Core Data Model Release Notes

Formally set the three Dialysis Facility Encounter precursor objects to be dedicated precursors.

Add Transaction Paid Date to all financial transaction Natural Objects (and Semantic Mapping Templates).

Added some fields to the Claim Transactions and Billing Transactions Natural Objects (and Semantic Mapping Templates).

Removed errant Place of Service Code = 10 entry from URSA SETTING TIER 1 = UNCLASSIFIABLE value set.

Addition of two frequently requested CMS Revenue Center Code value sets; INPATIENT PSYCHIATRIC FACILITY SETTING and CRITICAL ACCESS HOSPITAL FACILITY SETTING

Significant updates to Home Health Care Visit encounter objects (to better capture professional claims / bills related to home health, and to generate home health visits when there is only a professional bill / claim); added new encounter type: Dialysis Facility Encounter; updated downstream encounter infrastructure and analytic fields to reflect this new encounter type.

Tweaks to Capitation Financial Transaction field names; added Provider Contract ID field to Patient Timelines of Plan Membership Natural Object (and select downstream objects).

Refinements to Capitation Financial Transactions concept / assets.

Modest overhaul to Capitation Revenue Transactions Natural Objects (and associated assets) to be more expansive Capitation Financial Transactions; this represents a design decision to model both revenue and expense (and other) capitation-style financial transactions in one Natural Object, rather than two.

Refinements to new MAO-004 Diagnosis Transactions object.

Added MAO-004 Diagnosis Transactions Natural Object (including precursor); updated MAO-004 Diagnosis Fields Semantic Mapping Template to include additional fields used for this new object.

Updated Universal Patient Document Aggregator to include MAO-004 Diagnosis records.

Added fields related to provider contract to MAO-004 Natural Object and Semantic Mapping Template; added some additional fields to the MAO-004 Semantic Mapping Template that are useful for integration (but are not published to the Natural Object).

Added Natural Objects and Semantic Mapping Template for MAO-004 Diagnoses

Minor field tweaks to MMR Natural Objects.

Further refinements to MMR Member-Months and MMR Member-Month Transactions concepts (both Natural Objects and Semantic Mapping Templates)

Added MMR Member-Months Natural Object (and Semantic Mapping Template); renamed MMR Records object (and SM Template) to MMR Member-Month Transactions.

Rebranded "Contract" as "Provider Contract" for clarity (affecting Natural Objects and Semantic Mapping Templates)

Added new Natural Object (and Semantic Mapping Template): MMR Records; updated Patient-Plan Timelines of Plan Membership Natural Object (and SM Template) to be consistent with new MMR Records fields -- specifically: updated fields for LTI status and OREC, and added field for RAF Type code -- and made the necessary changes to downstream objects.

Submitting updated DM for URSA-CORE Patient Timelines to reflect changes made to the SO Patient Timelines Master for URSA-CORE Concepts which rebuilt some long column names (in context of recent increase to column name max length for non-Postgres DBMS).

Added Contract ID to Pre-Calculated Measure Results natural object; tweaked Professional Bill Service Line Items and Patient Timelines Master for URSA-CORE Concepts to rebuild some very long column names (in context of recent increase to column name max length for non-Postgres DBMS).

Made some tweaks to the Capitation Revenue Transaction object (and Semantic Mapping Template), reflecting a new, finer grain size for the object (i.e., each transaction now only covers a single revenue type, e.g., part A, part B, etc.). Added and/or updated terms related to this.

Significant update to how financial / transaction information is modeled in the existing billing natural objects; added two new objects to capture transactions on the claims side: Claim Transactions and Claim Transaction Details (analogous to the two existing billing transaction objects); added a third natural object, Capitation Revenue Transactions, to capture information about payments for patients in a capitated arrangement.

Added a new field, "CMS DRG Weight", to the Data Mart for Hospital Inpatient Admission Encounters (ursa.dm_ursa_core_002) to enable the calculation of CMI. Added several new DRG and MDC related fields to the Data Mart for SNF Encounters (ursa.dm_ursa_core_007).

Updated Claim Aggregator object to use (recently updated) CMS Type of Bill Code Reference to obtain Ursa Setting Tier 1 values, rather than (now outdated) Lookup Table URSA SETTING TIER 1 DESCRIPTION, which is now retired and no longer in the URSA-CORE namespace.

Modifications to the new Home Health Care Visit objects: fixed some bugs; added logic to generate primary HCPCS procedure; no longer using Attending provider as a backup for Service provider.

Several modifications and additions related to adding a new Ursa encounter type: Home Health Care Visits; including:

• New value sets to identify home health care services;
• New encounter document aggregator and encounter objects for home health care visit encounters;
• Updates to the standard Ursa Core encounter objects (Encounter Aggregator for All URSA-CORE Encounter Types, Universal Encounter Document Aggregator, Data Mart for URSA-CORE Encounters), including updating the Ursa Encounter Type Tier 1 Category and Ursa Encounter Type Tier 2 Category fields to include a new category;
• Updates to the data diagnostic measure, URSA-CORE-922 (Documents with Conflicting Encounter Types) to additionally check for conflicts with home health care visit encounters.

In the Patient Timelines for CCW Conditions [ursa.so_ursa_core_pat_007] individual conditions are grouped into system categories. The field "Is CCW Hyperlipidemia" has been added to the category "Is CCW System Endocrine/Metabolic". Previously it was in the "Cardiovascular" system category.

• Fixed a bug in the Primary Care Providers object that was resulting in preventive care visits only being counted for one provider per encounter, even for encounters where multiple providers participated in the encounter in some capacity; the intended logic -- now implemented correctly -- is that any provider participating in a preventive care visit should receive "credit" for that participation when calculating the share of each provider's visits that are preventive care visits.

• Added a number of terms related to the Ursa Hospital Admission Condition-Treatment Type classification system.

• Updated data diagnostic measures to include payor ID as an analytic field.

• Update of ZIP Code Reference object to include census boundary coordinates data to power choropleths.

• In the Emergency Department Visit Parent Encounter Document Aggregator, Precursor 1 (Qualifying Non-Inpatient Documents) object, made the following changes to the EMR Encounter stack (to better prevent duplicate qualifying records and improve consistency with how we’re dealing with claims data): (1) we now keep at most a single qualifying record from among an EMR Encounter or its children EMR Encounter Service Line Item records; (2) we set the qualifying document to be the EMR Encounter ID if the encounter type or setting is qualifying, else we use the service line item record; (3) whether it is qualifying or not, we now use the EMR Encounter record as the master document.

• In the Universal Patient Document Aggregator object, updated the logic for Medication Dispense documents to use a coalesce of Dispensed Date, Administered Date, and Encounter Start Date when populating the Document Effective Date, Document Effective Start Date, and Document Effective End Date fields.

• Set Medication Dispenses, Precursor 1 (All Source Records) to be dedicated precursor;
• Updated Medication Orders, Medication List Entries, and Pharmacy Claims natural objects to use new Medi-Span GPI Code 14-Digit field name; updated logic in Universal Patient Document Aggregator to expect the new name where appropriate. (These changes should now complete the transition to using the new nomenclature across the data model.)

• Rebrand of “Medication Dispensing” (object and field names) as “Medication Dispense”;
• Added Order ID, Medication Dispense ID, Ordering Provider ID, Dispensing Provider ID, Is Document Type Medication Dispense flag, RxNorm Code, Medication SNOMED CT Code, and CDC CVX Code to Universal Patient Document Aggregator to better incorporate Medication Dispense information;
• Updated Universal Patient Document Aggregator mappings for Pharmacy Claims and Patient Observations to also populate some of these new fields (e.g., Order ID) as appropriate;
• Updated Semantic Mapping Templates for Pharmacy Claims, Medications, Medication List Entries, Medication Orders, Medication Dispenses to renamed Medi-Span GPI 14-Digit to Medi-Span GPI Code 14-Digit, for consistency with other code field names; and updated term;
• Updated Medication Dispenses and Medications Natural Objects to use Medi-Span GPI Code 14-Digit field name.

• In Patient-Plan Timeline of Plan Membership Fields Semantic Mapping Template, corrected data type of Is Dual Medicare-Medicaid Enrolled to be integer
• Added new Natural Object (and Semantic Mapping Template) for Medication Dispensing

• Update of CPT and HCPCS Reference object to include additional fields related to Restructured BETOS Classification System and to remove fields classifying CPT and HCPCS codes by setting (which was determined to be too unreliable)
• Removed an errantly added field on the Patient Communications object.
• Added Provider Description as an input to the Provider mastering object and updated the logic to publish a reconciled Provider Description in the final output of the object.

Added some terms related to the recently added CMS status fields.

Added Is CMS Aged Status, Is CMS Long-Term Institutionalized Status, and Is CMS New Enrollee Status fields to Patient-Plan Timelines of Plan Membership natural object (and related Semantic Mapping Template); this supports new development related to calculating HCC/RAF scores.

Initial release of URSA-CORE v3