Volume 2, Issue 3
CESR: Social Needs Patient Reported Outcomes Surveys Added to the VDW


What's going on?

The Center for Effectiveness and Safety Research (CESR) project, funded by Kaiser Permanente (KP), added two new social needs assessments to the Patient Reported Outcomes (PRO) tables in the CESR Virtual Data Warehouse (VDW).

  1. The Medicare Total Health Assessment (MTHA) – Became part of clinical care across many KP regions in 2012
  2. The Your Current Life Situation (YCLS) – Multi-regional pilot testing began in 2016 for specific programs (see tables below)

Why is this important?

Data is easier for researchers to access - Both assessments have been compiled into the CESR VDW tables. Previously, researchers wanting access to these data, searched multiple places, making it challenging to extract and organize the data. For example, in Clarity they examined questionnaire data, flowsheets and smart data elements (or smart data forms). In other instances, they may have contacted outside vendors (e.g., PTI ). Finding all data sources remains an ongoing challenge, so our CESR team partners with researchers across all regions and KP Operations to make these data as complete as possible.

The PRO tables include data for each survey administered, with variables such as:

  • Type of survey: (YCLS, MTHA, PHQ9 (Patient Health Questionnaire, a depression screener), AUDIT (Alcohol Use Disorders Identification Test), GAD (Generalized Anxiety Disorder screener), etc.)
  • Question: (e.g., In the past 3 months, how often have you worried that your food would run out before you had money to buy more?)
  • Response: (e.g., Never, Sometimes, Often, Very Often)
  • Medical Record Number and Encounter ID: gives users the ability to link to other VDW data (e.g., office visits, dispensings, diagnoses, etc.)
  • Survey mode: (e.g., telephone, office visit, mail, web, etc.)

What can we expect?

Enhancing the social needs data in the VDW - Additional activities in 2018 are enhancing the social needs data in the VDW. A feasibility assessment survey was sent to each region’s lead VDW data manager to determine other potential sources for these data. Some examples of these sources include:

  • CESR PRO data: AUDIT data may include important related social needs information. The PHQ9 includes data for Kaiser Permanente patients who might be suffering from depression.
  • VDW Diagnosis and Procedure data: Specific social needs diagnosis and procedure codes are being used in HealthConnect. These data are pulled into the VDW via the Diagnosis and Procedures tables.
  • Clarity Clinical Terms: Providers enter clinical terms and they are cross walked into diagnosis codes. These clinical terms can have greater detail than a diagnosis code.

Researchers at the Center for Health Research (KPNW) believe that the PRO data we have captured is a great resource, although we continue to find additional sources that identify more patients with social needs. These include ICD-9 (v codes) and ICD-10 (z codes) which have been used for social needs diagnosis. Collectively, the use of PRO and ICD data enables KP researchers to assess social needs of KP members, as well as include these data in analyses, providing a rich and unique data source that is available at few other research institutions.

Medicare Total Health Assessment – Preliminary Counts in the CESR PRO Tables

SITE 2011 2012 2013 2014 2015 2016 2017 2018 TOTAL
KPCO TAKERS 0 5108 12355 8855 7620 11863 13483 2434 61718
ADMD 0 5122 12450 8949 7655 12000 13724 2458 62358
KPGA TAKERS 0 262 1967 3023 4602 4279 5524 1492 21149
ADMD 0 263 1998 3135 4759 4415 5535 1492 21597
KPHI TAKERS 56 798 1665 2854 4898 6717 6631 1780 25399
ADMD 56 799 1667 2859 5103 7282 7456 2010 27232
KPMA TAKERS 0 346 27 0 0 10 0 0 383
ADMD 0 346 27 0 0 10 0 0 383
KPNC TAKERS 0 10 4 218 337 360 293 73 1295
ADMD 0 10 4 218 337 360 293 73 1295
KPNW TAKERS 0 75 7507 15291 12245 10878 10809 2337 59142
ADMD 0 75 7869 16089 13153 11646 11649 2350 62831
KPSC TAKERS 14 273 301 196 251 175 362 180 1752
ADMD 14 273 301 196 251 175 363 180 1753
TOTAL TAKERS 70 6872 23826 30437 29953 34282 37102 8296 170838
ADMD 70 6888 24316 31446 31258 35888 39020 8563 177449

  • Takers = Total Count of Members with questionnaires
  • ADMD = Total Count of Questionnaires administered (at least 1 question answered)
  • 2018 contains data through March 2018

Your Current Life Situation – Preliminary Counts in the CESR PRO Tables

SITE 2016 2017 2018 TOTAL
KPCO TAKERS 212 1451 413 2076
ADMD 212 1475 414 2101
KPMA TAKERS 5578 7407 12985
ADMD 7069 10080 17149
KPNC TAKERS 295 261 556
ADMD 296 262 558
KPNW TAKERS 2806 1380 4186
ADMD 2889 1398 4287
KPSC TAKERS 195 154 349
ADMD 196 154 350
TOTAL TAKERS 212 10325 9615 20152
ADMD 212 11925 12308 24445

  • Takers = Total Count of Members with questionnaires
  • ADMD = Total Count of Questionnaires administered (at least 1 question answered)
  • 2018 contains data through March 2018

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