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COVID-19 Data and Analytics

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Data Definitions

Note: Data definitions that pertain exclusively to the Tableau dashboard can be found in the Data Dictionary tab at the end of the other displays—select the dashboard using the radio button on the left to view this detail. Data definitions that apply more globally to COVID-19 are as follows:

Testing, Results, and Infection Flags

COVID Test

There continue to be several different COVID tests in use. A COVID test grouper, IHS VH COVID 19 EAP is being maintained and updated as new tests are added. Where possible, the grouper is used as the basis for reporting. To account for multiple orders per test (as is expected in some workflows) orders for a single patient at a single facility on the same day are grouped as a single "test." Definition owner: Karen McHale

  • DIVISION OF CONSOLIDATED LABORATORY SERVICES (VDH) TEST [LAB12919]
  • CORONAVIRUS, COVID-19 [LAB14600]
  • VH SARS-COV-2 RNA QUALITATIVE REAL-TIME RT-PCR [LAB5101986]
  • VH VIRGINIA DEPT. OF HEALTH 2019 N-COV REAL-TIME RT-PCR [LAB5101989]
  • VH WVDHHR 2019 N-COV REAL-TIME RT-PCR [LAB5101990]
  • SARS COV-2 RNA RT-PCR, SOFT [LAB14602]
  • VH SARS CORONAVIRUS WITH COV-2 RNA QUALITATIVE REAL-TIME PCR [LAB5101991]
  • COVID-19 (SARS-COV-2) - GIVF [LAB14606]
  • COVID 19 (SARS-COV-2) [LAB14668]
  • COVID 19 (SARS-COV-2) [LAB15129]
  • COVID-19 (SARS-COV-2), NAA (BDMAX) [LAB14609]
  • COVID-19 (SARS-COV-2), NAA (GENMARK) [LAB14607]
  • COVID-19 (SARS-COV-2), NAA (ABBOTT) [LAB14608]
  • VH XPERT XPRESS(C) SARS-COV-2 QUALITATIVE PCR [LAB5101992]
  • VH SARS COV 2 RNA [LAB5101993]
  • COVID-19 (SARS-COV-2) [LAB14615]
  • COVID-19 (SARS-COV-2) [LAB14700]
  • EXTERNAL ENTER.EDIT SARS-COV-2 VIRAL TESTING [LAB14640] - documents a test done outside of Inova

COVID Result

Any final value in any of the components below. Final values: “Detected, Presumptive Pos, Positive” or a flagged abnormal result. Components listed below.  Definition owner: Michelle Mason

  • 2019-NCOV-N1,N2-22618
  • SARS-COV-2-22587
  • SARS COV 2 OVERALL RESULT-22605
  • SARS COV-2 RNA RT PCR-22592
  • VIRGINIA DEPARTMENT OF HEALTH 2019-NCOVPCR-22603
  • WEST VIRGINIA DEPARTMENT OF HEALTH 2019-NCOVPCR-22604 
  • DCLS RESULTS-19594 
  • SARS COV-2 BY PCR-22633
  • SARS-COV-2 RNA (COVID-19) QUALITATIVE NAAT-22637
  • SARS-COV-2 VIRUS EXTERNAL TESTING-22727 - document the results of a test done outside of Inova

 
Infection Flag Values

Placed by Infection Prevention according to the following definitions:

  • COVID-19 Confirmed - Patient has COVID-19 currently
  • COVID-19 Rule Out - Patient is being evaluated for COVID-19 with a test
  • Repeat COVID-19 Rule Out - Patient has had one negative COIVD-19 test but there is still high clinical suspicion and so are still being treated as a possible COVID-19 patient

Definition Owner: Michelle Peninger


Encounters, Admissions, and Patients

COVID Positive Patient/Encounter – A patient with an infection flag of COVID Confirmed on day of discharge (or if still admitted: currently), or a positive test during encounter. For real-time reporting an additional criteria of having a COVID-19 diagnosis also qualifies the patient as COVID positive. This list of diagnosis is found in the reporting workbench report IHS COVID Testing Current Inpatients [8312441]. In the future these patients will be identified in a registry. Definition Owner: Karen McHale
 
COVID Negative Patient/Encounter – A patient who has no positive or pending COVID tests during this encounter and no active COVID infection flag. Definition owner: Andrew Miner
 
Pending Test – COVID-19 test that has not resulted. With workflows that include multiple orders on the same patient, day, and location the following convention applies: if any of the orders on a single day/location have resulted than the "test" for that patient/day/location is considered to be resulted even if not all of the orders have an associated result. For most reporting purposes only discrete results can be interpreted, so those that returned via scanned fax or phone call only will be reported as pending. Definition Owner: Andrew Miner
 

PUI patient/encounter – A patient/encounter that does not qualify as positive or negative by has a pending COVID-19 test and/or one of the Rule Out IP flags. When the information is available discretely, patients who were testing for screening purposes (e.g. prior to a procedure) are excluded from this category. This information has been available in the “Purpose of test” question in the order since May 7. Definition Owner: Andrew Miner
 
COVID-19 + Admission – An encounter with patient class of inpatient, observation, inpatient pediatric, hospice inpatient, or inpatient transplant that meets the definition for a COVID positive encounter (for cohort analysis only infection flag and test results are included; diagnoses are not). Definition Owner: Andrew Miner

COVID-19 PUI Admission – An encounter with patient class of inpatient, observation, or inpatient pediatric that does not meet the definition for a COVID positive encounter but in which the patient was tested for COVID-19 and/or the patient had an infection flag of COVID-19 Rule Out or Repeat COVID-19 Rule Out at the time of discharge (or if still admitted: currently). Definition Owner: Andrew Miner

COVID-19 + Discharge – A COVID-19 + Admission for which a disposition and discharge date have been set and the disposition is not “Expired." When patient class is not specified this includes all classes except Emergency and Hospice Inpatient. Definition Owner: Andrew Miner
  
COVID-19 + Death – A patient who meets criteria for COVID positive above who has an ED or hospital disposition of expired; all patient classes (emergency, inpatient, hospice, etc.) are included in this number unless otherwise specified. Definition Owner: Andrew Miner

Convention for Locations: Hospital locations - includes ED's including the freestanding ED's licensed under the hospital. Fairfax Heart Hospital, Fairfax  Hospital, and Fairfax Women's and Children's Hospital are grouped under Fairfax Medical Campus. Ambulatory - includes offices using Epic including urgent care centers.


Capacity Metrics

Bed/Unit Type (Critical Care, IMC, Floor) – Beds/units that may be used to treat COVID-19 patients are designated with a type or level of care. For analytics purposes, units that have beds of more than one level are given a level based on the majority and all beds in that unit are treated as being of that level. As units change designation these are updated, but changes are made retrospectively. Beds/units that would not care for COVID-19 patients are excluded. Definition Owner: Erin Hodson and Kem Hicks

ICU Patient/Bed – A patient/bed in a unit identified as critical care. These departments have DEP item “ICU Department” 28500 set to “yes." The list of these departments is dynamic and is maintained by definition owners Erin Hodson and Kem Hicks. 

Patient on Ventilator – Patients with an active order for a ventilator.  The list of ventilator orders is maintained in the grouper EAP General Ventilators [2310000002] and in the reporting workbench report IHS Patients with Ventilator Active Orders- Admitted” [8312440]. Definition Owner: Karen McHale
 
Patient on Extracorporeal Membrane Oxygenation (ECMO) – Patients who have been on ECMO during their admission are identified in the reporting workbench report “IFMC IP Patients on ECMO” [2088697] based on documentation in flowsheet row R $ HIS ECMO STATUS [30440113090]. To optimize real-time reporting of ECMO use, Patrick Moran reports daily on the number of patients receiving ECMO. Definition Owners: Karen McHale, Patrick Moran
 
Patients on Continuous Renal Replacement Therapy (CRRT) – Patients with an active order of the CRRT type. In reports these are identified by the rule VH/HIS Rx Dialysis Patient – Active Order CRRT.  Definition Owner: Karen McHale
 
Lab Turnaround Time Metrics (for COVID-19): A patient is not considered to have been tested if no specimen collection was documented. Definition Owner: Ben Coonfield

Test Date/Times:

  • Test Time – The date and time that the specimen was collected
  • Result Time  – The date and time that a final result of positive or negative, or undetermined was posted in Epic (not the time the lab technician determined the result).
  • Turnaround Time  – The duration from the Test Time (specimen collection), to the Result time (Final result posted) in calendar days.