Toward a National Health Information Infrastructure: A Key Strategy for Improving Quality in Long-Term Care. A. Purpose of the Study


The study had three objectives: The first objective was to determine, as a pilot activity, whether leading terminology and classification systems provided content coverage to support clinical decision-making and quality of care oversight in nursing homes as recommended by clinical experts and as reflected in the literature for three domains: pressure ulcers, chronic pain, and urinary incontinence. The second objective was to examine the content of the federally required nursing home minimum data set (MDS) to determine whether it provides the information needed to understand quality of care in nursing homes in the three selected domains. The third objective was to examine the extent to which the content of the MDS was captured by SNOMED CT, ICF, or ICNP.

Specifically, we set out to:

  • Identify the concepts, terms, and data elements recommended by domain experts as needed for risk adjusted assessments of pressure ulcers, pain, and urinary incontinence in nursing homes;

  • Determine the content coverage needed for these assessments provided by: (i) three terminology coding systems: SNOMED CT, ICF, and ICNP; and (ii) the MDS;

  • Determine the extent to which the data elements of MDS are captured by SNOMED CT, ICF and ICNP.

This project was deliberately limited in scope to three clinical conditions in order to provide a focused, "pilot" study that examines the comprehensiveness of leading terminology code sets and the MDS with respect to clinically relevant data and concepts needed to measure quality for those three clinical conditions.

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