Ursa Health Chronic Kidney Disease Module

Overview

Chronic Kidney Disease includes data assets related to identifying patients with chronic kidney disease and optimizing their care, both in terms of improving clinical outcomes and reducing financial waste.

The objects in this module build on the many useful concepts implemented in the Ursa Health Core Data Model, integrating claims, billing, and EMR encounter and lab data, when available, to present a robust picture of each CKD patient. These objects are dynamic, capturing the changes to a patient’s status longitudinally, and allowing tracking of performance over time.

Assets in this module are identified by the namespace URSA-CKD.

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Key Concepts

• Chronic Dialysis Episode
• CKD Patients
• CKD Stage
• Clinician Office Visits with Nephrology Provider
• Dialysis Encounter
• ESRD Start Encounters
• Kidney Transplantation Surgery Encounter
• Nephrologist
• Nephrology Group Provider
• Patient Attribution to Nephrology Provider
• Primary Care Clinician Office Visit for CKD

Release Notes

• Ursa Health Chronic Kidney Disease Module Release Notes

Reports

• URSA-CKD | Basics of the CKD Module

Objects

• Data Mart Objects

  • Data Mart for URSA-CKD Patient Timelines
  • Data Mart for ESRD Start Encounters

• Synthetic Objects

  • Clinician Office Visit with Nephrology Provider
  • Dialysis Encounters
  • Primary Care Clinician Office Visits for CKD
  • Kidney Transplantation Surgery Encounter
  • ESRD Start Encounters
  • Dialysis Encounter Document Aggregator
  • Chronic Dialysis Episodes
  • Document Aggregator for URSA-CKD Concepts
  • Patient Timelines Master for URSA-CKD Concepts
  • Nephrologists and Nephrology Group Providers
  • Patient Timelines Master for CKD Stage
  • Patient Timelines of Empirical Attribution to Nephrology Provider

Measures

• URSA-CKD-R01: CKD Patients
• URSA-CKD-R02: Registry of CKD Patient Dialysis Encounters
• URSA-CKD-R03: Registry of Hospital IP Encounters
• URSA-CKD-001: CKD Patient PMPM Plan Spending
• URSA-CKD-002: Spending in First 6 Months of Chronic Dialysis
• URSA-CKD-004: Hospital Admissions per 1000 CKD Patient-Years
• URSA-CKD-100: Advance Care Planning for Stage 4+ CKD Patients
• URSA-CKD-101: Controlled High Blood Pressure for CKD Patients
• URSA-CKD-102: Diabetic CKD Patients with Controlled HbA1C
• URSA-CKD-103: Chronic Dialysis Patients with Catheter Only
• URSA-CKD-104: Nephrologist Visit 180+ Days Prior to Dialysis
• URSA-CKD-105: Home or Dialysis Facility ESRD Dialysis Starts
• URSA-CKD-901: Office Visits with HbA1c Results in Claims

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Terms

• Ursa Health Chronic Kidney Disease Module Terms