Procedure
Procedure
Introduction
The Procedure data model is designed to capture and manage information related to patient procedures within a healthcare setting. It encompasses details about various aspects of a procedure, including the type of procedure, associated codes, timing, and relevant identifiers. This data model is essential for tracking and documenting procedures performed on patients, contributing to comprehensive patient care and medical record-keeping.
Use Case
Developers can utilize the Procedure data model for various use cases to query and analyze procedure details and anesthesia details, enhancing healthcare processes and patient care. Some common use cases include:
- Procedure Documentation Systems: Build applications that enable healthcare providers to document and store procedural details, including procedure codes, descriptions, and associated information. This ensures accurate and comprehensive records for each patient procedure.
- Real-time Procedure Updates: Implement systems that allow healthcare professionals to update procedural information in real-time. This includes recording the start and end times of procedures, any modifications made during the procedure, and the use of specific modifiers or codes.
- Medical History: Procedure data model can be used to provide with relevant information about the procedures a patient has undergone in past. This information can aid in clinical decision-making, such as selecting appropriate treatment options or assessing potential complications.
- Procedure Code Validation: Develop applications that validate procedure codes against standardized code sets to ensure accuracy and compliance. This helps in preventing errors related to coding and enhances the quality of procedural data.
- Anesthesia Management: Create tools for managing anesthesia-related information, such as anesthesia codes, minutes, and associated details. This supports anesthesiologists in documenting and tracking anesthesia administration during procedures.
- Procedure Coding Method Management: Build systems that allow healthcare providers to specify the coding method used for each procedure. This can include international classification systems or institution-specific coding methodologies.
- Procedure Consent Tracking: Implement features for tracking and documenting patient consent for specific procedures. Developers can create systems that capture consent codes, consent status, and associated information to ensure legal and ethical compliance.
- Procedure Priority Identification: Develop applications that allow healthcare providers to designate the priority of a procedure. This information helps in managing the scheduling and execution of procedures based on urgency or clinical significance.
- Procedure Duration Monitoring: Create tools for monitoring and recording the duration of procedures. This can include features to capture both the total procedure time and specific phases within the procedure.
- Procedure Minute Calculation: Implement features for calculating and recording the duration of procedures in minutes. This information is valuable for billing, resource allocation, and operational analysis.
Data Fields
| Attribute Name | Description | HL7 Mapping | Data Type | Label | Use Case |
|---|---|---|---|---|---|
| visit_number | Id of the visit | PV1-19-1 | string | Visit Number | Developers may query visit numbers to check when procedures are scheduled. This ensures that each visit is uniquely identified and tracked. |
| alternate_visit_id | Alternative visit id | PV1-50/PID-18 | string | Alternate Visit Id | Alternate visit IDs can be used for specific billing or claims processing scenarios, such as when a patient has multiple insurance policies or requires different billing codes for different aspects of their care. |
| procedure_datetime | Procedure Datetime | PR1-7 and not PR1-5-5 | date | Procedure Datetime | "Procedure_datetime" provides the date and time when a specific medical procedure or observation was performed. It is often used to timestamp events such as laboratory tests, surgeries, or imaging studies. |
| bundle_id | ID of bundle | MSH-10 | string | Bundle ID | Bundle_id is typically used to group related data or transactions together, especially in situations where multiple pieces of information need to be processed or managed as a single unit. It could be used to check for the message in which information has been received in. |
| procedure_description | Procedure Description | PR1-4 | string | Procedure Description | "Procedure_description" typically contains a human-readable description or name of a medical procedure. It helps provide context and clarity to the procedure code. |
| encounter_id | Encounter ID | PV1+MSH-10 | string | Encounter ID | Encounter_id is crucial for tracking and managing patient encounters within healthcare systems. It allows healthcare providers and systems to associate various clinical and administrative data with a specific patient visit or encounter. |
| lineage | This is lineage attribute | Fixed - HL7 | string | Lineage | lineage is essential for assessing genetic predispositions to hereditary diseases and conditions. |
| anesthesia_code | Anesthesia Code | PR1-9 | string | Anesthesia Code | This field typically contains a code or identifier that represents the type or method of anesthesia administered to a patient during a medical procedure. It helps in accurately documenting the anesthesia method. |
| associated_diagnosis_code | Associated Diagnosis Code | PR1-15 | string | Associated Diagnosis Code | This field typically contains the diagnosis code(s) related to a medical procedure or clinical event, providing a link between the procedure and associated diagnoses. |
| procedure_coding_method | Procedure Coding Method | PR1-2 | string | Procedure Coding Method | This attribute contains the code or identifier that uniquely represents a specific medical procedure. It is a critical part of the procedure documentation, allowing for accurate coding and billing. |
| batch_id | Batch id | System Generated | string | Batch ID | Batch IDs are used to label and track blood products, tissues, and organs in blood banks and tissue banks. This helps ensure patient safety by verifying the origin and quality of these products. |
| procedure_priority | Procedure Priority | PR1-14 | string | Procedure Priority | This field typically contains information indicating the priority or urgency level assigned to a medical procedure. It helps healthcare providers and staff prioritize and schedule procedures based on clinical need. |
| anesthesia_minutes | Anesthesia Minutes | PR1-10 | string | Anesthesia Minutes | This field typically contains the duration of time anesthesia was administered to a patient during a medical procedure. It is crucial for tracking the time a patient is under anesthesia. |
| xc_visit_id | XC visit id | Based on alternate_visit_id followed by visit_number followed by system generated ID | string | XC visit id | Alternate IDs may be used to quickly access a patient's medical information if their primary identification is not readily available. This ensures that the right medical care is provided promptly. |
| procedure_drg_type | Procedure Drg Type | PR1-17 | string | Procedure Drg Type | This field would typically contain information about the specific DRG category or type related to a medical procedure. Procedure Drg Type are used for healthcare payment and classification purposes. |
| procedure_code_modifier | Procedure Code Modifier | PR1-16 | string | Procedure Code Modifier | This field typically contains modifiers that provide additional information or context to a medical procedure code. Modifiers can impact the billing and reimbursement of procedures. |
| patient_id | Id of the patient | PID-3-1 | string | Patient ID | patient id can be used to prevent confusion or errors that can arise from similar names or demographics. |
| tissue_type_code | Tissue Type Code | PR1-18 | string | Tissue Type Code | This field typically contains a code or identifier that represents the type of tissue or organ involved in a medical procedure, surgery, or diagnosis. Common coding systems may include LOINC (Logical Observation Identifiers Names and Codes) for laboratory observations or other relevant coding systems. It is majorly required in procedures like biospy. |
| procedure_code | Procedure Code | PR1-3-1 | string | Procedure Code | This field typically contains a code or identifier that uniquely represents a specific medical procedure. Common coding systems include CPT (Current Procedural Terminology) or ICD-10-PCS (International Classification of Diseases, 10th Edition, Procedure Coding System). |
| procedure_action_code | Procedure Action Code | PR1-20 | string | Procedure Action Code | This field could contain codes or information related to the action or status of a medical procedure, such as whether it is scheduled, performed, canceled, or rescheduled. |
| consent_code | Consent Code | PR1-13 | string | Consent Code | This field would typically contain information related to a patient's consent, such as whether the patient has provided consent for a specific procedure, treatment, or data sharing. |
| procedure_id | Id of procedure | PR1,MSH-10 | string | Procedure ID | This field would typically contain a unique identifier or code for a medical procedure. It aids in accurately tracking and referencing specific procedures. |
| procedure_minutes | Procedure Minutes | PR1-5-5 | date | Procedure Minutes | This attribute typically contain the duration, in minutes, of a medical procedure. It helps in understanding the time resources required for a procedure. |
| procedure_functional_type | Procedure Functional Type | PR1-6 | string | Procedure Functional Type | This attribute typically describes the functional type or category of a medical procedure. It helps provide additional context or classification for the procedure beyond the standard procedure code |
Similar Models
Here are the models that are similar to the current data model