[DM/URSA-PHARM] Data Mart for URSA-PHARM Patient Timelines

Object Description

One record per patient - period during which the patient was alive and had one or more outpatient medication fills in the previous 12 months.

Metadata

• Table Name: ursa.dm_ursa_pharm_002
• Layer: DATA_MART
• Object Type: Single Stack
• Temporal Class: Interval (Timeline)
• Case ID: Patient ID
• Interval Start Date: Period Start Date
• Interval End Date: Period End Date
• Primary Key: Patient ID, Period Start Date, Period End Date

Published Fields

• Data Model Keys

  • Patient ID -- The internal database identifier (used, e.g., for joins and primary keys) for the patient. This value is typically mastered, i.e., all records for the same patient, regardless of the source data system from which that record originated, should have the same Patient ID value. (Note that while the mastered Patient ID value might resemble a local identifier used in one of the upstream data sources, this does not indicate any special priority of that source system in determining the characteristics of the patient.) (See also [URSA-CORE] Patient)
  • Primary Payor ID -- The internal database identifier (used, e.g., for joins and primary keys) for the Primary Payor. (See also [URSA-CORE] Primary Payor)
  • Primary Plan ID
  • Primary Plan Attributee Provider ID
  • Empirical Attributee Primary Care Individual Provider ID
  • Empirical Attributee Primary Care Provider Group Provider ID

• Operations Support Fields

  • Patient Operational ID -- The user-facing value used by staff used to uniquely identify the Patient in their administrative systems and/or day-to-day operations. (See also [URSA-CORE] Patient)
  • Primary Payor Operational ID
  • Primary Plan Operational ID

• Patient Fields

  • Patient Date of Birth -- The patient's date of birth. On the Patients Natural Object, this field reflects the "best" known value for the patient available from all data sources; on other Natural Objects, e.g., MMR Member-Months, the value faithfully reflects the date of birth found on that particular type of record in the source data.
  • Patient Age Integer -- Patient age, expressed as an integer, as of a reference date or interval.
  • Patient Age Category Tier 1 -- Non-overlapping ranges of the patient age in years into three categories; [01] Pediatrics < 19, [02] Adults 19 - 64, and [03] Older Adults >= 65. Coarser grain to the Patient Age Category Tier 2. (See also [URSA-CORE] Patient Age Category Tier 2)
  • Patient Age Category Tier 2 -- Non-overlapping ranges of the patient age in years representing finer grain categories than the Patient Age Category Tier 1. This field incorporates findings from publications on defining meaningful age groups in the context of disease. These ranges closely, but not exactly, align with standard age ranges such as those defined by the Medical Subject Headings (MeSH). See results of K-Means simple clustering method at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825015/ (See also [URSA-CORE] Patient Age Category Tier 1)
  • Patient Sex Category
  • Is Patient Sex Female -- Indicates the patient's sex is female. On the Patients Natural Object, this field reflects the "best" known value for the patient available from all data sources; on other Natural Objects, e.g., MMR Member-Months, the value faithfully reflects the patient sex documented on that particular type of record in the source data.
  • Is Patient Sex Male -- Indicates the patient's sex is male. On the Patients Natural Object, this field reflects the "best" known value for the patient available from all data sources; on other Natural Objects, e.g., MMR Member-Months, the value faithfully reflects the patient sex documented on that particular type of record in the source data.
  • PCP Attribution Category
  • Primary Care Engagement Category
  • Count Primary Care Visits in Last 36 Months
  • Specialty Care Engagement Category
  • Count Specialty Care Office Visits in Last 36 Months
  • Primary or Specialty Care Engagement Category
  • Count Clinician Office Visits in Last 3 Years
  • Count Hospital Inpatient Admissions in Last 12 Months
  • Count ED Visits Without Inpatient Admissions in Last 12 Months

• Date Fields

  • Period Start Date
  • Period End Date
  • Current Continuous Primary Payor Membership Episode Start Date -- The start date of the Continuous Primary Payor Membership Episode in effect as of the (potentially historical) period covered by the record. (See also [URSA-CORE] Continuous Primary Payor Membership Episode)
  • Current Continuous Primary Payor Membership Episode End Date -- The end date of the Continuous Primary Payor Membership Episode in effect as of the (potentially historical) period covered by the record. Values follow the standard exclusive convention for Period End Dates. (See also [URSA-CORE] Continuous Primary Payor Membership Episode, [URSA-CORE] Period End Date)
  • Current Continuous Pharmacy Claim Data Coverage Episode Start Date -- The start date of the Continuous Pharmacy Claim Data Coverage Episode in effect as of the (potentially historical) period covered by the record. (See also [URSA-CORE] Continuous Pharmacy Claim Data Coverage Episode)
  • Current Continuous Pharmacy Claim Data Coverage Episode End Date -- The end date of the Continuous Pharmacy Claim Data Coverage Episode in effect as of the (potentially historical) period covered by the record. Values follow the standard exclusive convention for Period End Dates. (See also [URSA-CORE] Continuous Pharmacy Claim Data Coverage Episode)

• Provider Fields

  • Count Distinct Filling Providers Last 12 Months
  • Count Distinct Prescribing Providers Last 12 Months
  • Count Distinct Opioid Prescribing Providers in Last 6 Months
  • Count Distinct Opioid Filling Providers in Last 6 Months
  • Count Distinct Opioid Prescribing Providers in Last 12 Months
  • Count Distinct Opioid Filling Providers in Last 12 Months
  • Empirical Attributee PCP Provider NPI
  • Empirical Attributee PCP Provider Description
  • Empirical Attributee Primary Care Provider Group Provider NPI
  • Empirical Attributee Primary Care Provider Group Provider Description
  • Count Visits with Attributee Individual Primary Care Provider in Last 36 Months
  • Count Visits with Attributee Primary Care Provider Group in Last 36 Months

• Location Fields

  • Patient State Abbreviation
  • Patient ZIP Code 5-Digit
  • UW HIP Area Deprivation Index National Percentile -- A value between 1 and 100 representing the composite measure of socioeconomic deprivation from University of Wisconsin’s School of Medicine and Public Health. Scores are for Census Block Group geographic level, which generally contains between 600 and 3,000 people. Higher scores indicate more deprivation, so a score of 1 indicates the least deprivation while a score of 100 indicates the most deprivation. Percentiles are constructed by ranking the ADI from low to high for the nation and grouping the block groups into bins corresponding to each 1% range of the ADI. The 2019 ADI was constructed using the 2015-2019 5-year estimates from the US Census' American Community Survey and includes 17 component measures that span the domains of income, education, employment, and housing quality. It may be linked with the 9-digit ZIP code crosswalk, which was built to correspond directly to Census block groups. The 2019 ADI was released on 07/14/2021 and is the most recent version as of 02/02/22.
  • UW HIP ADI Quintile Category -- The UW HIP Area Deprivation Index National Percentile grouped into 5 levels, each spanning 20 percentile points (ADI 1 is percentile scores from 1 to 20 while ADI 5 is scores from 81 to 100). Higher scores indicate more deprivation, so ADI 1 is the least deprived while ADI 5 is the most deprived. Quintiles are frequently used in health research. They give larger sample sizes per group and are easier to plot and interpret. Quintiles also carry less information and group more dissimilar patients. Quintiles are good for descriptive analyses while the original percentile measure is preferable for predictive modeling. (See also [URSA-CORE] UW HIP Area Deprivation Index National Percentile)
  • UW HIP ADI Decile Category
  • CDC SVI Overall National Percentile -- Social Vulnerability Index is a composite score maintained by the Center for Disease Control and Prevention using data from the U.S. Census of Population and Housing. The score is a composite of 15 measures, with all directed so that higher values indicate more vulnerability. The composite finds the percentile ranking of each component value, sums the percentile rankings, and then finds the percentile ranking of the sums. Percentile ranks are found with the formula: Percentile Rank = (Rank-1) / (N-1). If any component is missing, then the composite is also recoded as missing. Measures are organized into the four themes of Socioeconomic Status, Household Composition & Disability, Minority Status & Language, and Housing Type & Transportation, and composites for these themes are constructed with the same methodology. SVI is reported at the Census Tract level. Tracts aim to include about 4000 people each. On average, there are about 4 Census Block groups for each Census Tract, so the SVI has less geographic resolution than the ADI. Ursa stores the 2018 version of the SVI, which was released on 01/31/2020 and is the most recent as of 02/02/22. (See also [URSA-CORE] CDC SVI Overall Quintile Category)
  • CDC SVI Overall Quintile Category -- The CDC SVI Overall National Percentile grouped into 5 levels, each spanning 20 percentile points (the first quintile is percentile scores from 1 to 20 while the fifth is scores from 81 to 100). Higher scores indicate more vulnerability, so the first quintile is the least vulnerable while the fifth is the most vulnerable. Quintiles are frequently used in health research. They give larger sample sizes per group and are easier to plot and interpret. Quintiles also carry less information and group more dissimilar patients. Quintiles are good for descriptive analyses while the original percentile measure is preferable for predictive modeling.
  • CDC SVI Socioeconomic Theme National Percentile -- Includes the five Census measures of (1) Percent below 150% poverty, (2) Unemployment rate, (3) Per-capita income, and (4) Percent with no high school diploma, (5) percent uninsured. Follows the same methodology as the overall SVI composite. (See also [URSA-CORE] CDC SVI Socioeconomic Quintile Category, [URSA-CORE] CDC SVI Overall National Percentile)
  • CDC SVI Socioeconomic Quintile Category -- The CDC SVI Socioeconomic Theme National Percentile grouped into 5 levels, each spanning 20 percentile points (the first quintile is percentile scores from 1 to 20 while the fifth is scores from 81 to 100). Higher scores indicate more vulnerability, so the first quintile is the least vulnerable while the fifth is the most vulnerable. (See also [URSA-CORE] CDC SVI Socioeconomic Theme National Percentile )
  • CDC SVI Household / Disability Theme National Percentile -- Includes the four Census measures of (1) Percent aged 65 or older (2) Percent aged 17 or younger, (3) Percent with a disability (noninstitutionalized and older than age 5), and (4) Percent single parent households. Follows the same methodology as the overall SVI composite. (See also [URSA-CORE] CDC SVI Household / Disability Quintile Category, [URSA-CORE] CDC SVI Overall National Percentile)
  • CDC SVI Household / Disability Quintile Category -- The CDC SVI Household/Disability Theme National Percentile grouped into 5 levels, each spanning 20 percentile points (the first quintile is percentile scores from 1 to 20 while the fifth is scores from 81 to 100). Higher scores indicate more vulnerability, so the first quintile is the least vulnerable while the fifth is the most vulnerable. (See also [URSA-CORE] CDC SVI Household / Disability Theme National Percentile )
  • CDC SVI Minority / Language Theme National Percentile -- Includes the two Census measures of (1) Percent minority (all persons except white, non-Hispanic), (2) Percent who speak English "less than well" (persons age 5+). Follows the same methodology as the overall SVI composite. (See also [URSA-CORE] CDC SVI Minority / Language Quintile Category, [URSA-CORE] CDC SVI Overall National Percentile)
  • CDC SVI Minority / Language Quintile Category -- The CDC SVI Minority/Language Theme National Percentile grouped into 5 levels, each spanning 20 percentile points (the first quintile is percentile scores from 1 to 20 while the fifth is scores from 81 to 100). Higher scores indicate more vulnerability, so the first quintile is the least vulnerable while the fifth is the most vulnerable. (See also [URSA-CORE] CDC SVI Minority / Language Theme National Percentile)
  • CDC SVI Housing / Transportation Theme National Percentile -- Includes the five Census measures of (1) Percent housing structures with 10 or more units, (2) Percent mobile homes, (3) Percent households with more people than rooms, (4) Percent households with no vehicle available, (5) Percent living in group quarters (such as correctional facilities, nursing homes, college dorms, and military barracks). Follows the same methodology as the overall SVI composite. (See also [URSA-CORE] CDC SVI Housing / Transportation Quintile Category, [URSA-CORE] CDC SVI Overall National Percentile)
  • CDC SVI Housing / Transportation Quintile Category -- The CDC SVI Housing/Transportation Theme National Percentile grouped into 5 levels, each spanning 20 percentile points (the first quintile is percentile scores from 1 to 20 while the fifth is scores from 81 to 100). Higher scores indicate more vulnerability, so the first quintile is the least vulnerable while the fifth is the most vulnerable. (See also [URSA-CORE] CDC SVI Housing / Transportation Theme National Percentile)

• Insurance Fields

  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description
  • Is Primary Plan Financial Class Commercial
  • Is Primary Plan Financial Class Medicare Advantage
  • Is Primary Plan Financial Class Medicaid
  • Is CMS ESRD Status -- Indicates the patient meets the Medicare ESRD eligibility criterion as of a particular date; can be derived from the CMS Medicare Beneficiary Status Code. (See also [URSA-CORE] CMS Medicare Beneficiary Status Code)
  • Is CMS Hospice Status -- Indicates the patient is considered to be Hospice status.
  • Count Active Plan Memberships
  • Is Dual Medicare-Medicaid Enrolled -- Indicates that the patient is concurrently enrolled in both Medicare and Medicaid programs. (Identifies the population often described as "dually eligible" or "duals".)

• Medication Fields

  • Is Patient with any Active Chronic Medications
  • Count of Fills in Last 12 Months Category
  • Count of Fills Last 12 Months
  • Count Opioid Fills in Last 6 Months
  • Count Opioid Fills in Last 12 Months
  • Aggregate Opioid Days Supply in Last 6 Months
  • Aggregate Opioid Days Supply in Last 12 Months

• Diagnosis Fields

  • CCW Count Category
  • Count CCW Conditions -- The total of both Chronic Conditions and Potentially Disabling Events included in the CMS Chronic Condition Warehouse (CCW) library. (See also [URSA-CORE] CCW Comorbidity Category, [URSA-CORE] Count Potentially Disabling Events, [URSA-CORE] CMS Chronic Condition Warehouse (CCW), [URSA-CORE] Count Chronic Conditions)
  • Is CCW Asthma -- At least 1 inpatient, SNF, HHA OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW CKD -- Indicates that the patient meets the CMS Chronic Condition Warehouse criteria for chronic kidney disease; i.e., 2 or more qualifying outpatient or professional ICD codes in the prior 2 years, or 1 or more non-outpatient institutional claim ICD codes in the prior 2 years.
  • Is CCW COPD and Bronchiectasis -- At least 1 inpatient, SNF, HHA OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Depression -- At least 1 inpatient, SNF, HHA, HOP, or Carrier claim with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Diabetes -- At least 1 inpatient, SNF, HHA OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Heart Failure -- At least 1 inpatient, HOP, or Carrier claim with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Schizophrenia or Other Psychotic Disorders -- At least 1 inpatient OR 2 other nondrug claims of any service type with one ore more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Bipolar Disorder -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Acquired Hypothyroidism -- At least 1 inpatient, SNF, HHA OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Acute Myocardial Infarction -- At least 1 inpatient claim with one or more of the DX codes from the corresponding CCW value set as the first or second diagnosis position in the prior 1 year.
  • Is CCW ADHD, Conduct Disorders, and Hyperkinetic Syndrome -- At least 1 inpatient claim OR 2 other non-drug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Alzheimers Disease -- At least 1 inpatient, SNF, HHA, HOP, or Carrier claim with one or more of the DX codes from the corresponding CCW value set in the prior 3 years.
  • Is CCW Alzheimers Disease and Related Disorders or Senile Dementia -- At least 1 inpatient, SNF, HHA, HOP, or Carrier claim with one or more of the DX codes from the corresponding CCW value set in the prior 3 years.
  • Is CCW Anemia -- At least 1 inpatient, SNF, HHA, HOP, or Carrier claim with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Anxiety Disorders -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Atrial Fibrillation -- At least 1 inpatient OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set as the first or second diagnosis position in the prior 1 year.
  • Is CCW Autism Spectrum Disorder -- At least 1 inpatient claim OR 2 other non-drug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Benign Prostatic Hyperplasia -- At least 1 inpatient, SNF, HHA OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year. Exclusion: If any of the qualifying claims also have an ICD-10 DX of D29.1, then it is excluded.
  • Is CCW Blindness and Visual Impairment -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Breast Cancer -- At least 1 inpatient, SNF OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in prior 1 year.
  • Is CCW Cataract -- At least 1 HOP or Carrier claim with one or more of the DX codes from the corresponding CCW value set as the principal diagnosis position in the prior 1 year.
  • Is CCW Cerebral Palsy -- At least 1 inpatient claim OR 2 other non-drug claims of any service type with DX codes over the last 2 years (See also [URSA-CORE] CMS Chronic Condition Warehouse (CCW))
  • Is CCW Colorectal Cancer -- At least 1 inpatient, SNF OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Cystic Fibrosis and Other Metabolic Disorder -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Deafness and Hearing Impairment -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Depressive Disorders -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Endometrial Cancer -- At least 1 inpatient, SNF OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Epilepsy -- At least 1 inpatient claim OR 2 other non-drug claims of any service type during the two-year period (See also [URSA-CORE] CMS Chronic Condition Warehouse (CCW))
  • Is CCW Fibromyalgia and Chronic Pain and Fatigue -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Glaucoma -- At least 1 Carrier claim with one or more of the DX codes from the corresponding CCW value set as the principal diagnosis position in the prior 1 year.
  • Is CCW Hip or Pelvic Fracture -- At least 1 inpatient or SNF claim with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Hyperlipidemia -- At least 1 inpatient, SNF, HHA OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Hypertension -- At least 1 inpatient, SNF, HHA OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Intellectual Disability -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Ischemic Heart Disease -- At least 1 inpatient, SNF, HHA, HOP, or Carrier claim with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Learning Disability -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Leukemia -- At least 1 inpatient OR 2 non-inpatient claims with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Lung Cancer -- At least 1 inpatient, SNF OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Migraine and Chronic Headache -- At least 1 inpatient claim OR 2 non-inpatient claims with DX codes within a 2 year period. (See also [URSA-CORE] CMS Chronic Condition Warehouse (CCW))
  • Is CCW Mobility Impairment -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Multiple Sclerosis -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Muscular Dystrophy -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Obesity -- At least 1 inpatient OR 2 non-inpatient claims with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Osteoporosis -- At least 1 inpatient, SNF, HHA OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW Other Developmental Delay -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Personality Disorder -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Pressure or Chronic Ulcer -- At least 1 inpatient OR 2 non-inpatient claims with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Prostate Cancer -- At least 1 inpatient, SNF OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
  • Is CCW PTSD -- At least 1 inpatient OR 2 other nondrug claims of any service type with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW PVD -- At least 1 inpatient OR 2 non-inpatient claims with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Rheumatoid Arthritis or Osteoarthritis -- At least 2 inpatient, SNF, HHA, HOP, or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 2 years.
  • Is CCW Schizophrenia -- At least 1 inpatient claim OR 2 other non-drug claims of any service type with DX codes at least one day apart in the prior within the 2 year reference period. Qualifying codes can also be found as a subset of those in the CCW "Schizophrenia or Other Psychotic Disorders". (See also [URSA-CORE] Is CCW Schizophrenia or Other Psychotic Disorders)
  • Is CCW Stroke or Transient Ischemic Attack -- At least 1 inpatient OR 2 HOP or Carrier claims with one or more of the DX codes from the corresponding CCW value set in the prior 1 year.
    EXCLUSIONS: If any of the qualifying claims have : 800 <= DX Code <=
    804.9, 850 <= DX Code <= 854.1 in any DX position OR DX V57xx as the principal DX Code, then the claim is excluded.
  • CCW Systems Category
  • Count CCW Systems -- The count of distinct systems of the body with one or more active CCW Condition. CCW Systems are as a parent category to the individual CCW Conditions grouping them based primarily on the human body system they impact such as; Behavioral Health, Cancers, Cardiovascular, Cerebrovascular, Endocrine, Genitourinary, Musculoskeletal, and Pulmonary. (See also [URSA-CORE] CMS Chronic Condition Warehouse (CCW))
  • Is CCW System Behavioral Health -- Indicates the patient has one or more of the following CCW conditions; ADHD, Conduct Disorders, and Hyperkinetic Syndrome, Anxiety Disorders, Autism Spectrum Disorder, Bipolar Disorder, Depression, Depressive Disorders, Personality Disorders, PTSD, Schizophrenia, or Schizophrenia and Other Psychotic Disorders.
  • Is CCW System Cardiovascular -- Indicates the patient has one or more of the following CCW conditions; Acute Myocardial Infarction (AMI), Atrial Fibrillation, Heart Failure, Hypertension, Ischemic Heart Disease, or Peripheral Vascular Disease (PVD).
  • Is CCW System Congenital -- Indicates the patient has one or more of the following CCW conditions; Cerebral Palsy, Cystic Fibrosis and Other Metabolic Disorder, Intellectual Disability, Learning Disability, Muscular Dystrophy, or Other Developmental Delays.
  • Is CCW System Endocrine/Metabolic -- Indicates the patient has one or more of the following CCW conditions; Diabetes, Acquired Hypothyroidism, Hyperlipidemia, or Obesity.
  • Is CCW System Genitourinary -- Indicates the patient has one or more of the following CCW conditions; Benign Prostatic Hyperplasia or Chronic Kidney Disease (CKD).
  • Is CCW System Hematologic -- Indicates the patient has one or more of the following CCW conditions; Anemia.
  • Is CCW System Musculoskeletal -- Indicates the patient has one or more of the following CCW conditions; Hip or Pelvic Fracture, Rheumatoid Arthritis or Osteoarthritis, or Osteoporosis.
  • Is CCW System Neurological -- Indicates the patient has one or more of the following CCW conditions; Alzheimer's Disease, Alzheimer's Disease and Related Disorders or Senile Dementia, Stroke or Transient Ischemic Attack, Epilepsy, Migraine and Chronic Headache, Mobility Impairment, Multiple Sclerosis, or Deafness and Hearing Impairment.
  • Is CCW System Oncologic -- Indicates the patient has one or more of the following CCW conditions; Breast Cancer, Colorectal Cancer, Endometrial Cancer, Lung Cancer, Prostate Cancer, or Leukemia.
  • Is CCW System Ophthalmologic -- Indicates the patient has one or more of the following CCW conditions; Cataract, Glaucoma, or Blindness and Visual Impairment.
  • Is CCW System Pulmonary -- Indicates the patient has one or more of the following CCW conditions; Asthma, or Chronic Obstructive Pulmonary Disease (COPD) and Bronchiectasis.
  • Is CCW System Other -- Indicates the patient has one or more of the following CCW conditions; Fibromyalgia and Chronic Pain and Fatigue, Pressure or Chronic Ulcer.

• Financial Fields

  • Medication Plan Paid Amount in Last 12 Months
  • Medication Patient Paid Amount in Last 12 Months
  • Total Medication Paid Amount Last 12 Months
  • Cumulative Calendar Year Rx Plan Paid Amount
  • Cumulative Calendar Year Rx Patient Paid Amount

• Metadata Fields

  • Random Integer 1 to 1000

• Module Fields

  • Medication Management Trigger Category
  • Is Patient with Active Medication Management Trigger
  • Count Active Medication Management Trigger Categories
  • Is High Medication Spend -- One of the Medication Management Triggers; indicates that, as of a given date, the total spending on outpatient medication fills for the patient in the prior 12 months is between $4,800 and $9,600, inclusive. Total spending includes both plan and patient paid amounts. (See also [URSA-PHARM] Medication Management Trigger Category)
  • Is Very High Medication Spend -- One of the Medication Management Triggers; indicates the total spending on outpatient medications for the patient in the prior 12 months is greater than $9,600. Total spending includes both plan and patient paid amounts.
  • Is High Number of Prescribing Providers -- One of the Medication Management Triggers; indicates that, as of a given date, the patient has filled outpatient medication prescriptions written by five or more distinct prescribing providers in the prior 12 months. (See also [URSA-PHARM] Medication Management Trigger Category)
  • Is High Number of Filling Providers -- One of the Medication Management Triggers; indicates that, as of a given date, the patient has been dispensed outpatient medications from five or more distinct pharmacies or other filling providers in the prior 12 months. (See also [URSA-PHARM] Medication Management Trigger Category)
  • Is Multiple Opioid Prescribing Providers Last 6 Months -- One of the Medication Management Triggers; indicates that, as of a given date, the patient has had medication fills for opiate agonists from two or more distinct prescribing providers in the prior 6 months. (See also [URSA-PHARM] Medication Management Trigger Category)
  • Is Multiple Opioid Filling Providers Last 6 Months -- Indicates (true = "1") if the patient has had fills for opiate agonists from two or more distinct filling providers (pharmacies) in the prior 6 months.
  • Is Active Chronic Opioid Episode -- One of the Medication Management Triggers; indicates that, as of a given date, the patient has an active Medication Therapy Episode for an Opiate Agonist (true = "1") based on the URSA-PHARM value set for Opiate Agonists and logic for classifying fills as Is Chronic. (See also [URSA-PHARM] Chronic Medication, [URSA-PHARM] Targeted Medication Therapy Episode, [URSA-PHARM] Medication Management Trigger Category)
  • Is High Number of Chronic Medications -- If the patient has 5 or more active medication therapy episodes for chronic medications as of the snapshot date then 1, else 0. This is often referred to as "Polypharmacy". (See also [URSA-PHARM] Chronic Medication)
  • Count Active Chronic Medications -- The number of distinct chronic medications the patient is currently taking; operationalized as the count of targeted medication therapy episodes for a chronic medication currently active for the patient. (See also [URSA-PHARM] Chronic Medication, [URSA-PHARM] Targeted Medication Therapy Episode)
  • Active High Risk Medication Episode Category
  • Is Any Active High Risk Medication Episode -- Indicates whether the patient, as of a given date, has one or more active medication therapy episodes for High Risk Medication(s) as defined by the URSA-PHARM module. High Risk medications include; anticoagulant, oral antiplatelet, cardiac glycoside, opiate agonist, oral hypoglycemic, or insulin. (See also [URSA-PHARM] Count Active High Risk Medication Types, [URSA-PHARM] Is High Risk Medication)
  • Count Active High Risk Medication Types -- The number of active medication therapy episodes for high risk medications as defined by the URSA-PHARM module this includes any medication classified as a; anticoagulant, oral antiplatelet, cardiac glycoside, opiate agonist, oral hypoglycemic, or insulin. (See also [URSA-PHARM] Is Any Active High Risk Medication Episode)
  • Count Active Oral Antiplatelets -- One of the High Risk Medication types; a medication classified as an oral antiplatelet based on the AHFS therapeutic class or Red Book Generic Cross Reference Code. (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Count Active Anticoagulants -- One of the High Risk Medication types; counts, as of a given date, the number of distinct anticoagulants medications the patient has an active medication therapy episode for. (See also [URSA-PHARM] Anticoagulant, [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Count Active Cardiac Glycosides -- One of the High Risk Medication types; a medication classified as a cardiac glycoside based on the AHFS therapeutic class. (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Count Active Opioids -- One of the High Risk Medication types; a medication classified as an opiate agonist based on the AHFS therapeutic class. Full agonist opioids activate the opioid receptors in the brain fully resulting in the full opioid effect. Examples of full agonists are heroin, oxycodone, methadone, hydrocodone, morphine, opium and others. Partial agonist opioids activate the opioid receptors in the brain, but to a much lesser degree than a full agonist. Buprenorphine is an example of a partial agonist. In clinical practice, they are used for opioid agonist maintenance therapy or withdrawal management. (See also [URSA-PHARM] Is Active Chronic Opioid Episode)
  • Count Active Oral Hypoglycemics -- One of the High Risk Medication types; a medication classified as a hypoglycemic based on the AHFS therapeutic class. (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Count Active Insulins -- One of the High Risk Medication types; a medication classified as an insulin based on the AHFS therapeutic class or NDC present in the CMS Stars PDC oral anti-diabetic adherence measure specifications (used as an exclusion). (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Active Priority Adherence Medication Type Category
  • Is Any Priority Adherence Medication Active
  • Count Active Priority Adherence Medications
  • Count Active Priority Medication Types
  • Count Active Antidepressants -- One of the Priority Adherence Medication types; a medication classified as an antidepressant based on AHFS Therapeutic Class code or Red Book Generic Cross Reference Code. (See also [URSA-PHARM] Is Priority Adherence Medication)
  • Count Active Antidiabetics -- One of the Priority Adherence Medication types; a medication classified as an antidiabetic based on AHFS Therapeutic Class code or Red Book Generic Cross Reference Code as an antidiabetic of any type (insulin, oral, etc.). (See also [URSA-PHARM] Is Priority Adherence Medication, [URSA-PHARM] Active Priority Adherence Medication Type Category)
  • Count Active Oral Antidiabetics
  • Count Active Antineoplastics -- One of the Priority Adherence Medication types; a medication classified as an antineoplastic based on AHFS Therapeutic Class code. Antineoplastic drugs are medications used to treat cancer. Other names for antineoplastic drugs are anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs. (See also [URSA-PHARM] Is Priority Adherence Medication, [URSA-PHARM] Active Priority Adherence Medication Type Category)
  • Count Active Beta Blockers -- One of the Priority Adherence Medication types; indicates a medication classified as a beta blocker based on the Red Book Generic Cross Reference Code classification. (See also [URSA-PHARM] Is Priority Adherence Medication)
  • Count Active Oral ACEI/ARBs -- One of the Priority Adherence Medication types; indicates a medication classified as a angiotensin-converting enzyme inhibitor (ACEI) and an angiotensin receptor blocker (ARB) based on the Red Book Generic Cross Reference code and/or NDC being included in the CMS Stars measure specifications for Oral ACEI/ARB PDC measures. (See also [URSA-PHARM] Is Priority Adherence Medication, [URSA-PHARM] Active Priority Adherence Medication Type Category)
  • Count Active Statins -- One of the Priority Adherence Medication types; indicates a medication classified as a Statin based on the Red Book Generic Cross Reference code and/or NDC being included in the CMS Stars Statin proportion of days covered (PDC) measure value sets. (See also [URSA-PHARM] Is Priority Adherence Medication)
  • Active PDC Medication Type Category
  • Is Patient with Any Active PDC Medications
  • Count Active PDC Medication Types
  • Is Active Oral Antidiabetic PDC Medication
  • Is Active Oral ACEI/ARB PDC Medication
  • Is Active Statin PDC Medication

Foreign Keys

• pat_id → ursa.no_ursa_core_pat_001.pat_id
• primary_payor_id → ursa.no_ursa_core_struct_004.payor_id
• primary_plan_id → ursa.no_ursa_core_struct_005.plan_id
• primary_plan_attributee_prov_id → ursa.no_ursa_core_prov_001.prov_id
• empirical_attributee_primary_care_individual_prov_id → ursa.no_ursa_core_prov_001.prov_id
• empirical_attributee_primary_care_prov_group_prov_id → ursa.no_ursa_core_prov_001.prov_id