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Clarity > Mapping Chronicles Relationships In Clarity > Flashcards

Mapping Chronicles Relationships In Clarity Flashcards

1
Q

Why doesn’t one chronicle master file translate into one clarity table?

A

As tempting as it may be to suggest that one chronicles master file would translate to one clarity table, that would be impossible due to two main principles for constructing tables in the clarity database: Minimize redundant data and maintain consistent granularity.

Video: We want to maintain consistent granularity. We want to say one row per (can be patient, encounter (Visit), Chief complain, phone number) We need to pick one item to maintain the consistent granularity. If we can other items like patient demographics, and chief complaint we would join from the two tables who’s granularity is that item.

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2
Q

True or False:Chronicles was designed to easily store and retrieve large amounts of information about one entity as a time?

A

True, for instance, fetching all the data about one patient, or one account, or one provider, or one user. This emphasis is reflected in the structure of the database, where records and contacts store a variety of information about each master file they are a part of.

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3
Q

True or False: Clarity was built to retrieve large sets of data?

A

False, Clarity was built to easily store and retrieve small amounts of information across many topics at once. This emphasis is also reflected in the structure of the database where each row in a table represents a different entity.

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4
Q

What are the two main reasons as to why one Chronicles master file would not translate to one Clarity table?

A

Minimize redundant data
Maintain consistent granularity

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5
Q

True or False: Patient data is stored as records with contacts in the EPT master file.

A

True

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6
Q

True or False: In the EPT Master file, each contact on a record represents a different encounter with a patient?

A

True

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7
Q

How does clarity minimize data redundancy while maintaining granularity?

A

Clarity minimizes data redundancy while maintaining granularity by mapping a single chronicles master file to multiple clarity tables. These two characteristics give key insights to how the data is stored in chronicles and inform the structure of the table when an item is extracted to clarity.

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8
Q

What are two chronicles item characteristics that are important for clarity queries?

A

They are Add Type and Response Type. These two characteristics give key insights to how the data is stored in chronicles, and inform the structure of the table when an item is extracted to clarity.

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9
Q

True or False: Add Type Indicates if data is stored on a record or on a contact in a record?

A

True

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10
Q

True or False:Response Type does not indicate how many lines of data an item can hold?

A

False, Response type does indicate how many lines of data na item can hold

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11
Q

True or False:Add Type does not categorize as either No-add or oVer time

A

False, it does categorize as either No-Add or Overtime.

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12
Q

True or False: Over time can be known as Response each time or look back?

A

True

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13
Q

True or False:Response time Categorize as either single or multiple?

A

True

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14
Q

True or False: Multiple can be known as multiple response or related group?

A

true

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15
Q

True or False:No-Add means stored on the contact?

A

False, No-add means stored on the record always considered “Current”

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16
Q

True or False:Overtime means stored on the contact?

A

True

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17
Q

True or False: (Video) Add Type is a record or contact level?

A

True, it is at a record or contact level.It is either NO-add or overtime. They are different ways to track the add type. No-add is patient name, date of birth, social security. Overtime, is like a chief complaint or encounter date.

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18
Q

True or False: Single means it can hold multiple lines?

A

False it hold only one line of data.

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19
Q

True or False: Multiple means holds only one line of data?

A

False, multiple means holds multiple lines of data.

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20
Q

True or False: Chronicles records contain an internal identifier and often an external identifier?

A

True, The internal identifier is stored in the .1 item on the record and is referred to as a record ID. External identifiers are stored in other items. External identifiers are not unique like the internal identifier that are unique across all records in that master file.

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21
Q

What is the internal identifier stored as?

A

It is stored as a .1 item on the record and is referred to as a record ID.

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22
Q

True or False: the value stored in the .1 is not unique?

A

False, the value stored in the .1 is unique across all records in that master file.

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23
Q

True or False: the value stored in the .1 is not unique?

A

False, the value stored in the .1 is unique across all records in that master file.

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24
Q

True or False: External Identifiers are not stored in other items?

A

False, External identifiers are stored in other items.

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25
Q

True or False: External identifiers are not necessarily unique.

A

True,External identifiers are not necessarily unique. For example, two patient records may have the same MRN, but just have a unique EPT .1. In addition, a single patient record may store more than one MRN, but can only have one EPT .1 stated another way. I EPT 2061 is multiple response item, while I EPT .1 is a single response item.

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26
Q

What are two possible identifiers for contacts in EPIC?

A

A contact serial number (CSN) and a Contact Date Real (CDR)

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27
Q

What is a contact serial number (CSN)?

A

A CSN is a serial number that is unique for all contacts within that master file.

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28
Q

What is a Contact Date Real (CDR)?

A

Is a date in epic’s internal format, followed by two decimal places that start at .00 and increment for each additional contact on the same date.

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29
Q

What are add type and response type?

A

They determine how many times an item can be stored. This affects granularity (the level of detail, what does one row represent).

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30
Q

What are add type and response type?

A

They determine how many times an item can be stored. This affects granularity (the level of detail, what does one row represent).

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30
Q

True or False: Will most master files use a CSN to identify their records’ contacts?

A

True, master files will use CSN to identify their records’ contacts. Thus, most clarity tables based on overtime items will have a CSN in their primary key. PAT_ENC_HSP is an example of a table that uses the CSN.

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31
Q

True or False: (Video) Response Type is how many lines you can have at once?

A

True, I can have many chief complains at once. This is where single versus multiple comes in. Where Multiple would be chief complain and Single would be admission Provider where you can only have one admission provider.

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31
Q

What are add type and response type?

A

They determine how many times an item can be stored. This affects granularity (the level of detail, what does one row represent).

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32
Q

What are add type and response type?

A

They determine how many times an item can be stored. This affects granularity (the level of detail, what does one row represent).

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32
Q

True or False: (Video) Response Type is how many lines you can have at once?

A

True, I can have many chief complains at once. This is where single versus multiple comes in. Where Multiple would be chief complain and Single would be admission Provider where you can only have one admission provider.

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33
Q

(Video) In Clarity how do we define a primary key?

A

It is from what the unique identifier was in chronicles. Clarity relies on what chronicles is storing.

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34
Q

(Video) What are the identifiers in chronicles?

A

The identifiers in chronicles are Records, contacts, and Lines.

Records: Records have a record ID .1 which is unique for every master file.

Contacts: Contacts have two different ways to identify a unique contact. Which are contact serial number and contact date real.

Lines: A line number- unique within the item. Let us say you have 4 unique chief complaints, you have 4 lines, one on each line for your 4 different complaints.

35
Q

(Video) If a patient has two encounters in the same day , how can we tell the difference between the two?

A

With the CSN, it is a contact serial number, that is assign to every contact. It is going to be different and unique for every visit.

36
Q

(Video) Explain the difference between CDR and CSN.

A

CSN to be unique for two different contacts in the same day. In contrast, the CDR will be the same except for the decimal place.

37
Q

What are add type and response type?

A

They determine how many times an item can be stored. This affects granularity (the level of detail, what does one row represent).

38
Q

True or False: (Video) Response Type is how many lines you can have at once?

A

True, I can have many chief complains at once. This is where single versus multiple comes in. Where Multiple would be chief complain and Single would be admission Provider where you can only have one admission provider.

38
Q

(Video) If you wanted to find a patient’s second visit. What would you use the CSN or the CDR?

A

You would use the CSN because that is unique for all contacts within that master file.

Now, if master files do not store a CSN, you can use the PAT_ID and the CDR.

39
Q

(Video) True or False: If you only search by CDR will you find information on multiple patients?

A

Yes, if two patients came in for a flue shot at the same place and same organization. They would both have the same CDR for the flu shots, which is why if you are searching in SQL, you need the Pat_Id and the CDR, both.

40
Q

What are add type and response type?

A

They determine how many times an item can be stored. This affects granularity (the level of detail, what does one row represent).

40
Q

True or False: (Video) Response Type is how many lines you can have at once?

A

True, I can have many chief complains at once. This is where single versus multiple comes in. Where Multiple would be chief complain and Single would be admission Provider where you can only have one admission provider.

41
Q

True or False: (Video) Response Type is how many lines you can have at once?

A

True, I can have many chief complains at once. This is where single versus multiple comes in. Where Multiple would be chief complain and Single would be admission Provider where you can only have one admission provider.

41
Q

(Video) True or False: In the CDR, the decimal incrimination are not patient specific?

A

False, they are.

42
Q

What are add type and response type?

A

They determine how many times an item can be stored. This affects granularity (the level of detail, what does one row represent).

43
Q

True or False: The majority of Master files will use CDR?

A

False, the majority of master files will use CSN. Thus, most clarity tables based on overtime items will have a CSN in their primary key.

44
Q

What can you do if the master file does not have CSN?

A

For records in these master files, contacts can only be identified by using the combination of the CDR and record ID. The clarity tables derived from these records will have both a CDR and ID in their primary key.

45
Q

True or False: Master files other than EPT do not treat contacts as an instance in which the patient interacted with your organization?

A

True, other master files do not treat an encounter the same way. The meaning of a contact differs between master files.

46
Q

True or False: some master files contain contacts that do not change meaning within the master file, depending on the type of record that contact is stored in?

A

False, some masters contain contacts that change meaning within the master file, depending on the type of record the contact is stored in.

A contact for a medication prescription in the ORS master file represents an action taken on the order, such as a refill. And in the same master file, a contact for a lab procedure order in the ORD master file represents different states of the order such as ‘ordered’ or ‘Resulted’.

A record in the OVQ master file is quality control material for a lab. Each contact is a different lot of the material.

47
Q

True or False: Some master files only ever use one contact per record?

A

True, although each record must contain at least one contact to adhere to the hierarchy structure of chronicles, some master files do not attach meaning to this contact. Master files like ADT or EAR store new information on a new record, rather than a new contact within a record.

All data in such master files is considered No-Add data.

48
Q

True or False: You can assume that one master file has the same structure as another?

A

False, you can not assume that one master file has the same structure as another.

49
Q

What is the tool you would use to figure out if an item as a no-add or over-time (Single or Multiple)?

A

Item editor is how you would figure out the add type and response type.

50
Q

What are the two categories that master files fall under?

A

Static and dynamic

Static master files typically contain build records, such as department, medications, and providers. Such records can be created before documenting care for a patient. In general, the meaning of a contact within a static master file is an update.

In contrast, records in dynamic master files are generally created as part of a workflow. For example, when dr. Whitecoat places an order for a patient, this will create a new record in the ORD master file. ORD is considered a dynamic master file. Whether a dynamic master file uses contacts, and what a contact means, varies.

51
Q

Where is the CDR in the picture?

A

The contact date determines the CDR. It is the internal number of days since dec 31, 1840.

52
Q

True or False: in chronicles, multiple response and related group items have a line number.

A

In Chronicles, multiple response and related group items have a line number, which distinguishes one entry from another within a single item. Clarity tables extract this number to a line column, which becomes part of the primary key. This line number helps uniquely identify each row in the table. Pat_Address is an example of a multiple response item with line columned. Other_communication is an example of a related group item with a line column. Both tables extract data from the EPT master file.

53
Q

True or False: (Video)The add type and response type of an item does not determine the granularity of the table that extracts it?

A

True, The add type and response type of an item determines the granularity of the table that extracts it?

54
Q

Each of the four combinations of chronicles add types and response type map to a particular primary key structure representing four granularities. What are they?

A

1 row per record
1 row per line per record
1 row per contact
1 row per line per contact

55
Q

Based on the Pat_ENC_CSN_ID and the line variables. What type of add type and response type would it be?

A

Add Type: Over time.
Response Type: Multiple/ related

56
Q

What is the add type and response type.

A

Add type: No-Add
Response Type: Single
This means that the granularity is one row per transaction.

57
Q

True or False: All data in a single extracted table in Clarity typically come from the same chronicles TABLE?

A

False, All data in a single extracted table in Clarity typically come from the same chronicles MASTER FILE.

58
Q

True or False: All data in a single extracted table in clarity typically come from items with the same ADD TYPE and RESPONSE TYPE

A

True

59
Q

True or False: Multiple response chronicles items typically extract to SIMILAR Clarity tables, unless they are part of the same related group.

A

False, Multiple response chronicles items typically extract to SEPARATE Clarity tables, unless they are part of the same related group.

60
Q

Why is it better to write reports from the most granular level and to move back up?

A

This is due to the cardinality of the joins. Cardinality is the numerical relationship between entities in two different tables. For the table Patient (one row per patient) and Pat_Enc (One row per encounter), the cardinality would be one to many (One patient can have many encounters).

61
Q

What is Cardinality?

A

Cardinality is the numerical relationship between the entities in two different tables.

62
Q

Looking at the picture, what should the join be?

A

You should start from the more granular to less granular.

Select *
From Order_Results
Inner join Order_PROC
ON Order_results. Order_Proc_ID=Order_Proc,Order_Proc_ID

63
Q

True or False: (Video) granularity is based on Primary key?

A

True, you can find the granularity looking at the data book and what the primary keys are.

64
Q

What is one way that you can find the registry number?

A

You look at the record viewer.

65
Q

You are able to connect tables from the same master file using primary and foreign keys, you need a way to connect master files to each other, how can you do that?

A

You are able to connect master files to each other is by using networked items.

66
Q

What are networked items?

A

Networked items in chronicles define relationships between an item in one master file and a record or contact. each networked item will store the ID of a chronicles record or contact.

67
Q

(video) What do network items do?

A

Networked items job are to connect records together in chronicles.

68
Q

True or False: A particular network item will always reference the same master file?

A

True, an example would be EPT 80150 which holds the ID of the patient’s primary care provider. No matter the patient, EPT 80150 can only store the .1 of an SER record. This relationship is part of the item definition.

69
Q

True or False: The Cur_PCP+PROV_ID will act as a foreign key?

A

True, the valued stored in CUR_PCP_PROV_ID is the provider record ID. This column will act as a gireign key, pointing to any table where the provider ID is part of the primary key.

70
Q

If I did the record viewer search and I find that I want the .2 and the 80150 variables from the picture, how do I find the clarity tables and columns?

A

I would use column search or the catalogs dictionary.

71
Q

True or False: Clarity does have referential integrity?

A

False. clarity does not enforce referential integrity. This means that records may be lost from your results if you choose an inner join. that decision will depend on the what your report requester expects in to see in the results.

72
Q

What would happen if you did a left join versus a an inner join?

A

By doing a left outer join we will return all patients, and if they have a primary care provider, we will return the providers. name.

If we choose instead to do an inner join, we would only return patients who had a primary care provider, and that providers name.

73
Q

Contact serial number

A

A contact serial number or CSN is a serial number that is unique for all contacts within that master file.

74
Q

Contact Date Real

A

A contact date real or CDR, is a date in epic’s internal format, followed by two decimal places that start at .00 and increment for each additional contact on the same date.

75
Q

Granularity

A

granularity refers to the level of detail at which the data is stored in the database. It can store information on the record or on an individual contact. For example, the Pat_enc table’s granularity is at the encounter level. In contrast, the Patient table stores data at the patient level. In addition to table granularity, there is also the concept of results granularity. When you join tables together, the resulting granularity could be different than the granularity of either table individually, depending on your join.

76
Q

Cardinality

A

The numeric relationship between rows in the parent table and rows in the child table. Though chronicles records are constructed and stored from the top down, it is usually better to write reports from the most granular level and to move back up. For the table Patient (One row per patient) and PAT_ENC (One row per encounter), the cardinality would be one to many (One patent can have many encounters)

77
Q

Networked Item

A

Networked items in chronicles define relationships between an item in one master and a record or contact. Each network item will store the ID of a chronicles record or contact.

78
Q

Identify the granularity of a table based on the primary key documented in the documentation.

A

When looking up a table, you can base how the primary key situation is. For example, the HSP_Account table. The HSP_Account table has one primary key, which is HSP_Account_ID. That means that the granularity will be one row per ID (1 row per record) and the internal identifier is stored in the .1 item on the record; thus, being referred to as the record ID for that table. Now an add type of No add and Response type of single doesn’t make the value unique across all records. Uniqueness is a property specific to the .1 item. For example, Patient Sex (I EPT 130) is No Add, Single response. But multiple patients can have the same sex, so this isn’t unique. What we can say is that since there is only one value stored per record, we only need the record ID to identify the row of the Clarity table that stores this value. But for phone numbers, we’d need a record ID and a line to find which row contains a particular phone number.

In contrast, the table Pat_Active_Reg has two primary keys (1 row per line per record), that means that the granularity will be a line per the registry. That means we can have multiple lines within the table. For example, let us say that a person is enrolled in multiple registries. For each registry he or she is enrolled in areas such as ADHD, Pregnancy, and the wellness registry that will be the detail that the table will be in.

79
Q

Identify the cardinality of a join based on primary keys in Clarity.

A

Cardinality is the numerical relationship between the entities in two different tables. When writing reports, it is better to go from the most granular level and to move back up. Let us look at the Patient table. The granularity of the table is one row per one patient. This is apparent because it just has one primary key. In contrast, in the Pat_Active_Reg the granularity is 1 row per line per record. This is apparent in the primary keys because it has two which are the Pat_ID and the line columns. When joining the Patient to the Pat_active_reg we would be doing one-to-many. When joining, we want to start the join with the most granular table because it will maintain consistency in the granularity in each subsequent join. When joining to tables we need to think about the granularity and join type because it could change the result set. For example, if the main table is patient and the left join is Pat_active_reg that means that it would bring back all the rows from pat_active_ref that have something in common with the left table (main table). An inner join only shows the things from both groups that have something in common. That means we would get more results with the left join instead of an inner join.

Select *
From Patient
Left Join Pat_active_reg Pat ON Pat.Pat_ID = Patient.Pat_ID

80
Q

Identify the granularity of a result set based on primary keys in Clarity.

A

Depending on the granularity of a table, the results may change how they are displayed. For example, the cardinality of the joins, there could be one-to-one, one-to-many, and many-to-many. Now if we have one to one that means that one row in a table relates exactly to one row in the second table. This means that the primary key is going to be like the primary key in the other table.
One-to-many relationship, means that one row in a database table relates to many rows in the second table. You see this in the primary key-foreign key relationship because it uses primary keys and foreign keys to enforce the relationship.
Now the many-to-many relationship means that many rows at one table are related to many rows in a second table. In other words, many instances in one entity corelate with many instances in a second entity.
Now, if you have one primary key, you will either have 1 row per record or 1 row per contact. This would lead to either one-to-one or one-to-many. If you have two primary keys you are more likely going to deal with a one-to-many or a many-to-many. Thus, based on the primary keys in a table, this will define the granularity and how the cardinality will affect the table.
* 1 row per record
* 1 row per line per record
* 1 row per contact
* 1 row per line per contact.

81
Q

Determine foreign keys between Clarity tables that extract from the same master file.

A

When joining tables, you want to start from the most granular to the less granular. When joining tables to the same master file, you are lucky that you can use the same primary key to join tables. If you are joining to a record, you would use the record_ID or if you are joining to a contact you would use the CSN. It gets tricky when you are joining different master files. Such as EPT to HAR or EPT to DEP. In this situation, you would be using foreign keys between tables. A foreign key is a column or a set of columns in a table that refers to the primary key of another table. For example, the PAT_ENC_HSP table with an EPT master file and the HSP_Account table has a HAR master file. In the HSP_account table the primary key is the HSP_Account_ID. Now the Pat_ENC_HSP has the same variable; however, in t his table it would be a foreign key and not the primary key.
When joining tables, you can use a left or inner join. If we have the patient table and I do a left join based on the HSP_account table, it will return all of the patients from the patients table including those not assign an HSP_account. If the patient is not assigned an HSP_account t he columns for the HSP_account will have a null value in the result. An inner join only matches rows from both tables if there is no match between the HSP table and the Patients table then those rows are not included in the result set. It only returns rows where there is a match between the columns of the two tables.

82
Q

Use Epic tools to identify networked items.

A

When researching network items, the record viewer is the best way to research networked items. Network items are to connect records together. When using the record viewer, the items in blue are hyperlinked and it is pointing you to another item.

83
Q

Use Chronicles networked items to determine Clarity foreign keys.

A

The tables in clarity are composed of data extracted from chronicles. Chronicles is designed to easily store and retrieve large amounts of information about one entity at a time. This structure is particularly useful for displaying records and contacts that are able to store a variety of information about each master file. In contrast, clarity was built to easily store and retrieve small amounts of information across many topics at once. Now, even though clarity gets its data from chronicles, one chronicles master file does not translate to one clarity table. The two main principles because of this is to minimize redundant data and maintain a consistent granularity.

84
Q

Relate the structure of Clarity to Chronicles item.

A

The add type and the response type are related to the primary keys of the clarity tables. Clarity is based on four granularities 1 row per record, 1 row per line per record, 1 row per contact, and 1 row per line per contact. For example, if I had a table that had pt name, sex, pcp, or ssn, this table would be single for response type and no-add for add type and I would identify the patient by ID and it would be 1 row per record id.

85
Q

Write a SQL query on Clarity data based on Chronicles research.

A

Let’s say a provider wants a report about a particular client’s PFL.
1. Look up the client in record viewer.
2. Look for the EAR in networked item and click on the blue item. It is a network item.
3. You are able to get the income FPL items which are EAR 121,122,123,128
4. Look up the item in the column search and click accept and select on the column name.
5. You are table to the column, but you can also see all the other items in the extracted table account_FPL_Info
6. Then you write the query in SQL using the clarity database.
Select
Account_ID –Primary Key
, FPL_EFF_Date
,FPL_INCOME
,FPL_FAMILY_SIZE
,FPL_PERCENTAGE
–,FPL_EXP_DATE
From (Select *,
RANK()
over(order by FPL_EFF_Date desc) as The_rank
from ACCOUNT_FPL_INFO
Where ACCOUNT_ID = ‘50042248’
) Account
Where The_rank =1

Clarity (7 decks)

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