March 25, 2010Ravi Pallipamu, Microbiologist, MBACDPH/LA County HDInfection PreventionistRavi.pallipamu@cdph.ga.gov

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.