Core Data Model

Overview

Versatile and reporting-ready, the Core Data Model is a hierarchical data structure that incorporates decades of experience turning data into answers, helping clients unlock the value in their data right away.

The Core Data Model has been carefully built to contain a wealth of information, yet only the information you truly need to support any healthcare use case. Our connectors clean and integrate source data—from claims, EMR, billing, and other systems—then enrich the data with reference material from across healthcare in preparation for synthesis. Instead of cleanup work, you’re starting with ready-to-use tables covering a wide range of useful concepts, from encounters and clinical episodes to provider attribution models and timelines of patient risk and disease status.

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

Disclaimer: "Measure Case" is now referred to as "Data Mart".

Key Concepts

• Allergy/Intolerance List Entry
• Appointment
• Clinician Office Visit
• Document
• Emergency Department Visit Parent Encounters
• Hospital Inpatient Admission Encounter
• Patient
• Patient Timeline of Time-Varying Features
• Primary Care Clinician Office Visit

Release Notes

• Core Data Model Release Notes

Objects

• Data Mart Objects

  • Data Mart for URSA-CORE Patient Timelines
  • Data Mart for Hospital Inpatient Admission Encounters
  • Data Mart for Clinician Office Visits
  • Data Mart for Emergency Department Visit Parent Encounters
  • Data Mart for Hospital Observation Stay Encounters
  • Data Mart for URSA-CORE Surgery Encounters
  • Data Mart for URSA-CORE Encounters
  • Data Mart for Claim Financials
  • Data Mart for Distinct Member-Months
  • Data Mart for SNF Encounters
  • Data Mart for Primary Care Office Visits

• Synthetic Objects

  • Hospital Inpatient Admission Encounters
  • Clinician Office Visits
  • Dialysis Facility Encounter Document-Encounter Pairs
  • Dialysis Facility Encounters
  • Emergency Department Visit Parent Encounters
  • Hospital Observation Stay Parent Encounters
  • SNF Encounters
  • Ambulatory Surgical Center Encounters
  • Hospital Outpatient Surgery Encounters
  • Other Hospital Outpatient Encounters
  • Surgery Encounters
  • Birthing Center Encounters
  • Encounter Aggregator for all URSA-CORE Encounter Types
  • Hospital Inpatient Admission Encounter Document Aggregator
  • Clinician Office Visit Document Aggregator
  • Emergency Department Visit Parent Encounter Document Aggregator
  • Hospital Observation Stay Parent Encounter Document Aggregator
  • Other Hospital Outpatient Encounter Document Aggregator
  • Surgery Encounter Document Aggregator
  • Birthing Center Encounter Document Aggregator
  • Universal Encounter Document Aggregator
  • Primary Care Clinician Office Visits
  • Continuous Primary Payor Membership Episodes
  • Continuous CMS Hospice Status Episodes
  • Non-Membership Episodes
  • Episodes of Hospice in Last 12 Months
  • Claim Aggregator
  • Patient Timelines of Primary Plan Membership
  • Universal Patient Document Aggregator
  • Patient Timelines Master for URSA-CORE Concepts
  • Patient Timelines of Source Data Coverage
  • Patient Timelines of Integer Age
  • Patient Timelines of Any Plan Membership
  • Patient Timelines of Empirical Attribution to Primary Care Provider
  • Patient Timelines for CCW Conditions
  • Patient - Month Starts with Primary Payor Membership in Prior 12 Months
  • Primary Care Providers
  • Home Health Care Visit Document-Encounter Pairs
  • Home Health Care Visits

• Natural Objects

  • Institutional Claim ICD Discharge Diagnoses
  • Professional Claim ICD Diagnoses
  • Institutional Bill ICD Discharge Diagnoses
  • Professional Bill ICD Diagnoses
  • EMR Encounter Diagnoses
  • Problem List Entries
  • Allergy / Intolerance List Entries
  • EMR Encounters
  • EMR Encounter Service Line Items
  • Appointments
  • Appointment Slots
  • Institutional Claim Headers
  • Institutional Claim Service Line Items
  • Professional Claim Service Line Items
  • Pharmacy Claims
  • Institutional Bill Headers
  • Institutional Bill Service Line Items
  • Professional Bill Service Line Items
  • Billing Transactions
  • Billing Transaction Details
  • Capitation Financial Transactions
  • Claim Transaction Details
  • Claim Transactions
  • Medications
  • Medication Orders
  • Medication Dispenses
  • Medication List Entries
  • Clinical Notes
  • Tasks
  • Patients
  • Patient-Source Timelines of Data Coverage
  • Patient Observations
  • Observation Reports
  • Patient Communications
  • Patient Timeline of Time-Varying Features
  • Patient-Program Entity Affiliation Timelines
  • Institutional Claim ICD Procedures
  • Institutional Bill ICD Procedures
  • Services
  • Service Orders
  • Providers
  • Provider Local Specialties
  • Provider Credentials
  • Provider-Provider Group Affiliation Timelines
  • Provider-Health System Affiliation Timelines
  • Provider-Program Entity Affiliation Timelines
  • Health Systems
  • Program Entities
  • Payors
  • Plans
  • Locations
  • MAO-004 Diagnoses
  • MAO-004 Diagnosis Transactions
  • MMR Member-Month Transactions
  • MMR Member-Months
  • Pre-Calculated Measure Results

• Metadata and Integration Objects

  • Source Local Patient ID Crosswalk to Data Model Patient ID
  • Source Local Provider ID Crosswalk to Data Model Provider ID

Measures

• URSA-CORE-901: Claims without Contemporaneous Membership
• URSA-CORE-902: Medical Claims Missing Service Line Number 1
• URSA-CORE-903: Document Patient Not in Patients Natural Object
• URSA-CORE-904: Document Providers Not in Providers Natural Object
• URSA-CORE-905: Institutional Claims with Single Paid Line Item
• URSA-CORE-906: Professional Claims with Single Paid Line Item
• URSA-CORE-907: Document Dates Outside Parent Document Dates
• URSA-CORE-908: Hospital Services without Institutional Claim
• URSA-CORE-909: Documents with Non-Standard HCPCS Code
• URSA-CORE-910: Inpatient Services Not Matched to Admission
• URSA-CORE-911: ED Visit Services Not Matched to ED Visit
• URSA-CORE-912: SNF Services Not Matched to SNF Encounter
• URSA-CORE-913: Office Visit Services Not Matched to Office Visit
• URSA-CORE-914: Documents with Non-Standard Revenue Center Code
• URSA-CORE-915: Conflicting Claim Header and Line Financials
• URSA-CORE-919: Pharmacy Claims with Suspected Duplicate
• URSA-CORE-920: Professional Claims with Suspected Duplicate
• URSA-CORE-921: Institutional Claims with Suspected Duplicate
• URSA-CORE-922: Documents with Conflicting Encounter Types
• URSA-CORE-930: Claims or Billing Documents Without Diagnoses
• URSA-CORE-931: Zero-Cost Professional Service Line Items
• URSA-CORE-932: Excess Principal Diagnoses
• URSA-CORE-933: Claims or Bills with Negative Financial Amount
• URSA-CORE-934: Institutional Headers with Critical Missing Data
• URSA-CORE-935: Institutional SLIs with Critical Missing Data
• URSA-CORE-936: Institutional Diagnoses with Critical Missing Data
• URSA-CORE-937: Institutional ICD Procs with Critical Missing Data
• URSA-CORE-938: Professional SLIs with Critical Missing Data
• URSA-CORE-939: Professional Diagnoses with Critical Missing Data
• URSA-CORE-940: Pharmacy Claims with Critical Missing Data
• URSA-CORE-941: Institutional Headers with Important Missing Data
• URSA-CORE-942: Institutional SLIs with Important Missing Data
• URSA-CORE-943: Professional SLIs with Important Missing Data
• URSA-CORE-944: Diagnosis Records with Critical Missing Data
• URSA-CORE-945: ICD Procedure Records with Critical Missing Data
• URSA-CORE-946: Documents with Null or Non-Standard ICD-10-CM Code
• URSA-CORE-947: Documents with Non-Standard NPIs
• URSA-CORE-948: Patients with a Non-Standard Zip Code
• URSA-CORE-949: Documents with Non-Standard ICD-10-PCS Code
• URSA-CORE-950: Documents with Non-Standard NDC Code
• URSA-CORE-951: Documents with Non-Standard MS-DRG Code
• URSA-CORE-952: Providers with Null or Non-Standard NPI

Terms

• Core Data Model Terms