JCI Standard MCI.20.1 – patient based data and aggregate data, in a process available to aggregate data to meet the needs of internal and external users

Health data collection at hospitals is a responsibility of the health information department and  performed by Health Information Management (HIM) / Medical Records (MR) practitioners. It is common for hospitals to generate monthly and annual reports that describe the number of patients treated and the types of services delivered. The data to generate the monthly and annual reports are typically based on patient data relating to a single patient, such as his/her diagnosis, name, age, earlier medical history etc. from a single patient-health care worker interaction.

For instance, when a patient visits a hospital, a variety of details may be recorded, such as the patient’s temperature, their weight, and various blood tests. Should this patient be diagnosed as having “Vitamin B 12 deficiency anaemia, unspecified”, HIM/MR practitioners are all too familiar to code the diagnosis as corresponding to ICD-10 code D51.9, this particular interaction might eventually get recorded as an instance of “Anaemia” in an aggregate based system, that is reported in the monthly morbidity report, for example.

Patient based data is important when you want to track longitudinally i.e concerned with the development of patients over time. For example, if we want to track how a patient is adhering to and responding to the process of TB treatment in Malaysia (typically taking place over 6-9 months), we would need patient based data.

Aggregated data differs from patient based data.

It is the consolidation of data relating to multiple patients, and therefore cannot be traced back to a specific patient. They are merely counts, such as incidences of Malaria, TB, or other diseases. Typically, the routine data that a hospital deals with is this kind of aggregated statistics, and is used for the generation of routine reports and indicators, and most importantly, strategic planning within the health system. Aggregate data cannot provide the type of detailed information which patient level data can, but is crucial for planning and guidance of the performance of health systems.

HIM/MR practitioners know very well that patient data is highly confidential and therefore must be protected so that no one other than doctors can get it. For HIM/MR practitioners who continue to work with paper-based medical records, they are very aware that it must be properly stored in a secure place. For HIM/MR practitioners who choose to work with computers (EMRs/EHRs), they are aware that patient data needs secure systems with passwords and restrained access.

With the kind of introduction above laid out before you, I am going to write about the Joint Commission International (JCI) Standard MCI.20.1 which states that “The organization has a process to aggregate data and has determined which data and information are to be regularly aggregated to meet the needs of clinical and managerial staff in the organization and agencies outside the organization.”

JCI Standard MCI.201. has specific requirements.

The first requirement for JCI Standard MCI.20.1 is to ensure that hospitals as “The organization has a process to aggregate data in response to identified user needs.”

The second requirement is when the hospital as “The organization provides needed data to agencies outside the organization.”

Given the wide issues of concern for the above two requirements  I shall not rush to complete writing about JCI Standard MCI.20.1 for the sake of publishing on the web in a hurry while compromising the quality of the posts.

I like to say once again that what I am blogging about in posts like this one is simply a collection of my experiences and working knowledge accrued over the long years. I hope the posts I bring you in this blog convey best practices in HIM/MR which I hope young HIM/MR practitioners can learn to improve and the senior ones to compare, re-learn and adapt to bring HIM/MR practices to a higher level.

However, I am not implying what I am blogging here is all the gospel truth about standards to maintain or processes and procedures which need to be followed, as what I have written about are not carved in stone.

I ask you as the reader to make meaningful comments on posts I bring. I wish to continue to learn in the process and grow.

I shall post about the first requirement of the two requirements for this standard in my next post for this standard.

References :
Joint Commission International 2010, Joint Commission International Accreditation Standards For Hospitals, 4th edn, JCI, USA