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 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.

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 CKD Outpatient Medication Fills
  • [DM/URSA-CKD] Data Mart for ESRD Start Encounters
  • [DM/URSA-CKD] Data Mart for Qualifying Medication Synchronization Fills
  • [DM/URSA-CKD] Data Mart for URSA-CKD Patient Timelines

• Synthetic Objects

  • [SO/URSA-CKD] All Class CKD ARB Episode Fills
  • [SO/URSA-CKD] All Class CKD Ace Inhibitors Episode Fills
  • [SO/URSA-CKD] All Class CKD In-Supply Periods
  • [SO/URSA-CKD] All Class CKD Medication Fills
  • [SO/URSA-CKD] All Class CKD Medication Fills and Inpatient Episodes
  • [SO/URSA-CKD] All Class CKD SGLT2 Episode Fills
  • [SO/URSA-CKD] All Class CKD Statin Episode Fills
  • [SO/URSA-CKD] All Class CKD nsMRA Episode Fills
  • [SO/URSA-CKD] CKD PDC Measures Inpatient and SNF Episodes
  • [SO/URSA-CKD] CKD Patients with an at least 4 Visits
  • [SO/URSA-CKD] CKD Patients with an eGFR and uACR Test
  • [SO/URSA-CKD] Chronic Dialysis Episodes
  • [SO/URSA-CKD] Clinician Office Visits with Nephrology Provider
  • [SO/URSA-CKD] Clinician Office Visits with Vascular Surgeon and Interventional Radiologist Provider
  • [SO/URSA-CKD] Completed uACR Tests
  • [SO/URSA-CKD] Controlled High Blood Pressure for CKD Patients
  • [SO/URSA-CKD] Diabetic CKD Patients with Controlled HbA1C Name
  • [SO/URSA-CKD] Dialysis Encounter Document Aggregator
  • [SO/URSA-CKD] Dialysis Encounters
  • [SO/URSA-CKD] Document Aggregator for URSA-CKD Concepts
  • [SO/URSA-CKD] Document Aggregator for URSA-CKD Concepts (Oct 8th Recovery)
  • [SO/URSA-CKD] ESRD Start Encounters
  • [SO/URSA-CKD] Kidney Transplantation Surgery Encounter
  • [SO/URSA-CKD] Nephrologists and Nephrology Group Providers
  • [SO/URSA-CKD] Non-Chronic Dialysis Episodes
  • [SO/URSA-CKD] Outpatient Medication Fills Aggregator for Medication Synchronization Fills
  • [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
  • [SO/URSA-CKD] Vascular Surgeon and Interventional Radiologist Providers and Group Providers

• Unknown Layer Objects

  • [URSA-CKD] Registry of CKD Patients R01

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-005: Percent of Patients with Chronic Kidney Disease
• 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: Optimal ESRD Dialysis Starts
• URSA-CKD-106: CKD Patients with an eGFR and uACR Test
• URSA-CKD-107: CKD Patients with an at least 4 Visits
• URSA-CKD-108: Optimal ESRD Dialysis Access Type Starts
• URSA-CKD-109: VS or IR Visit 24 Months to Dialysis
• URSA-CKD-110: CKD ACE/ARB PDC
• URSA-CKD-111: CKD Ace Inhibitor PDC
• URSA-CKD-112: CKD ARB PDC
• URSA-CKD-113: CKD SGLT2 PDC
• URSA-CKD-114: CKD nsMRA PDC
• URSA-CKD-115: CKD Statin PDC
• URSA-CKD-116: Distinct Refill Dates for CKD Pts on 2+ CKD Meds
• URSA-CKD-117: 3b CKD Patients with an at least 1 Visits
• 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
• URSA-CKD-R04: Registry of Less than 90-Day CKD Fills
• URSA-CKD-R05: Registry of High-Cost CKD Fills
• URSA-CKD-R06: Registry of Chronic Dialysis Episodes

Terms

• Ursa Health Chronic Kidney Disease Module Terms