We have 3 types of patient reported data:
- Health Risk Assessment Data
- Patient Reported EMR Data
- Survey Data
Currently if we get data from these sources, if they map to a domain like DRUG or CONDITION domain we move the record there. However we are struggling a bit with this.
1) Health Risk Assessment
This data comes from questionnaires completed by employees within a certain insurance. The data comes in bulk typically at the end of a calendar year when insurance is being renewed. The date around occurrence is the date in which the survey was filled out. This data is typically accompanying claims data.
Self Reported Asthma. Yes or No?
If Yes, we were writing a record to the CONDITION_OCCURRENCE for
2) Patient Reported Medications in EMR Data
At the point of seeking care a patient will declare what medications they are on and it is recorded within the medical record. Typically this data is accompanying other medical record type data.
Patient states they are taking 300MG of Clindamycin and the nurse selects an of NDC
63304069301. And we write a record for997899-Clindamycin 300 MG Oral Capsule` to the DRUG_EXPOSURE table.
3) Survey Data
Specifically thinking of something like NHANES survey data where we have an entire data set comprised of questions asked of someone.
Have you ever been told you have high blood pressure? Yes or No?
If yes, we record a CONDITION_OCCURRENCE record for
QUESTIONS WE HAVE
What we couldn’t decide is if:
- Given these types of patient reported data does it make sense to move the data to their proper domain or just dump everything to the OBSERVATION table. The TYPE field can always help you know where it came from but we are not sure people will know to exclude certain types during analysis time.
- Do we treat all patient reported data in the same way in regards to the movement or should we treat them differently depending on source.
My gut right now is telling me that we should handle patient reported data differently depending on how we get it. I think the HRA data should go to the OBSERVATION table given the date is completely unreliable. EMR patient reported medication data may be somewhat reliable given that it is usually asked during the time the patient might be exposed. The Survey data should move to the proper domains given that the entire dataset is survey based and should be analyzed as such.