can you do visit_end_date = date of most recent data/etl, but mark discharge_to_concept_id as 'receiving care actively"
I like @Gowtham_Rao add above but is there a concept for this. There is a discharge code of 30-still patient but that doesn’t seem to have a good standardize CONCEPT_ID. Do we need to create one or was there one you were thinking of?
If I’m processing all this properly . . .
ACTION
`Visit_end_date is mandatory. Use the best information to infer a visit end date. If end dates are not provided, possible ways to derive them include:
- Outpatient Visit: end_date=start_date
- Emergency Room Visit: end_date=start_date
- Inpatient Visit: usually there is information about discharge. If not you should be able to derive from the sudden decline of activity, or from the absence of inpatient procedures/drugs. But the latter would be not obvious.
- Long Term Care Visits: particularly for claims data, if end dates are not provided assume the visit is for the duration of month that it occurs.
- For inpatient visits ongoing at the date of ETL, put today’s date as mandatory visit_end_date and set the DISCHARGE_TO_CONCEPT_ID as TBD CONCEPT_ID`
ACTION
Add this as a convention under VISIT_OCCURRENCE
@MPhilofsky - what do you think?
1 Like
#5, Ongoing inpatient visits, with the concept_id Gowtham suggested will work for our purposes.
Thanks!
2 Likes
Good add @Gowtham_Rao and @MPhilofsky.
RECOMMENDATION
`Visit_end_date is mandatory. Use the best information to infer a visit end date. If end dates are not provided, possible ways to derive them include:
- Outpatient Visit: end_date=start_date
- Emergency Room Visit: end_date=start_date
- Inpatient Visit: usually there is information about discharge. If not you should be able to derive from the sudden decline of activity, or from the absence of inpatient procedures/drugs. But the latter would be not obvious.
- Long Term Care Visits: particularly for claims data, if end dates are not provided assume the visit is for the duration of month that it occurs.
- For inpatient visits ongoing at the date of ETL, put date of processing the data as mandatory visit_end_date and VISIT_TYPE_CONCEPT_ID with 32220-“Still patient” to identify the visit as incomplete.`
ACTION
Add this as a convention under VISIT_OCCURRENCE
Great!
1 Like
All - The concept ID 32220 - Still Patient is not standard. Should we really be using this?
What for?
Should we bring this to Themis or petition the vocabulary team to make this a standard concept id?
it’s already there.
@Christian_Reich I don’t see any reasons why this concept can’t be standard.
2 Likes
Probably we should populate with that concept discharge_to_concept_id field since 32220-“Still patient” concept is from domain “Visit” and vocabulary “UB04 Pt dis status” and has nothing to do with the provenance of source data?
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Yeah, this is a little odd. I don’t think a Type Concept is the right way. It would be something “From UB04 claim form” if we need that level of detail. What we really need is a convention for a future unknown date and put that into VISIT_END_DATE. How about 31-Dec-2099 like in the vocabularies? However, this would screw up Visit duration calculations. To be honest with you an empty VISIT_END_DATE makes the most sense here. Should we revoke the THEMIS rule?
2 Likes
I like that
VISIT_OCCURRENCE.visit_end_date is nullable.
So there’s no CommonDataModel issue.
Is nullable in v6, but the VISIT_OCCURRENCE.visit_end_datetime is required in v6. And in v5.3 the visit_end_date is required, but visit_end_datetime is not required.
Having a nullable visit_end_date/time may not be the best idea because many sources don’t have end_date for Outpatient Visits. So, there will be millions/billions of visits with no end_dates if the field isn’t required. And then folks running a study will have all these visits that start and never end. Let’s keep visit_end_date/time as a required field UNLESS discharge_to_concept_id = 32220, “Still patient”. If the Person is not currently a patient, their Visit has ended and an end_date should be populated.
2 Likes
It sounds like we need to relive Still patient Visit concept.
But I wouldn’t use it in visit_type_concept_id field.
As for me, discharge_to_concept_id field suggested by @Gowtham_Rao fits better.
It’s currently the case for the patient’s death, absence without leave, and self-discharge against medical advice.
@ericaVoss Why had you switched to type_concept_id on some point? 
Discharge_to looks better, agree?
@Christian_Reich @DTorok @ericaVoss @MPhilofsky @Vojtech_Huser
1 Like
Agreed.
With? The still patient?
