Understanding Designated Provider and TMDS Data in Healthcare
Explore the characteristics of Designated Provider and Theater Medical Data Store (TMDS) tables, including important fields and potential uses for analysis. The Designated Provider table contains claims associated with the program, while TMDS is a relational database with various healthcare data tables. Learn about the data available, refresh frequencies, patient categories, and more.
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DaVINCI: Theater Medical Data Store (TMDS) and Designated Provider (USFHP) Data
Objectives Describe the Designated Provider table characteristics Describe the TMDS table characteristics Highlight important fields and consider how this data can be used in analyses 2
Whats in the Designated Provider Table Designated Provider Claims: Claims associated with the Designated Provider Program Content: Medical and Pharmacy Claims; Person Identifiers, Types of Care, Diagnosis, Payment Amounts, Dates, etc. Potential Uses: To study the Designated Provider program. To complete the health history of beneficiaries enrolled in DP Refresh Frequency: Monthly in MDR; Quarterly in DaVINCI Comment: These patients do not use MTFs or purchased care (ACV=Desig Prov) 3
Designated Provider patients, setting Program mostly used by family members (dependents) and military Retirees, which are part of the DaVINCI cohort Combines institutional and non-institutional claims Beneficiary Category Active Duty Dependents of Active Duty Dependent of Guard/Reserve Dependents of Retiree Dependent Survivor Guard/Reserve on Active Duty Dependent of Inactive Guard/Reserve Inactive Guard/Reserve Other Retirees Claims 183 1,272,155 255,788 3,933,993 1,182,644 Encounter Setting H = Hospital Services I = Inpatient Professional O = Outpatient Professional Claims 229,767 908,106 10,709,266 306 15,632 5,210 8,668 4,025,898 5
Table Location in DaVINCI Location of Designated Provider Tables in DaVINCI: VHACDWRB02 \ Databases \ DaVINCI \ Tables \ DaVINCI.DesigProv_Clin & DaVINCI.DesigProv_Pharm 6
Designated Provider pharmacy Claims for medications are also in DaVINCI, with common pharmacy related fields available including: NDC (National Drug Code) Quantity Dispensed Days Supply Prescribing Provider 7
Whats in the TMDS Tables Theater Medical Data Store TMDS is a relational database with separate tables for encounters, diagnoses, medications, symptoms, vitals signs, services, etc. MDR processing combines many of the tables into two tables: Encounter level Medication level Fields: EDIPI, Name, Dates of Care, Procedure and Diagnosis Codes, Service, Theater location, vitals (BP, pulse ox, temperature, etc.) Potential Uses: To complete the health history of ADSM who have deployed. Refresh Frequency: Monthly on the MDR; Quarterly on DaVINCI Comment: An important component to understand the full healthcare of Active Duty service members. 8
Table Location in DaVINCI Location of Theater Medical Data Store Tables in DaVINCI: TMDS data is still in the mail ; waiting for DoD to send it over to VINCI via the approved SFTP path 9
Theater data by source and Top Sites Site 379TH EMDG AL UDEID 380TH EMDG (AL DHAFRA) USMHK ROLE 3 386TH EMDG (ALI AL SALEM) CRAIG JOINT THEATER HOSPITAL (BAGRAM) TMC BUEHRING (21ST CSH) USS HARRY S. TRUMAN (CVN 75) USS CARL VINSON (CVN 70) USS DWIGHT D EISENHOWER USS GERALDFORD CVN78 USS STENNIS USS RONALD REAGAN ASG-KUWAIT TMC (ARIFJAN) USS THEODORE ROOSEVELT CVN-71 USS NIMITZ (CVN 68) CAMP AS SAYLIYAH TROOP MEDICAL CLINIC Encounters 164,940 95,928 83,489 64,380 57,604 51,033 50,800 44,641 37,796 34,061 32,033 30,494 27,729 26,786 26,416 25,177 Source System AHLTA-T CHCSTC2 JPTA SAMS8 TRAC2ES Encounters 1,582,285 10,605 9,663 4,641 19,048 10
Top Diagnoses in TMDS Dx Code V705 9 7242 71946 DOD0212 71941 4659 Z0289 5589 7295 460 7048 78055 V7260 7231 84500 Description DoD Separation Exam Lumbago Unspecified knee pain ASSESS,POST-DEPLY DD2796 Unspecified shoulder pain Acute upper respiratory infections of unspecified site Encounter for other administrative examinations Noninfectious gastroenteritis and colitis Pain in limb Acute nasopharyngitis Other specified diseases of hair and hair follicles Disruption of 24 hour sleep wake cycle, unspecified Laboratory examination, unspecified Cervicalgia Sprains and strains of ankle and foot Records 172,282 47,800 39,345 30,466 28,183 25,912 18,017 16,191 16,078 14,928 14,811 12,385 11,224 11,126 10,588 11
Procedure codes in TMDS Unfortunately, CPT codes in theater data are very poorly populated (99.9% null) There is virtually no data quality discipline for theater entry of these data Navy seems to be doing better at data quality on shipboard care, and the data supports the Navy uses TMIP-maritime (their package for AHLTA-T and TMDS) for recording some clinical information 12
Questions 13