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U.S. Department of Health and Human Services
National Patient Information Reporting System (NPIRS)

Data Management

During the initial load of the data warehouse, NPIRS asked the sites to send all registration and encounter data dating back to October 1, 2000. Most sites were able to do so, but not all. Some also sent encounter data prior to that date, but this data is sparse.

Data includes (but is not limited to):

Registration
  • Patient identification
  • Chart numbers and locations
  • Address
  • Social Security Number
  • Tribal membership and benefit class
  • Insurance eligibility
  • Alias (AKA names)
Encounter
  • Admission and discharge dates
  • Patient data
  • Location (Facility/clinic) of the service
  • Provider discipline
  • Procedure, diagnosis, injury and dental codes
  • Lab tests and clinical measurements
  • Health factors
  • Patient Education
  • Medication
  • Contract Health Service data such as authorization number, authorizing facility and cost

Please refer to the Meta Data and Standard Code Book tabs under this section for further information on those subjects.

Below are some commonly asked questions concerning data content within the NDW:

A: The goal of the NDW is to load the data as it is sent to us. The data is not edited for validity. Thus the data is available ‘as is’ for IHS analyst review and analysis of data quality so that improvements may eventually be made at the source. The NDW performs scheduled data integrity checks on samples to ensure the NDW is storing data as it is received from the sites. Data quality reports are becoming available to inform our customers of possible data corrections, especially to improve the quality of workload and user population counts.

A:The meta data web site contains a data dictionary that lists the physical database name for the element, the logical (plain English) name and a description. The meta data may be searched using any word, phrase, or part of a word that pertains to the element.

A: Yes; RPMS chart numbers are 6 characters in a 10 character field (i.e.: 0000007330, 0000T07330). A ‘T’ in the 5th position of an RPMS chart number indicates it is a temporary chart number. Non-RPMS systems may use other ways to indicate temporary charts.

RPMS will, and non-RPMS systems may, send registrations and visits with temporary charts to the NDW. They are not treated any differently than records containing permanent charts.

  • Facility name and location
  • Prevalence of diabetes in the population served by the facility
  • Diabetic retinopathy examination rate for the past three Government Performance and Reporting Act (GPRA) years.

A: The NDW contains a Medicaid indicator on the registration record. The insurance category code (INSUR_CAT_CD field) will be MCD if they are eligible for Medicaid. There is also a Medicaid eligibility flag on the encounter record (MCD_ELIG_FG field). This may mean the person receives SSI, since that program is a subset of Medicaid. However, the NDW does not have a designated indicator for SSI.

The field INSURER_NM in the REG.INSUR_ELIG table is meant to hold the name of the insurance for a registrant. As a free-text field, the lack of structure in the names makes this field difficult for analysis, but on rare occasions it will hold values that indicate SSI (SOCIAL SECURITY ADMINISTRATION, SSI, SOCIAL SECURITY DISABILITY, etc.)

A: RPMS Encounters are screened before being exported to the NDW and any encounter records that are for patients whose name begins with the standard phrase “DEMO,PATIENT” are excluded.   It is important to note, however,  that non-RPMS submissions, RPMS non-standard demo names, or RPMS name changes made after an encounter is sent will all circumvent this exclusion.

RPMS Registrations are not screened to exclude patients whose name begins with the standard phrase “DEMO,PATIENT”. Those received by the NDW may be activated by visits received from other sources (from the Fiscal Intermediary for example).

A: The Standard Code Book for facility data does not contain address data. It specifies the area the facility is in, but this has no relation to the state. Your Area Statistical Officer may have this information.

A: A chart abstract (synopsis of the conditions and problems of the patient) is not currently available in the NDW. It is on the list for possible future enhancements to the data that is maintained in the NDW.

A: NPIRS maintains an informal ‘wish list’ of new fields that have been requested for possible implementation in a future version of the NDW. If you would like something added to this list, send your request via e-mail to itsupport@ihs.gov. However, the formal process of getting the field added would require the following:

 (1) Approval:

  • The process for approving additions to the export will be directed by the NPIRS Investment Sponsor, Director of IHS Office of Public Health Support (currently Dr. Richard Church).
  • With the concurrence of the NPIRS Investment Sponsor, the project would be submitted to the IHS Information Technology Investment Review Board (ITIRB).
  • Adding data elements to the NDW exports will require tribal consultation.
  • It will require those who use these data to provide information to convince Tribes, IHS sites, and IHS leadership of the critical importance of their having access to additional data.
  • One of the most effective advocacy methods will likely be for programs (requestors) to demonstrate, with ‘real life’ examples, the value of the information these additional data elements could provide.

 (2) Funding:

  • Adding data elements to the data the NDW can accept will require changes to both the exports and internal NPIRS processes and databases.
  • NPIRS/NDW is entirely outsourced to a contractor.
  • Major changes to the NDW will require a task order and additional funding.
  • Funding priorities within OIT are debated and established by the Information Systems Advisory Council (ISAC).