{"id":811,"date":"2016-09-16T11:41:41","date_gmt":"2016-09-16T09:41:41","guid":{"rendered":"https:\/\/m-nc.de\/en\/dmp-tour-datenfluss"},"modified":"2022-11-03T16:54:47","modified_gmt":"2022-11-03T14:54:47","slug":"dmp-tour-datenfluss","status":"publish","type":"page","link":"https:\/\/m-nc.de\/en\/dmp-tour-datenfluss","title":{"rendered":"DMP-Tour"},"content":{"rendered":"

DMP data flow tour<\/font><\/b><\/h1>\n

Data transfers and creating reports for Disease Management Programs<\/font><\/b><\/h2>\n

We would like to take you on a trip through the data jungle of the German health care system. Let us show you how your data becomes part of a report. Below, the data flow is explained step by step.<\/font><\/h3>\n<\/i><\/span>Start tour<\/span><\/a>\n\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

Part 1: medical documentation (MD)<\/p>\n

DMP participants are meant to visit their diabetologist four times a year. The main events and parameters are discussed between physician and patient, recorded and sent to one of the 6 data authorities for testing and pseudonymisation.<\/font><\/p>\n

line<\/p>\n

Medical Netcare – Management in health care<\/font><\/p>\n

fadeIn<\/p>\n

Data acquisition in a physician’s practice<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"md01-datenerfassung-bis-zur-datenstelle_fl\"<\/p>\n

top<\/p>\n

fadeIn<\/p>\n

\"Pfeil_flach\"<\/p>\n

center<\/p>\n

55<\/p>\n

Pseudonymisation and forwarding<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"md02-pseudonymisierung_fl\"<\/p>\n

top<\/p>\n

\"Pfeil_flach\"<\/p>\n

center<\/p>\n

55<\/p>\n

Data processing by MNC<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"md03-datenempfang-mnc_fl\"<\/p>\n

top<\/p>\n

The medical documentation is recorded in the surgery and sent to one of the data authorities. First, there is a plausibilty check. In case of any problems detected, the documentation is handed back to the surgery for correction until the check can be completed successfully.<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

The data authority bundles data while excluding all person identifying elements replacing them by a pseudonym and forwards all documentations to the evaluator Medical Netcare on two yearly due dates, March 31st and September 30th. The pseudonyms used are sent to the respective statutory health insurance company of the insurant, too.<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

Separately for each indication, the data is imported into the respective database by Medical Netcare. But the data cannot be proceded sensibly by now, as there are still missing three main components of data…<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n<\/i><\/span>Part 2 of the data transfer<\/span><\/a>\n\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

Part 2: data on patient characteristics (PM)<\/p>\n

Data on patient characteristics is generated and transferred by the statutory health insurance companies. For each participant, information regarding their enrollment in a DMP, gender and age are transmitted. <\/font><\/p>\n

line<\/p>\n

Medical Netcare – Management in health care<\/font><\/p>\n

fadeIn<\/p>\n

Generating the data on patient chracteristics<\/p>\n

h4<\/p>\n

icon-steam<\/p>\n

\"kd01-kassen-erzeugen-pm-daten_fl\"<\/p>\n

top<\/p>\n

fadeIn<\/p>\n

\"Pfeil_flach\"<\/p>\n

center<\/p>\n

55<\/p>\n

Data transfer to Medical Netcare<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"kd02-kassendatenuebermittlung-zu-mnc_fl\"<\/p>\n

top<\/p>\n

\"Pfeil_flach\"<\/p>\n

center<\/p>\n

55<\/p>\n

Data processing by Medical Netcare<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"kd03-datenempfang-mnc_fl\"<\/p>\n

top<\/p>\n

Data on patient characteristics is generated by the statutory health insurance funds. To this end, the funds draw on their customer master data. Data identifying a person, like name and adress, are not exported, the lifetime insured person number is replaced by a pseudonym. The state of attendance of their insurants is administered by each health fund themselves. Date of entry and (if applicable) exit and reason are part of the transmitted data, too.<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

Twice a year – as per March 31st and September 30th – the data of patients participating in a DMP is collected by the three authorised organisations (for and by BKK, IKK and vdek), encrypted and transmitted on a data carrier to MNC.<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

At Medical Netcare, data is imported into the respective database per indication. In combination with the medical documentation, a complete progress documentation will be avilable later on. To combine this data, there are still two parts missing…<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n<\/i><\/span>Part 3 of the data transfer<\/span><\/a>\n\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

Part 3: Data for consolidating pseudonyms to a master record (MK)<\/p>\n

The data for consolidating pseudonyms to a master record is generated and transmitted by the health insurance funds. The data consolidation program was established in order to pseudonymise all patients in a standardised way and is based on this data. Data on medical parameters and patient characteristics can deviate from the proper main pseudonym. For all records of one patient to bear the same pseudonym, pseudonyms are translated by the procedure depicted here into the main pseudonym.<\/font><\/p>\n

line<\/p>\n

Medical Netcare – Management in health care<\/font><\/p>\n

fadeIn<\/p>\n

Generating translation lists<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"mk01-kassen-erzeugen-mk-listen_fl\"<\/p>\n

top<\/p>\n

fadeIn<\/p>\n

\"Pfeil_flach\"<\/p>\n

center<\/p>\n

55<\/p>\n

Data transfer to Medical Netcare<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"mk02-mk-datenuebermittlung-an-mnc_fl\"<\/p>\n

top<\/p>\n

\"Pfeil_flach\"<\/p>\n

center<\/p>\n

55<\/p>\n

Data processing by Medical Netcare<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"mk03-datenempfang-mnc_fl\"<\/p>\n

top<\/p>\n

The data authorities forward the pseudonyms used in the medical documentation including person identifying data of the insurants to the respective health insurance fund. For each patient, a so-called master pseudonym is available here that shall be used in all patient records in the end. The health insurance fund collects all pseudonyms used and compiles a translation list following this scheme: ” the patient with the pseudonym A, ensured with fund X, DMP entered in the first half of 2012 in Bavaria gets the master pseudonym C.”<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

The translation lists by the health insurance funds are collected by the three authorised organisations (for and by BKK, IKK and vdek), encrypted and transmitted on a data carrier to MNC.<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

At Medical Netcare, data is imported into the respective database per indication. Meanwhile, first plausibilty checks are performed. Rules contradicting each other, rules building invalid concatenations (e.g., rule 1: translate A into B – rule 2: translate B into C) as well as duplicates and empty records are rejected in the process.<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n<\/i><\/span>Part 4 of the data transfer<\/span><\/a>\n\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

Part 4: Data assigning membership of a distinct health insurance fund (IK)<\/p>\n

The institution codes (IK) used in the medical documentation can differ from the main institution code of a fund due to administrative reasons. In order to state a participant’s membership of a distinct health insurance fund, these differing codes have to be translated. This is the only way to reunite medical documentations with patient characteristics. Institution codes are generated and transmitted by the health insurance funds.<\/font><\/p>\n

line<\/p>\n

Medical Netcare – Management in health care<\/font><\/p>\n

fadeIn<\/p>\n

Generating the institution code translation table<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"ik01-kassen-erzeugen-ik-listen_fl\"<\/p>\n

top<\/p>\n

fadeIn<\/p>\n

\"Pfeil_flach\"<\/p>\n

center<\/p>\n

55<\/p>\n

Data transfer to Medical Netcare<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"kd02-kassendatenuebermittlung-zu-mnc_fl\"<\/p>\n

top<\/p>\n

\"Pfeil_flach\"<\/p>\n

center<\/p>\n

55<\/p>\n

Data processing by Medical Netcare<\/p>\n

h4<\/p>\n

icon-lamp<\/p>\n

\"ik03-ik-listen-einlesen_fl\"<\/p>\n

top<\/p>\n

The health insurance funds collect all institution codes used and compiles a translation list with the main codes. These lists are collected and bundled by the three authorised organisations (for and by BKK, IKK and vdek).<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

The institution code translation tables by the health insurance funds are collected by the three authorised organisations (for and by BKK, IKK and vdek), encrypted and transmitted on a data carrier to MNC as per March 31st and September 30th.<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

At Medical Netcare, institution code tables are imported into the respective database per indication. Meanwhile, formal checks are performed. Duplicates, empty records, rules building invalid concatenations (e.g., rule 1: translate A into B – rule 2: translate B into C) as well as rules contradicting each other are removed in the process. The result is a distinct translation table.<\/p>\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n<\/i><\/span>data integration<\/span><\/a>\n\n

center<\/p>\n

no-repeat;center top;;<\/p>\n

auto<\/p>\n

fadeIn<\/p>\n

\"VV01<\/p>\n

Translation of institution codes<\/p>\n

The new data is not yet containing the final health insurance fund’s assignment. The included institution codes have to be translated first. By translating using the institution code translation tables, data is assigned to the correct health insurance fund.<\/p>\n

Translating is processed for each of the three other data types: patient characteristics, medical documentations and consolidation data.<\/p>\n

In case of modifications in the translation tables, all records in stock<\/span>\n are to be translated by means of these new tables. For example, this case occurs when two health insurance funds fuse. The institution codes of the fusioning funds are joined via new translation tables. This way, such modifications are implemented rather quickly.<\/p>\n<\/i><\/span>Generating master records<\/span><\/a>\n\n

left<\/p>\n

fadeIn<\/p>\n

\"vv02-pseudonymuebersetzung-mit-mk-liste_fl\"<\/p>\n

Generating master records – translating pseudonyms<\/p>\n

The translation lists by the health insurance funds are provided twice a year. Each time they arrive at Medical Netcare, the whole stock in translation rules is replaced and rebuilt. This means, on the one hand, that the translation is to be operated on the whole data in stock<\/span>\n \u2013 on the other hand, a health insurance fund can report tranlations late or correct them providing missing data to connect medical documentations to the respective patient characteristics in retrospect.<\/p>\n

The translation is operated on the patient characteristics provided by the health insurance funds as well as on the medical documentation.<\/p>\n

When the translation is processed, the data fusion is complete for the moment. Now, MNC checks for loose ends (medical documentation without matching patient characteristic record or vice versa) and reports these to further enhance data quality. Within a time limit of 4 weeks, MNC accepts corrections or additional data. Afterwards, the data processing is finished.<\/p>\n<\/i><\/span>Development of a medical case<\/span><\/a>\n\n

left<\/p>\n

\"VV03<\/p>\n

Progress documentation<\/p>\n

In their translated form, all data of a patient can be merged sensibly. The data of each DMP participant is a progress documentation by now.<\/p>\n

The diagram on the left depicts a patient’s progress with respect to the data. In order to further procede the data, a few more steps and algorithms are necessary. The current evaluation demands analyses on the basis of half-years as well as years. Due to regular consultations<\/span>\n, there are normally two medical documentations per half-year (and accordingly four in a year). For example, each patient has two blood pressure values and two HbA1c values in a half-year. Data has to be further concentrated to suit the systematic evaluation with just one value per observation time.<\/p>\n<\/i><\/span>data condensation<\/span><\/a>\n\n

left<\/p>\n

Operationalisations to condense data<\/p>\n

<\/font><\/p>\n

Within DMP evaluation, yearly as well as half-yearly presentations are chosen for the evalution of data. If there is more than one medical documentation per patient and evaluation point, documentations have to be condensed.<\/font><\/p>\n

MNC developed operationalisations prescribing for each medical parameter how to calculate or determine them. In defining these operationalisations, we took care to understand the meaning of each value and condense them accordingly. These are a few representative rules:<\/font><\/p>\n


\n<\/font><\/font><\/font><\/font><\/p>\n

line<\/p>\n

Medical Netcare – Management in health care<\/font><\/p>\n

fadeIn<\/p>\n

\"vv04-md-merge_fl\"<\/p>\n

First or last value<\/p>\n