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Database & Methods Cyberseminar SeriesOverview of VA Data, Information Systems,National Databases & Research UsesOctober 2, 2017Maria Souden, MSI, PhDAssociate Director, VA Information Resource Center
2Database & Methods Cyberseminar SeriesInformational seminars to help VA researchersaccess and use VA databases.Topics VA data sources & data access systems Application of VA data to research and qualityimprovement questions Limitations of secondary data use Resources to support VA data use10/2017
3FY ‘18 Database & Methods ScheduleFirst Monday of the month* 1:00pm-2:00pm ETVisit our Educationpage for moreinformation ®istration verview of VA Data & Research Uses11/6/2017Requesting Access to VA Data12/4/2017VA Medicare Data (VA/CMS)1/8/2018*Mortality Ascertainment & Cause of Death2/5/2018Assessing Race & Ethnicity3/5/2018TBD4/2/2018Pharmacy Data5/7/2018VA Healthcare idity Measures Using VA & CMS Data*Schedule shifts by one week in event of VA holiday.10/2017
Database & Methods Cyberseminar SeriesSession 1: Overview of VA Data, InformationSystems, National Databases & Research Uses
5Today’s objectiveThe purpose of this cyberseminar is toprovide an introduction to VA data andresources for using it effectively.10/2017
6Session roadmap Introduction to VIReC Overview of the VA data environment Highlights of commonly used VA data sources Platforms & tools for using data Where to go for more help10/201610/2017
7Poll #1: Your role as a data user What is your role in research and/or quality improvement? Investigator, PI, Co-I Data manager, analyst, or programmer Project coordinator Other – please describe via the Q&A function10/2017
8Poll #2: Your experience with VA dataHow many years of experience do you have working withVA data? One year or less More than 1, less than 3 years At least 3, less than 7 years At least 7, less than 10 years 10 years or more10/2017
9Session roadmap Introduction to VIReC Overview of the VA data environment Highlights of commonly used VA data sources Platforms & tools for using data Where to go for more help10/201610/2017
10Meet VIReCMissionTo advance VA capacity to use data effectively for research and quality improvementand to foster communication between data users and the VA healthcare community.ActivitiesDEVELOPDISSEMINATEIMPROVEdata knowledge and methodsdata knowledgedata access and availabilityAdvocate on nationalcommittees & workgroupsFactbooks and User GuidesIntranet websiteSummary informationVHA Data PortalTechnical documentation(collaboration with NDS & VINCI)Real SSN request reviewsHelpDesk 1:1 consultationVA/CMS Data for ResearchHSRData ListservVA REDCapCyberseminars(hosted by CIDER)10/2017
11Session roadmap Introduction to VIReC Overview of the VA data environment Highlights of commonly used VA data sources Platforms & tools for using data Where to go for more help10/201610/2017
12Activities that generate VA data Administrative / Operations activities Clinical care / Patient records Financial recordkeeping Veteran surveys & patient portals Patient care outside the VA system10/2017
13Veterans Health Information Systems &Technology Architecture (VistA) Integrated system of softwareapplications Directly supports patient careat Veterans HealthAdministration (VHA)healthcare facilities Source of data for many VHAdatasets or databases10/2017
14Commonly used VA data sourcesVA CorporateData Warehouse(CDW)VA Medical SAS(MedSAS)VA Vital StatusFileVA MCA NationalClinical DataVA PharmacyDataVA/CMS Data forResearch10/2017
15Commonly used VA data sourcesEHR/VistAVA CorporateData Warehouse(CDW)VA Medical SAS(MedSAS)VA Vital StatusFileVA MCA NationalClinical DataVA PharmacyDataVA CMS Data forResearch10/2017
16Commonly used VA data sourcesUtilization and StatusVA CorporateData Warehouse(CDW)VA Medical SAS(MedSAS)VA Vital StatusFileVA MCA NationalClinical DataVA PharmacyDataVA CMS Data forResearch10/2017
17Commonly used VA data sourcesVA CorporateData Warehouse(CDW)VA Medical SAS(MedSAS)VA Vital StatusFileVA MCA NationalClinical DataVA PharmacyDataVA CMS Data forResearchClinical Care Activities & Costs10/2017
18Commonly used VA data sourcesVA CorporateData Warehouse(CDW)VA Medical SAS(MedSAS)VA Vital StatusFileVA MCA NationalClinical DataVA PharmacyDataVA CMS Data forResearchNon-VA Data10/2017
19Session roadmap Introduction to VIReC Overview of the VA data environment Highlights of commonly used VA data sources Platforms & tools for using data Where to go for more help10/201610/2017
20Highlight: Corporate Data WarehouseData steward: National Data Systems (NDS)VA CorporateData Warehouse(CDW)VA Medical SAS(MedSAS)VA MCA NationalClinical DataVA Pharmacy DataVA Vital Status FileVA CMS Data forResearch10/2017
21CDW rolesBISLNDSVINCIVIReCBusinessIntelligenceService LineNational DataSystemsVA Informatics& ComputingInfrastructureVA DataProvisioningData UseSupportBuild the datawarehouse thatorganizes thesedataGrants access toCDW dataCreates subsetsof CDW data forusers who havebeen grantedaccessProvidesdocumentation &education to helpunderstand anduse the data10/2017
22CDW origin & content 130 VistASystemsRegion 1DataWarehouseRegion 2DataWarehouseRegion 3DataWarehouseMinute by minute transactionsadded – no changesRegion 4DataWarehouseCDW(60 tient RxOutpatient RxLab ChemistryLab MicrobiologyVital Signsetc.22Nightly updatesto architecteddatabase - no change to content10/2016
23CDW things to know Data straight from VistA– Not curated or transformed CDW is a relational database, not a dataset For SAS users, requires some conceptual shifts and newskills Relatively new and still evolving CDW SharePoint Site:https://vaww.cdw.va.gov/Pages/CDWHome.aspx (VA Intranet)10/2017
VIReC resources for CDW ntation.htm(VA Intranet)10/2017
25New to ation.htmEmail virec@va.gov to be notified of new CDW products and seminars.10/2017
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28Highlight: VA MedSAS DataData steward: National Data Systems (NDS)VA Corporate DataWarehouse (CDW)VA Medical SAS(MedSAS)VA MCA NationalClinical DataVA Pharmacy DataVA Vital Status FileVA CMS Data forResearch10/2017
29MedSAS things to know Data have been summarized and had business rulesapplied Inpatient discharges at the stay level (episode of care) Outpatient information at the visit and encounter level Include diagnostic, treatment, and some demographicinformation from the electronic health record Demographic information current at time of encounter or stay Includes data about care in non-VA facilities paid for byVA10/2017
30MedSAS inpatient overviewPTF dataPatient Treatment File (PTF)Austin Information Technology Center (AITC)National Data Systems (NDS)10/2017
31MedSAS inpatient data elementsExamples Patient demographics ICD-9/10 diagnosis codes ICD-9/10 procedure &surgery codes Discharge dates Treating specialty10/2017
32MedSAS outpatient overviewNational Patient Care Database (NPCD)National Data Systems (NDS)10/2017
33MedSAS outpatient data elementsExamples Patient demographics ICD-9/10 diagnosis codes CPT-4 procedure codes Event dates Provider specialty10/2017
34Coming soon! MedSAS Replacement data views NPCD Database to be discontinued MedSAS outpatient files (SF/SE/IE) will becomeavailable as SQL views in CDW Current variables recreated Will look the same to the end user, just in SQL Currently being tested to make sure workload logicapplied correctly Availability and access information to come10/2017
VIReC resources for MedSAS umentation.htm(VA Intranet)10/2017
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37More about MedSASJoin us May 7, 2018VA Healthcare UtilizationDr. Denise HynesArchived FY17 sessions:https://www.hsrd.research.va.gov/for researchers/cyber seminars/archives/video archive.cfm?SessionID 1241https://www.hsrd.research.va.gov/for researchers/cyber seminars/archives/video archive.cfm?SessionID 122410/2017
38Highlight: VA Vital Status File (VSF)Data steward: National Data Systems (NDS)VA Corporate DataWarehouse (CDW)VA Medical SAS(MedSAS)VA Vital StatusFile (VSF)VA MCA NationalClinical DataVA Pharmacy DataVA CMS Data forResearch10/2017
39VA Vital Status File things to know Includes death and birth dates from multiple sources ofmortality information VA Workload Data (PTF and Fee Basis) Beneficiary Identification and Resource Locator System (BIRLS)Death File (from VBA) Medicare Vital Status File Monthly Social Security Administration Death Master File Two files - Master and Mini10/2017
40VA Vital Status File data elementsVSF Master File Death dates from: VA & CMS enrollment &utilization VBA & Social Securitybenefits Last healthcare utilizationdates from multiplesourcesVSF Mini File Applies algorithm todetermine “best” Death date Birth date Gender Last utilization Presumed living indicator10/2017
41More about mortality dataJoin us Jan 8, 2018Mortality Ascertainment & Cause of DeathDr. Charles MaynardArchived FY17 session:https://www.hsrd.research.va.gov/for researchers/cyber seminars/archives/video archive.cfm?SessionID 124210/2017
42Highlight: MCA National Clinical DataData steward: VHA Managerial Cost Accounting OfficeVA Corporate DataWarehouse (CDW)VA MCA NationalClinical DataVA Medical SAS(MedSAS)VA Pharmacy DataVA Vital Status FileVA CMS Data forResearch10/2017
43MCA national clinical data things to know MCA creates 26 National Data Extracts (NDEs), classifiedas Core, Clinical, Financial, Program Activity See VHA Data Portal for full list Four clinical NDEs most relevant to health servicesresearch Lab tests & costs (LAB) Lab test results (LAR) Pharmacy prescriptions (PHA) Radiology procedures (RAD)10/2017
44VA MCA clinical NDE data elementsExamples Date Test results Ordering provider Costs10/2017
Resources for MCA NDEsVIReC MCA NDEs SAS/Documentation.htm(VA Intranet)MCAO National Data Extracts & Reporting /nr extracts.asp(VA Intranet)Health Economics Resource Center e.asp?id managerial-cost-accounting(VA Intranet)10/2017
46Highlight: VA pharmacy dataData stewards: PBM, MCAO, NDSVA Corporate DataWarehouse (CDW)VA Medical SAS(MedSAS)VA Vital Status FileVA MCA NationalClinical DataVA PharmacyDataVA CMS Data forResearch10/2017
47Sources of data on medications dispensed in VAPharmacy Benefits Management Data Steward: PBMMCA Pharmacy NDE Data Steward: MCAOFour CDW Production Domains Data Steward: NDS Pharmacy Bar Code Medication Administration (BCMA) Domain(inpatient pharmacy) Pharmacy Outpatient Domain Pharmacy Patient Domain Non-VA Meds10/2017
48VA pharmacy data elementsExamples Generic drug name VA drug class Days supply Cost Dosing instructions (PBM only)10/2017
Resources for pharmacy verview.htm(VA Intranet)10/2017
50More about pharmacy dataJoin us April 2, 2018VA Pharmacy DataDr. Charles MaynardDr. Bonnie ParisArchived FY17 session:https://www.hsrd.research.va.gov/for researchers/cyber seminars/archives/video archive.cfm?SessionID 125910/2017
51Highlight: VA/CMS Data for ResearchData steward: VIReCVA Corporate DataWarehouse (CDW)VA Medical SAS(MedSAS)VA MCA NationalClinical DataVA Pharmacy DataVA Vital Status FileVA/CMS Data forResearch10/2017
52VA/CMS - types of data Medicare & Medicaid enrollment and claims data Medicare Current Beneficiary Survey (MCBS) data Patient assessment data Healthcare Effectiveness Data and Information Set(HEDIS) - utilization in Medicare managed care United States Renal Data System (USRDS) data10/2017
53VA/CMS data elements Examples Medicare and Medicaid enrollment ICD-9 diagnosis codes ICD-9 and CPT4 procedure codes Charges and payments Veteran flag10/2017
Resources for VA/CMS S.htm(VA Intranet)10/2017
55More about VA/CMS data for researchJoin us December 4, 2017VA Medicare DataMs. Kristin de GrootArchived FY17 session:https://www.hsrd.research.va.gov/for researchers/cyber seminars/archives/video archive.cfm?SessionID 107910/2017
56Session roadmap Introduction Highlights of commonly used VA data sources Platforms & tools for using data Where to go for more help10/201610/2017
57VA Informatics and Computing Infrastructure Secure data environment High-speed processing platform Free data management and analytictools VINCI servicesVINCI Central Websitehttp://vaww.vinci.med.va.gov/vincicentral/ (VA Intranet)10/2017
58AITC (Austin Information Technology Center) Centralized computer processing center (mainframe) Available data MedSAS datasets VA Vital Status file Learn More VHA Data Portal AITC Mainframe es/AITCMainframe.aspx (VHA Intranet) AITC Mainframe es/Default.aspx (VHA Intranet)10/2017
59CAPRI & JLVRead-only access to patient electronic health records (EHRs)CAPRI* Uses desktop computersoftware application Can see patient recordone site at a time Includes search function Direct access to JLVJoint Legacy Viewer Replacing VistAWeb VA Intranet web portal Can see VA and DoDpatient records for all caresites at once VistA Imaging available*Compensation and Pension Record Interchange10/2017
60More about EHR viewer toolsDate TBD, join us in summer of 2018!Archived FY17 session:https://www.hsrd.research.va.gov/for researchers/cyber seminars/archives/video archive.cfm?SessionID 126010/2017
61Session roadmap Introduction Highlights of commonly used VA data sources Platforms & tools for using data Where to go for more help10/201610/2017
tal.med.va.govVA network onlyVA network onlyNews & newresourcesCollaborative withNDS & VINCIResources forworking with dataData source &access IReC overviewPublications &eventsCyberseminars10/2017
63VIReC options for specific questionsHSRData Listserv Community knowledgeHelpDesk Individualized supportsharing 1,200 VA data users Researchers, operations,data stewards, managersvirec@va.gov(708) 202-2413 Subscribe by HSRData-L.htm (VA Intranet)10/2017
64Quick links for VA data resourcesQuick Guide: Resources for Using VA esources-for-Using-VA-Data.pdf (VA Intranet)VIReC: http://vaww.virec.research.va.gov/Index.htm (VA Intranet)VIReC Cyberseminars: minars.aspVHA Data Portal: http://vaww.vhadataportal.med.va.gov/Home.aspx (VA Intranet)VINCI: http://vaww.vinci.med.va.gov/vincicentral/ (VA Intranet)Health Economics Resource Center (HERC): http://vaww.herc.research.va.gov (VA Intranet)CDW: https://vaww.cdw.va.gov/Pages/CDWHome.aspx (VA Intranet)Archived cyberseminar: What can the HSR&D Resource Centers do for you?http://www.hsrd.research.va.gov/for researchers/cyber seminars/archives/video archive.cfm?SessionID 10110/2017
65Take-aways VA has many data sources that can be used to addressresearch & QI questions Data are complex and distributed Use resources VIReC and others offer to help you navigate data sources connect you with peers, experts & additional info10/2017
66Contact informationMaria Souden, MSI, PhDAssociate DirectorVA Information Resource CenterHines VA 310/2017
Database & Methods Cyberseminar SeriesRequesting Access to VA DataLinda Kok, MAVA Information Resource Center
Clinical Data VA Vital Status File VA Pharmacy Data VA CMS Data for Research 20 10/2017 Data steward: National Data Systems (NDS) 21 CDW roles . BISL Business Intelligence Service Line . Austin Information Technology Center (AITC) National Data Systems (NDS) 31 10/2017
