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Understanding VA Data Repository: Key Information for Researchers

Learn about the VA data repository, VistA system, and national datasets available for medical research. Discover how to access and analyze VA healthcare data effectively.

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Understanding VA Data Repository: Key Information for Researchers

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  1. Getting Started Using VA Data(a.k.a “Help! Now What?”) Rebecca A. Drayer, M.D., M.Sc. VA Center for Integrated Healthcare Canandaigua Center of Excellence

  2. Veterans Health Administration (VHA) • Largest U.S. integrated health care system • 162 VA hospitals, 137 nursing homes, 43 domiciliaries, and > 850 clinics • VA Information Resource Center (VIReC) • Corporate Franchise Data Center • Local, VISN, and National data sets

  3. 3 Levels of Data • Local: Electronic medical record data from local VA facilities • Veterans Health Information Systems and Technology Architecture (VistA) • Regional: VA Integrated Service Network (VISN) • 21 geographic regions, local data warehouses • National: Databases constructed from all local facility data, stored in central location (Austin, TX)

  4. What is VistA? • Main data management system at VA facilities • Detailed clinical and administrative data on all inpatients and outpatients at a facility • Medical and healthcare utilization histories, demographics, medicines, practitioner information, diagnoses, procedures • Computerized Patient Record System (CPRS) is main component. • Local level data

  5. VISN 2 Data Repository • Regional level data • VISN 2: All of New York except New York City • Maintained by Center for Integrated Healthcare in Syracuse • Contains 15 months of patient data (4/1/04-7/1/05) • If need other years, need to request data pull

  6. VISN 2 Data Repository (2) • What’s in the repository? • Demographics • Clinics visited (health services utilization) • Diagnoses (ICD9 codes) • Health screens • e.g., smoking, AUDIT-C (alcohol) • Prescriptions written • Prescriptions actually released by pharmacy

  7. Medical SAS Datasets • Records exist starting in 1980 and contain diagnosis information on each subject using the International Classification of Diseases (ICD) • National level data • Also known as Patient Treatment File • Obtained from local VistA systems around the nation • Data transferred daily to central repository • SAS file created • Both inpatient and outpatient datasets available • Common element: patient identifier (scrambled SSN)

  8. Inpatient Datasets • Inpatient datasets cover 4 categories of inpatient care: • Acute: Inpatient stays for acute care • Extended: Inpatient stays paid for by the VA that occur in domiciliaries, VA nursing homes, or community nursing homes • Observation: Hospital stays (generally less than 24 hours) for monitoring, evaluation, or assessment • Non-VA: Data on care funded by the VA and provided in non-VA hospitals • Within each category of care, four datasets: • Main File:A patient's inpatient stay (episode of care) • Bed Section File:A patient's inpatient stay under a specified physician treating specialty service • Procedure File:One day's procedure during an inpatient stay • Surgery File:One day's surgeries during an inpatient stay

  9. Inpatient Data Flow

  10. Outpatient Datasets • Two types of outpatient dataset • Visit dataset: All outpatient encounters within a single day • Can have multiple clinic appointments in one day • Event dataset: Information about each encounter during a day’s worth of outpatient care

  11. VA Outpatient Data Flow to the MedSAS Datasets

  12. Other National VA Data Sources • Pharmacy Benefit Management (PBM) • All prescriptions dispensed within VA system since 1999 (inpatient and outpatient) • VA Vital Status File • Death dates from multiple sources, including VA Inpatient File, Medicare Vital Status, and Social Security Administration (SSA) death file. • VA-Medicare Data • Medicare use by veterans

  13. Accessing VA Data • Have to be a VA employee or work with a VA employee • Me, Xin Tu, Wan Tang • For VISN 2 dataset, submit application to Center for Integrated Healthcare • More complicated for national dataset

  14. Accessing VA Data (2) • Request access to Austin • Contact local Information Security Officer (ISO) • Identify data elements needed • Submit Form 9957 to get Time Sharing Option (TSO) logon ID

  15. Welcome to VACCESS

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