Ursa Health Chronic Kidney Disease Module

Overview

The Ursa Health Chronic Kidney Disease Module helps organizations achieve higher-value chronic kidney disease (CKD) care through a range of clinical, operational, and financial analyses that stage disease severity, determine the level and type of specialist engagement, and identify opportunities to avoid adverse outcomes through more appropriate utilization, care plan execution, and clinical interventions.

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 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.

Release Notes

• Ursa Health Chronic Kidney Disease Module Release Notes

Key Concepts

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

Reports

• URSA-CKD | Basics of the CKD Module

Objects

• Data Mart Objects

  • [DM/URSA-CKD] Data Mart for ESRD Start Encounters
  • [DM/URSA-CKD] Data Mart for URSA-CKD Patient Timelines

• Synthetic Objects

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

Measures

• 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
• URSA-CKD-R01: CKD Patients
• URSA-CKD-R02: Registry of CKD Patient Dialysis Encounters
• URSA-CKD-R03: Registry of Hospital Inpatient Admissions

Terms

• Ursa Health Chronic Kidney Disease Module Terms