |**visit_detail_id**|**No**|**integer**|**A foreign key to the visit in the VISIT_DETAIL table during which the observation was recorded.**| |
|observation_source_value|No|varchar(50)|The observation code as it appears in the source data. This code is mapped to a Standard Concept in the Standardized Vocabularies and the original code is, stored here for reference.| | |observation_source_value|No|varchar(50)|The observation code as it appears in the source data. This code is mapped to a Standard Concept in the Standardized Vocabularies and the original code is, stored here for reference.| | ||
|observation_source_concept_id|No|integer|A foreign key to a Concept that refers to the code used in the source.| | |observation_source_concept_id|No|integer|A foreign key to a Concept that refers to the code used in the source.| | ||
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|qualifier_source_value|No|varchar(50)|The source value associated with a qualifier to characterize the observation| | |qualifier_source_value|No|varchar(50)|The source value associated with a qualifier to characterize the observation| | ||
- | -------------------------------------------------------------------------------------------------------------- | ||
- | Representation of US claim data | ||
- | US claims data generally has header/summary data and line/detail level data. Detail is a child of the summary. If parent_visit_occurrence_id = visit_occurrence_id then it is header/summary data. If parent_visit_occurrence_id is not equal to visit_occurrence_id then it is a detail. We create new visit_type_concept_id for the following | ||
- | - Facility claim (Summary) | ||
- | - Facility claim (Detail) | ||
- | - Professional claim (Summary) | ||
- | - Professional claim (Detail) | ||
- | - Professional claim (Any) | ||
- | - Facility claim (Any) | ||
-------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------- | ||
+ | Representation of US claim data | ||
- | **Proposed new VISIT_OCCURRENCE_ERA table:** Will have the same structure as current VISIT_OCCURRENCE table. | + | US claims data generally has two-levels |
+ | - Header/summary data that summarizes the entire claim | ||
+ | - Line/detail that details a claim. | ||
- | ^ Field ^ Required ^ Type ^ Description^ | + | Detail is thus a child of the summary, and for every record in summary there is one or more records in detail. i.e. there will be atleast one FK link from visit_detail to visit_occurrence. |
- | | visit_occurrence_era_id| Yes| integer| A unique identifier for each Person's visit at a healthcare provider.| | + | |
- | | person_id | Yes | integer | A foreign key identifier to the Person for whom the visit is recorded. The demographic details of that Person are stored in the PERSON table.| | + | |
- | | visit_concept_id| Yes | integer | A foreign key that refers to a visit Concept identifier in the Standardized Vocabularies. | | + | |
- | | visit_start_datetime | Yes | datetime | The date and time of the visit started.| | + | |
- | | visit_end_datetime | No | datetime | The date and time of the visit end.| | + | |
- | | visit_type_concept_id | Yes | integer | A foreign key to the predefined Concept identifier in the Standardized Vocabularies reflecting the type of source data from which the visit record is derived. | | + | |
- | | provider_id | No | integer | A foreign key to the provider in the provider table who was associated with the visit. | | + | |
- | | care_site_id | No | integer |A foreign key to the care site in the care site table where visit occurred | | + | |
- | | location_id | No | integer |A foreign key to the location record in the location table where visit occurred| | + | |
- | | place_of_service_concept_id | No | integer |The standard concept id for place_of_service where visit occurred| | + | |
- | | admitting_source_concept_id | No | integer | A foreign key to the predefined concept in the Place of Service Vocabulary reflecting the admitting source for a visit. | | + | |
- | | discharge_to_concept_id | No | integer | A foreign key to the predefined concept in the Place of Service Vocabulary reflecting the discharge disposition (destination) for a visit.| | + | |
- | | visit_source_value | No | string | The source code for the visit as it appears in the source data. | | + | |
- | | admitting_source_value | No | string | The source code for the admitting source as it appears in the source data. | | + | |
- | | discharge_to_source_value | No | string | The source code for the discharge disposition as it appears in the source data.| | + | |
- | | preceding_visit_occurrence_id | No | integer | A foreign key to the visit_occurrence table record of the visit immediately preceding this visit. | | + | |
- | | | + | |
- | === Relationship between VISIT_OCCURRENCE and VISIT_OCCURRENCE_ERA === | ||
- | Linking VISIT_OCCURRENCE table to VISIT_OCCURRENCE_ERA will allow for provenance/lineage. | ||
- | |||
- | There may be n:m relationship between VISIT_OCCURRENCE and VISIT_OCCURRENCE_ERA, however one of them may be primary. This may be represented using primary_visit_ocurrence_era_id on VISIT_OCCURRENCE table. | ||
- | |||
- | | primary_vist_occurrence_era_id | Yes | integer | A foreign key that refers to the record in the VISIT_OCCURRENCE_ERA that was primary derived _ERA record from visit_occurrence_id | | ||
- | |||
- | All other non-primary relationship may be represented using FACT_RELATIONSHIP tables. | ||
- | |||
- | |||
- | -------------------------------------------------------------------------------------------------------------- | ||
- | **Relationship between visit_occurrence and clinical events tables** like CONDITION_OCCURRENCE, PROCEDURE_OCCURRENCE, SPECIMEN etc. | ||
- | |||
- | By joining through VISIT_OCCURRENCE table | ||
- | * Join VISIT_OCCURRENCE_ERA to VISIT_OCCURRENCE. | ||
- | * Join VISIT_OCCURRENCE to (event)_occurrence tables. | ||
- | |||
- | -------------------------------------------------------------------------------------------------------------- | ||