Maintaining Data Mapping in i2iTracks · PDF file7/12/17 Page 1 of 13 HEALTH INITIATIVES...

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HEALTH INITIATIVES CONSULTING,

INC.

Healthcare Transformation, Redesigned!

Your Partner in Data Stewardship

Maintaining Data Mapping in i2iTracks

Data Stewardship is a process of establishing and maintaining the validity and reliability of data used to

drive your business. This document will help you maintain the appropriate data mapping in i2iTracks, as

part of your data stewardship process. Health center teams are encouraged to do an initial “deep dive”

into all the data elements in i2iTracks. After the initial comprehensive process, it is best practice to

review and update data on a quarterly basis to include:

1. Linked Visit Types

2. Allergies

3. Educations

4. Immunizations

5. Medications

6. Problems

7. Procedures

8. Self-Management Goals

9. Treatment Plans

10. Other Profile Items

11. Labs

12. Custom Data Integrator

(CDI)

pg. 2 – HIC Maintaining Data Mapping in i2iTracks 2017 ©

Allergies, Problems, and Medications are displayed in a patient’s profile.

Items with the i2i

logo are Tracks

profile items that

are mapped and

active. Items with

the blue “leaves”

are external

items and come

over as-is from

the EHR.

In general, it is best practice to “enable” only the patient profile items that you are currently using on a population level.

If you determine that you need to add a new profile item, always click “Show Disabled Items” and check to see if the item

exists in the “disabled” library. If it does, simply enable and map that item. As you complete mapping, already mapped

data from the EHR/PM systems will disappear from the available library. If your search yields no results when you do

your quarterly review, it means that no new items have been added to the EHR/PM libraries. If this result is unexpected

the mapping should be reviewed for completeness.

Linked Visit Types:

ICD and CPT codes come from the Practice Management System. Linked Visit Types are a collection of CPT/ICD codes

that all mean the same thing. They should be unique and specific to the concept that is mapped. Review all of the code

mappings for the enabled Linked Visit Types during your initial Data Stewardship set-up process. Items that use Linked

Visit Types are one of the only items in i2iTracks that are not “self-healing” in the event of incorrect mapping. This

means that if an ICD or CPT code is incorrectly mapped in a linked visit type that drives a Procedure, Education or

Immunization and you identify that you can make the correction of future data by correcting the Linked Visit Type

mapping. However, in order for historical Procedures, Educations or Immunizations to be removed, you must open a

support case with i2i Population Health to have them remove the incorrect profile items that were populated by the

linked visit type.

Unless new codes are

introduced, linked visit

type mappings do not

need to be maintained

on a quarterly basis.


In this example, all Procedure and Diagnosis codes

mean a preventive care exam was done. There is

an “OR” relationship between the Procedure and

Diagnosis codes. Any one of the codes attributed

to a patient will bring that patient up in search

using this linked visit type. Patients do NOT need

to have BOTH a mapped procedure AND

Diagnosis code.

Allergies:

Review Allergy mapping (Setup > Patient Profile Items > Allergies) for all enabled allergies. Note that you only need to

enable and map allergies that you are concerned with on a population basis, or allergies that are relevant for quality

measures.

Select the Allergy, and click Edit. Then in the

new window, click Add to select from the

External Allergy library. External Allergies are

interfaced directly from your EHR (just like

External Problems). Filter items based on your

search criteria and select all that apply, then click

OK. Repeat this search on a quarterly basis to

identify mappings that need to be added,

especially if there are new allergies being added

to the EHR allergy library on a regular basis.

Educations:

Review Education mappings (Setup > Patient Profile Items > Educations) for all enabled Educations.


Select the Education, and click Edit. You will note that

Educations can be created through a Linked Visit Type. It is

also helpful to put “CDI” in the description if this item is

linked to Custom Data. Review the Custom Data mappings

in the External Data Diagnostics tool (EDD).

Verify that the

alert schedule is

still appropriate

for the practice.

External Data Diagnostics Tool (EDD):

File > Tools > External Data Diagnostics

Enter the name of the Profile Item in the search field as shown below. All mapped items will display with information

that will be helpful in determining if the mapping is appropriate. You can also search with appropriate terms to identify

potential data that are not currently mapped. Changing mapping in the Custom Data Integrator (CDI) is reviewed later in

this document.

Immunizations:

Most immunizations are populated via hard-coded behind-the-scenes programming linking the EMR immunization table

CVX codes to the Childhood Immunization elements in i2iTracks. “Childhood” immunizations capture ALL immunizations,

in spite of the nomenclature. Although immunizations can be mapped as part of the Profile Items using Linked Visit

Types, best practice is to rely on Immunization Type mappings. Rarely there are immunization types entered into the

EMR immunization table that are not associated with a CVX code. When this happens, these outliers must be mapped in

“Vaccine Type Mappings.”

Setup > Tracking > Childhood Immunizations > Vaccine Type Mappings


Note how this FLU VACC QUADRAVALENT is not

mapped. Select the unmapped item, click “Map”

and find the related vaccine type to map to. If the

specific vaccine type is not known, use the “NOS”

version.

If your organization does use the Immunization

Profile Items then go to:

Setup > Patient Profile Items > Immunizations >

Select Immunization to Validate

Go to the Vaccine Types tab and verify that all appropriate vaccine types

are linked. Using this method will bring in immunizations administered

at your clinic AND elsewhere that are documented in the EMR

immunization template.

Check the schedule to be sure it reflects current practice.

Caution: Using a Linked Visit Type is NOT self-healing and can create

duplicate immunizations based on the link to billing as well as the EMR

immunization template.

For each immunization, you can set custom schedules based on selected

patient characteristics. If a patient does not meet the established

schedule, you will see a notification on your Morning Huddle report. If you

need to set a schedule that is more complicated than the standard

schedule tool will allow, you can create a Protocol Search to display on the

Morning Huddle report. Schedules for Childhood Immunizations are

automatically loaded based off of the standard CDC guidelines. However,

children “of age” for Childhood Immunizations must be added to

Childhood Immunization Tracking in order for alerts to appear on the

huddle report or patient visit summaries.

Review each Immunization in your library on a quarterly basis.

Medications:

i2iTracks automatically maps a specific set of medications and updates the mapping on a regular basis.

The following i2iTracks medications are automatically mapped:

• ACE Inhibitor, Unspecified (i2i)

• ADHD Medications

• AG Inhibitor, Unspecified (i2i)

• Amylin Agonists

• Anti-depressant, Unspecified (i2i)

• Antibiotic

• Antihypertensive Pharmacological Therapy

• Antithrombotic Therapy (NQF) (Note: Some aspirins may not map to this and may require manual update)

• ARB, Unspecified (i2i)


• Aspirin (i2i)

• Asthma Controller Medication

• Asthma Rescue Medication

• Biguanides

• Contraceptives (NQF)

• Diabetes Medications (NQF)

• DPP 4 Inhibitors

• Glitazones, Unspecified (i2i)

• GLP 1 Analog (Byetta)

• Insulin (i2i)

• Lipid Lowerer (NQF)

• Meglitinides

• PCP Prophylaxis (Note: Bactrim and related medications are not auto-mapped and will need to be manually added as appropriate for your practice)

• Smoking Cessation (NQF)

• Sulfonylurea, Unspecified (i2i)

• Warfarin (NQF) (Note: Jantoven is not included auto-mapping and will need to be manually added as appropriate for your practice)

Medications that are auto-mapped but not used by your practice can be disabled to remove them from the visible pick

list. However they will continue to populate on the patient level based on their maping to EMR medications. DO NOT

change the names of any of the auto-mapped medications as this will interfere with the appropriate function of the

auto-map routine.

If you need a medication that is not listed on the

medication list, such as Hepatitis C Meds, it will need to be

manually created and mapped. First, ensure that the

medication is enabled (Setup > Patient Profile Items >

Medications > Medications). Once it is enabled (or

created), review the mapping (Setup > Patient Profile Items

> Medications > Medication Mapping). Select the

medication, and then Edit.

If there are no medications listed, you will need to Add

them manually. This is a labor intensive set-up process, but

only needs to be maintained on a quarterly basis for

enabled medications moving forward.

First, search the medication library for the root word of the

generic medication. In some EMRs the generic name is

included with the brand name of the drug. If not, you’ll

also need to do a search for all the brand named drugs

within the broader category.


Select OK to add the medication mappings.

On a quarterly basis, review the mapping for all

medications that are NOT auto-mapped by doing a

search for all the names that have already been

mapped (this will identify if a new dosage was

prescribed for the first time, for instance). Search

for new medications in the class of medications

that are being mapped. Is there a new brand name

or generic that has been released recently that is

now in use at your clinic?

Problems:

Review Problem mapping (Setup > Patient Profile Items > Problems) for all enabled problems. Note that you only need

to enable and map problems that you are relevant to a population or for quality measures. You do not need to replicate

your entire EHR problem list.

Problems can be mapped to diagnosis codes, procedure codes,

external problems, or custom data. If a problem is mapped to

custom data (CDI) exclusively or in addition to External Problems,

best practice is to write “CDI Mapping” in the Description to

prevent confusion.

It is best practice to map Problems to External Problems with

or without CDI mappings as these are both self-healing and

allow the problem in Tracks to resolve when the

corresponding problem in the EMR is resolved. Any mapping

changes in linked billing ICD codes will only change the

problem attribution in i2iTrakcs from that moment forward.

As with Procedures, Immunizations or Educations that are

created by linked visit types, past errors will need to be cleared by i2i Population Health by submitting a support ticket.


The “Related Profile Items” tab in Problem setup is where you

designate profile items of interest to patients that have that

particular problem (e.g. comorbidities). These Related Profile

Items will populate on the Patient Visit Summary for patients

with the i2iTracks problem(s), which is particularly useful if you

are using a generic “Preventive Care” patient visit summary.

This is a setup for the “i2i Preventive Care Template”

Patient Visit Summary. Check the “Include profile items

that are related to the patient’s problems” radio button

to have the visit summary personalize for each patient

based on their i2iTracks problems.

Procedures:

Review Procedure mappings (Setup > Patient Profile Items >

Procedures) for all enabled Procedures.

Select the Procedure, and click Edit. You will note that

Procedures can be created through a Linked Visit Type. It is

also helpful to put “CDI” in the description if this item is linked

to Custom Data. Review the Custom Data mappings in the

External Data Diagnostics tool (EDD).

Verify that the alert schedule is still appropriate for the

practice.

See the CDI mapping section at the end of this document for

more information on updating CDI mappings.


Self-Management Goals, Treatment Plans and Other Profile Items:

Setup > Patient Profile Items > Self Management Goals

Setup > Patient Profile Items > Treatment Plans

Setup > Patient Profile Items > Other

Self-Management Goals, Treatment Plans and Other Profile Items

can only be driven by the CDI. Review their mapping quarterly. See

the CDI section in this document.

Labs:

Review lab mappings quarterly or when sudden shifts in report outcomes are observed. Labs can change result codes

without your knowledge and EMR mappings can change. Either one of these events can change the lab result mapping

needed in i2iTracks.

As with all data elements, only enable the Labs that you will be

using to manage or report on the population. Labs are enabled

and disabled in “Labs”. Once you have a clean list of labs that

you will be using, lab mappings can be reviewed in “Lab

Mappings.” Note: The other functions in this menu are legacy

functions from a time before lab interfaces. These functions can

be ignored.


You will have a tab across the top for each of your lab sources.

Labs need to be mapped separately under each tab.

Prior to mapping it is a good practice to drill down on the

various results in the External Data Diagnostics tool to validate

appropriate results. Numeric results, like the HbA1c do not

require additional steps beyond mapping the results codes.

Qualitative and list values have additional mapping requirements. HIV screening is an example of a qualitative lab. HCV

Fibrosis stage is an example of a list value. Use the “Set” button to map the results.

Custom Data Integrator:

Mapping for custom data occurs in the Custom Data Integrator (CDI).

Items in the CDI are mapped on an as-needed basis. Depending on your

EHR interface, you may have thousands of items in this library. You only

need to maintain mappings (i.e. look for unmapped values) for items

that have equivalent i2iTracks items. Items that have unmapped values

will be highlighted in red UNLESS the “Ignore Unmapped Values” radio

button has been selected in the setup of that item. The selection of this

radio button is indicated by a “Yes” in the “Ignore Unmapped Values”

column of the CDI.


If you identify an item in the CDI that needs to be mapped and an equivalent i2iTracks item does not exist, the setup of

that item can be done right from the CDI. For example, you might want to also map this item to a Procedure of “Tobacco

Use Assessment.”

Click on “Add Another Mapping.” Choose the Category of item that you want to create. Then click on “Setup Items…”

1

2 3


Then create the required data element. Remember

to always check the disabled items before potentially

creating a duplicate data element. Add “CDI” to the

description for clarification. Once the item has been

created you can map it.

If you are creating a new Problem, you can map the

External Diagnoses from the setup within the CDI,

rather than having to go back through profile items

setup when done in the CDI.

When a new rule is added, you must determine how the rule will treat the EHR data.

Other Profile Items that are numeric values will give you the following mapping options:

Any date value (Use as event date

Any numeric value “As Is”

Any of the following values

Any value

When there are many text values, rules can be applied to simplify mapping maintenance.

Validation should be thorough

to be sure that the data is being

interpreted appropriately.


CDI Data Validation

Depending on the EMR interface with i2iTracks, there may not be a capability of drilling down on custom data in

the External Data Diagnostics tool prior to mapping that data element. Prior to mapping something to

production, when the data interpretation is not clear, you can map the data element to a Test List Value item in

Other Profile Items.

CDI mappings are self-healing. Once a mapping is cleared and auto-update has occurred (generally overnight for

most installations of i2iTracks) then the data that had been mapped to the i2iTracks items is removed from the

patient level. This allows you to repurpose any of the test list values for testing additional data elements. Simply

edit the name of the item and map it to the data that you want to validate. Wait for auto-update and then you

can drill down within the EDD or create searches and reports to validate the data.

Maintaining Data Mapping in i2iTracks · PDF file7/12/17 Page 1 of 13 HEALTH INITIATIVES...

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