The American Health Information Management Association has issued a white paper on data mapping and how it affects data integrity.
The increased demands for data sharing and interoperability, especially across different practice settings and different classification systems, increase reliance on data mapping tools and techniques, the report explains. The use of these tools requires frequent integrity checks. Understanding the role and context of data maps, as well as their strengths and weaknesses, is essential in ensuring the reliability of the data entries derived from maps.
The report gives several examples of inappropriate mapping practices. For instance, the SNOMED CT terminology includes content for human and veterinary medicine, so it is critical to ensure the correct reference set is used to exclude terms exclusively used for non-human concepts when working on human-only content.
Another example: Maps should not be used as a substitute for health record encoding, as maps are created without context and available information to assign codes. For example, the term allergy to penicillin can be appropriately coded when the context of the health record reveals this is a history or status rather than an acute allergic reaction. However, in mapping, this same contextual information is not available, which requires guidance for the user to confirm results. AHIMA also counsels against creating maps internally with unqualified personnel, but to use skilled individuals familiar with data mapping requirements, limitations and pitfalls.
All managers of health information should identify all existing applications that are using maps of any kind, and vendors should provide a list of maps that transpose or translate one data set to another being used for review, the association advises. HIM professionals should be aware of and monitor these, since there is significant potential for error if the vendor is not keenly aware of the content and how it is designated to be used. Further, maintenance of maps cannot be ignored as the source and target systems for any map can be expected to change over time.
The guidance also details 10 challenges in electronic systems and workflows that can affect data integrity. These challenges cover drop down pick lists, computer-assisted encoding, use of templates developed from mapped data, workflows involving maps, forgetting to update maps, automated mapping, interface engines, default responses, duplicate data entries and system override capabilities. The 8-page guidance is available here.
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