Excite welcomes you to this 3-part article series as we explore the uses and effects of coded data in various realms. We begin with federal and private agencies that depend on correctly coded and concise information for patient care, epidemiologic analysis, and outcomes analysis. Subsequent articles will focus on how coded data has the potential to affect healthcare providers and the individual patient.
How, where and why did data collection begin and how do federal and private agencies use the data today?
Data on deaths and diseases have been collected for almost 400 years, starting in the 1600s in London, England. In the 1850s, “The International List of Causes of Death” became an official database. Since then, the collection of data has been enhanced and standardized with the onset of the application of diagnosis and procedure codes. The information has also been refined with the addition of discharge disposition status and presents on admission indicators. Today, the use of coded data is widespread across various agencies.
In blinded format (meaning, no associated patient identifying information), coded data points are accessible by various institutions. Their uses have a wide range including disease monitoring and evaluation and healthcare facility and physician quality reporting. Various decisions are made based on the results of data analysis; therefore, the need for accurate documentation and code assignment is imperative.
The Centers for Disease Control (CDC) is one of the largest users of coded data. Information is analyzed and evaluated for health status, and for monitoring incidence and disease prevalence throughout various populations. Right now, the CDC is using this data to track cases of COVID-19 and trending associated morbidity and mortality. Of course, COVID-19 is not the only disease monitored. On a yearly basis, the CDC also monitors other diseases, both communicable and congenital, and publishes prevalence and mortality data on their website. (https://www.cdc.gov/)
The Agency for Healthcare Research and Quality utilizes coded data to evaluate outcomes and develop strategies for improving patient care. One of their ongoing programs is a reduction in healthcare-associated infections. Utilizing applied research methods, coded data along with actual healthcare delivery methods are reviewed and opportunities for improvement are identified. This information is then published and available to facilities to use for internal improvement initiatives. (https://ahrq.gov)
Various companies such as Healthgrades (www.Healthgrades.com) offer data to the public that rank physician practices and health care facilities on diagnoses, procedures, and outcomes. This information is gathered based on ICD-10-CM diagnosis and procedure codes, discharge disposition (mortality), and readmission rates. The intent of Healthgrades is to serve as a reference point for patients seeking to select a provider of choice. They can search and compare by location, a specialty of physician, and facility. In the facility category, the patient can drill down and look at a facility’s outcomes for various procedures such as orthopedic care (eg., hip replacements), cardiac care (eg., congestive heart failure outcomes) just to name a few.
The potential uses of coded data are vast and useful to a wide variety of audiences, too vast for a comprehensive overview here. This article scratches the surface in showing how the need for accurately coded data is universal and imperative. Watch for our next article exploring coded data and the healthcare provider.
Lisa Marks, VP of HIM Services
Robyn McCoart, Managing Auditor