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Frequently Asked Questions

  • What is Activity-Based Funding?

    Activity-based funding is a method of funding health-care providers (for example, acute-care hospitals, long-term care facilities, rehabilitation facilities) for the care and services they provide. 

    The Canadian Institute for Health Information (CIHI) has set up an Activity-Based Funding Unit to assist Canadian health system funders as they consider activity-based funding. CIHI has technical expertise in clinical data, financial data and case mix systems, all of which are important components in the design of an activity-based funding model. 

  • About CORR

    • What is the Canadian Organ Replacement Register?
      The Canadian Organ Replacement Register (CORR) is a pan-Canadian database managed by the Canadian Institute for Health Information (CIHI). CORR’s mandate is to record and analyze the level of activity and outcomes of vital organ transplantation and renal dialysis activities.
    • Who is responsible for this database?
      CIHI manages this register.
    • What is the value of this database?
      This pan-Canadian database provides statistics that track long-term trends for organ transplantation, organ donation, waiting list statistics and dialysis activity. In doing so, the database makes comparative data available that can contribute to better treatment and patient care, and enhance research.

    Organ transplants

    • How many organ transplants are done in Canada each year?
      In 2018, there were 2,782 solid organ transplant procedures in Canada.
    • Which organ is most commonly transplanted in Canada each year?
      In 2018, there were 1,706 kidneys transplanted in Canada, accounting for the majority of single-organ transplants (60%). Other organs transplanted included 533 livers, 189 hearts, 361 lungs and 57 pancreases.

    Transplant waiting lists

    • How many people are waiting for a transplant?
      As of December 31, 2018, there were 4,351 people waiting for an organ transplant. Of these patients, 72% were waiting for a kidney transplant, and 12% were waiting for a liver transplant. This does not include patients who were waiting for an islet cell transplant.

    Dialysis

    • How many people are on dialysis in Canada?
      In 2018, there were 5,882 new dialysis patients in Canada (excluding Quebec). The number of patients on dialysis followed in the CORR database as of December 31, 2018, was 23,305. The majority of dialysis patients were on hemodialysis (77%), with the balance on peritoneal dialysis (23%).
    • How many dialysis centres are there in Canada?
      The most recent information available from CORR reported a total of 75 hospital-based programs in Canada (excluding Quebec) in 2018 that offered full-care renal services.

    Organ donors

    • How many organ donors are there?
      In 2018, there were 761 deceased organ donors. In addition, there were 555 living donors.
    • How are organ donations from deceased and living organ donors different?
      A living donor provides a single organ for transplant, but a deceased organ donor can provide up to 8 organs. In addition, living donors are often related to the recipient, while this is not necessarily the case for deceased organ donors.
    • How can someone become an organ donor?
      If you or someone you know is interested in becoming an organ donor, please connect with your local organ procurement organization
  • FAQ

    General Questions

    1. What is the data request process at CIHI?

      The data request process involves five key steps:
      1. Submission of inquiry to CIHI
      2. Assessment by program area
      3. Finalization of specifications, documentation, and approvals
      4. Data processing and verification
      5. Data release (and data destruction, for third party, record-level requests)
         
    2. What is the purpose of the data inquiry form?

      The intent of the new online data inquiry form is to provide a centralized entry point for data requests and to allow CIHI to assess client needs prior to completion of any formal documentation or approvals.
       
    3. What additional documentation needs to be completed for data requests?

      For third-party data requests, completion of a formal data request form and signing of a Non-Disclosure/Confidentiality Agreement are required. For the Graduate Student Data Access Program (GSDAP), additional requirements apply (see www.cihi.ca/gsdap).
       
    4. What determines the turnaround time to receive the data?

      CIHI will begin to process the data request once the client has submitted all of the necessary documents and the data requirements are finalized. The time it takes to compile the data varies depending on the complexity of the request, for example, the number of databases involved and whether the data request requires privacy consultation and approval. Timing also depends on the client’s ability to respond to questions from the database area. Having a good understanding of the research purpose and how CIHI data can answer the research question, as well as knowledge of the CIHI database, will expedite the request.
       
    5. Will the data holding area help with my analysis?

      CIHI staff can provide advice on the structure and content of the data requested. You should consult a research advisor regarding statistical analysis.
       
    6. Does CIHI provide population statistics?

      No, population statistics are provided by Statistics Canada. Refer to Statistics Canada’s website at www.statcan.gc.ca.
       
    7. What if I don’t know which classification codes (ICD-9, ICD-10-CA and CCI) relate to the health-related condition of interest to me?

      You should consult with a research advisor or a hospital health records department to identify the codes. If you require further assistance, someone from the data holding area will work with you to determine the codes as part of the data specifications process.
       
    8. Is there any CIHI data that will not be released?

      Yes. Depending on the data holding, some specific data elements cannot be released, for example, for reasons of privacy. For all data holdings, data releases are subject to CIHI review from a privacy perspective to ensure that they are compliant with authoritative requirements set out in legislation, agreements with data providers and internal policies and practices.
       

    Data Definitions

    1. What is personal health information?

      Personal health information is health information about an individual that identifies the specific individual; that may be used or manipulated by a reasonably foreseeable method to identify the individual; or may be linked by a reasonably foreseeable method to other information that identifies the individual.
       
    2. What is aggregate-level data?

      Aggregate-level data is summed and/or categorized data that can answer research questions about populations or groups of organizations. The data has been compiled from record-level data to a level that ensures the identities of individuals or organizations cannot be determined by a reasonably foreseeable method.
       
    3. What is record-level data?

      Record-level data is data in which each record is related to a single individual or organization.
       
    4. How does CIHI de-identify record-level data?

      CIHI modifies personal health information records so that the identity of the individuals or institutions cannot be determined by a reasonably foreseeable method. This involves:
      1. Removing the name (if collected);
      2. Removing or encrypting identifying numbers, such as a personal health or chart number;
      3. Truncating the postal code to the first three digits or providing a geographic region;
      4. Converting the date of birth to month and year of birth, age or age group;
      5. Converting the date of admission and date of discharge to month and year only; and
      6. Reviewing the data elements in their totality to ensure they do not permit identification of the individual by a reasonably foreseeable method.
      7. Methodologies and standards, in addition to those listed above, may be developed to de-identify information to the fullest extent possible.
         

    Data Storage, Retention and Secure Destruction
     

    1. How long can I keep and use the data released to me?

      According to the Non-Disclosure/Confidentiality Agreement, clients must destroy or return all third-party data, as well as any copies made, within one year of any published work or three years after the receipt of record-level data (whichever comes first). CIHI does not require aggregate data to be returned.
       
    2. Is it possible to get an extension to keep the record-level data more than three years?

      In exceptional circumstances it may possible for data to be retained for longer than three years; however, this request for extension must be made in writing to CIHI.
       
    3. Are there any data use restrictions?

      Yes. In compliance with the Non-Disclosure/Confidentiality Agreement, recipients of CIHI data must take all reasonable measures to avoid residual disclosure of the identity of individuals or health facilities.
       
    4. Can I use CIHI data in publications?

      Yes. Any publications resulting from data provided by CIHI must cite CIHI as the source of the data and must indicate that the results or views expressed are those of the author(s).
       
    5. Are there any restrictions on moving or relocating data?

      For record-level data, the institution or organization requesting CIHI data is ultimately accountable for protecting the data and complying with the terms and conditions in Section 8 of the Non-Disclosure/Confidentiality Agreement. If, for any reason, the data is to be moved or relocated from the organization/institution, CIHI must be informed in writing prior to the move. CIHI follows up with third-party requestors to ensure secure destruction of record-level data at the end of its term.
       
    6. Are there requirements for the destruction of record-level data?

      Yes. The requirements with respect to the secure destruction of CIHI record-level data are set out as part of the data request process. Question 8 of CIHI’s record-level data request form requires the recipient of CIHI data to outline the approach (and/or methods) that will be used to securely destroy the data.

      At the end of the retention period, data must be securely destroyed in compliance with the Non-Disclosure/Confidentiality Agreement. Recipients of CIHI data, supervisors (in the case of GSDAP students) and ultimately the institution or organization will be asked to provide CIHI with a certificate of destruction, which certifies the completion of the secure destruction activity and sets out the date, time, location and method of secure destruction employed. A template for the certificate of destruction is available upon request from CIHI.
       
    7. What is secure destruction and how is this standard met?

      Secure destruction of record-level data refers to the destruction of the data in such a manner that reconstruction is not reasonably foreseeable in the circumstances, as defined in Section 19 of the Non-Disclosure/Confidentiality Agreement. Industry best practices for the secure destruction of data are constantly evolving; this is particularly true for data in electronic format. For general information with respect to secure destruction methods, please review the fact sheet available on the website of the Information and Privacy Commissioner of Ontario (www.ipc.on.ca/wp-content/uploads/Resources/fact-10-e.pdf ). This fact sheet includes suggested best practices for the destruction of personal information. More information about CIHI’s current secure destruction requirements is available upon request.
       

    The Graduate Student Data Access Program
     

    1. Who is ultimately responsible for the protection and ultimate destruction of data received from CIHI for GSDAP recipients?


      The university at which the GSDAP applicant was enrolled when the data was originally provided is ultimately accountable for protecting the data and complying with the terms and conditions stated in Section 8 of the Non-Disclosure/Confidentiality Agreement.
       
    2. Do all graduate student requests for data need to go through the complete GSDAP application process?


      No, students should first refer to existing published CIHI reports and Quick Stats on the CIHI website to see if the data are already publicly available. If the data request requires customized work, then students should contact the GSDAP coordinator.
       
    3. Are Canadian students studying abroad at universities eligible to apply to the GSDAP?

      Yes. Canadian graduate students studying abroad are eligible to apply. Priority will be given to Canadian students studying at Canadian universities. In all cases, CIHI does not disclose identifiable personal health information to entities located beyond Canadian borders. As is the case for all GSDAP applicants, data must remain in the custody and control of the university to which the data was originally provided.
       
    4. Can non-Canadian students apply for data under the GSDAP?

      Data will not be provided to non-Canadian residents studying at non-Canadian universities. Non-Canadian graduate students studying at Canadian universities are eligible to apply. Data must remain in the custody and control of the university to which the data was originally provided.
       
    5. Are undergraduate students eligible to apply for data through the GSDAP?

      No. The GSDAP is for graduate students needing data to fulfill graduate requirements (for example, master’s thesis, PhD dissertation or medical research fellow requirements).
       
    6. Does the GSDAP provide data to students who have received funding and/or grants to support access to data for research related to degree requirements?

      No. If you or your supervisor received funding and/or grants to support access to data, you will not be eligible to receive data through the GSDAP. You can apply directly to the data holding area to access data for a fee.
       
    7. Is there any other way that I can access data if I don’t qualify for the GSDAP?

      Yes. You can request data directly from a CIHI data holding. CIHI responds to custom data requests from researchers and others on a cost-recovery basis.
       
    8. Are there restrictions on how long record-level data can be kept?

      Yes. The Non-Disclosure/Confidentiality Agreement for record-level data indicates that data can be retained up to one year after any published work for graduate requirements or three years after the receipt of record-level data, whichever comes first, after which it and any copies must be securely destroyed. CIHI does not typically require the return or destruction of aggregate data. (Refer to your signed agreement for terms and conditions.)
       
    9. I am working on a study for my research advisor—can I apply for data through the GSDAP and then provide this data to my research advisor for further use once I complete my project?

      No. The intent of the GSDAP is to provide data to graduate students to fulfill degree requirements. Students should not be applying for or requesting data on behalf of their research advisors. In compliance with the terms and conditions stated in the Non-Disclosure/Confidentiality Agreement for record-level data, the data is released solely for the purposes set out in the request form and for no other purposes. If the research advisor wants to use the data for another purpose, then the advisor must go through CIHI’s formal data request process.
       
    10. Can I use data received through the GSDAP for another use, for example, ad hoc projects with my research advisor?

      No. The data set you receive is for graduate requirements stated in the project objectives submitted in the application. Any other use is not permitted, unless authorized by CIHI.
  • Frequently Asked Questions About the MIS Standards

    What is the MIS Standards?

    The MIS Standards is the Standards for Management Information Systems in Canadian Health Service Organizations. It is a set of national standards for gathering and processing data and for reporting financial and statistical data on the day-to-day operations of a health service organization. It provides a framework for integrating clinical, financial and statistical data.

    Why was it developed?

    The MIS Standards was developed to

    • Better measure the use of resources in relation to activities, by integrating financial, activity and clinical data; and
    • Improve the timeliness and comparability of information being collected within Canadian health care facilities.

    What is included?

    The MIS Standards includes

    • A chart of accounts;
    • Accounting principles and procedures;
    • Workload measurement systems;
    • Indicators;
    • Management applications; and
    • A glossary of terms.

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    Who uses the MIS Standards?

    Hospitals and health regions are expected to submit MIS Standards–compliant financial and statistical data relating to hospital services to the Canadian MIS Database. Health regions also submit data on other health service activities. Most provinces and territories submit hospital data through their respective ministries of health. This information can be used to cost the activities of health service organizations, and it forms the basis of management reporting, including annual general purpose financial statements, financial ratio analysis and operational budgeting.

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    Who advises CIHI on the development of and revisions to the MIS Standards?

    The Technical Working Group provides expert technical advice on the development, maintenance and effective implementation of the MIS Standards across the continuum of health service delivery. The working group is composed of CIHI’s MIS Standards team and provincial and territorial MIS coordinators.

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    How do I obtain a copy of the MIS Standards?

    The MIS Standards 2013 is the latest version of the MIS Standards. It will take effect April 1, 2013. Core Plan subscribers can obtain the MIS Standards 2013 for free. To find out whether your organization has already downloaded the MIS Standards or is a Core Plan subscriber, please send an email to orderdesk@cihi.ca.

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    How do I install the files on my computer or network?

    The files are simple to install. Detailed installation instructions are provided in CIHI’s online store.

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    Is there implementation support for the MIS Standards?

    Each province and territory has its own MIS coordinator who is part of the Technical Working Group. Please contact this person first if you need implementation support for the MIS Standards. If further information is required, please send an email to CIHI at fsi@cihi.caor call 613-241-7860 and ask to speak with an MIS Standards consultant.

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    Does CIHI offer education about how to use the MIS Standards?

    The MIS Standards operates using the Folio Views® platform. If you are familiar with using the internet, you should not have much trouble navigating the MIS Standards. Searching for specific information, printing and using hyperlinks are done in similar ways as online.

    New users are also advised to read the section MIS Standards Quick Start Guide, which is accessed from the main menu. You may also find it useful to register for CIHI’s online learning course entitled Navigating the MIS Standards With Folio Views® (MIS). This course is offered free of charge to Core Plan subscribers.

    CIHI offers other self-directed online learning related to the MIS Standards, as well as face-to-face workshops. Please visit CIHI’s Learning Centre to find the course or workshop that is best for you.

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    What is a workload measurement system?

    A workload measurement system (WMS) is a tool for measuring the volume of activity provided by a specific functional centre in standardized units of time. When used with other financial and statistical data (such as on hours, staff and service activity), a functional centre’s workload gives managers a good indication of the amount and kinds of services provided in terms of productivity, utilization and financial indicators. Section 4.4 of the MIS Standards provides an overview of workload measurement systems, including discipline-specific categories of workload and classifications for workload activities.

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    More Questions?

    Please send us an email at fsi@cihi.ca with any other questions or queries that haven’t been addressed here.

     
     
     
     
     
     
     
  • These frequently asked questions accompany the webinar ICD-10-CA Coding Direction for COVID-19 and address some of the most common questions about classifying COVID-19–related cases.

    About COVID-19

    What is COVID-19?

    COVID-19 (coronavirus disease 2019) is a disease caused by a new strain of coronavirus not previously identified in humans.

    • A confirmed COVID-19 case is one that has been diagnosed by a positive COVID-19 lab result. A confirmed COVID-19 case is classified to U07.1 COVID-19, virus identified.
    • A suspected COVID-19 case is one that has been diagnosed clinically or epidemiologically but lab results are inconclusive or not available, or testing is not performed. A suspected COVID-19 case is classified to U07.2 COVID-19, virus not identified.

    COVID-19 documentation

    Is U07.2 or Z03.8 assigned when the physician documents “COVID-19 negative”?

    U07.2 COVID-19, virus not identified is not assigned when the physician documents “COVID-19 negative.” U07.2 is assigned when COVID-19 has been diagnosed clinically or epidemiologically but lab results are inconclusive or not available, or testing is not performed.

    Z03.8 Observation for other suspected diseases and conditions may be assigned in an emergency department encounter when 

    • The patient presents with a sign or symptom (e.g., dry cough); and 
    • The physician documents a diagnosis such as “rule out COVID-19” or “suspected COVID-19”; and 
    • At the time of coding, the coder has access to the COVID-19 lab result, which is negative. 

    It is in this circumstance that the 3 criteria, per the Admission for Observation coding standard, have been met to justify assigning Z03.8:

    • The suspected condition (COVID-19) was ruled out by a negative COVID-19 lab result; and
    • There is no documentation to support that further investigation is required; and
    • Another underlying condition is not documented.

    In an acute inpatient episode of care, when the physician documents “COVID-19 negative,” neither U07.2 nor Z03.8 is assigned. Code assignment is based on the physician’s documented final diagnosis.

    Which code is assigned as the main problem for a patient who presents to the emergency department with a fever when the physician documents the diagnosis as “rule out COVID-19” and the COVID-19 lab results are negative?

    Assign Z03.8 Observation for other suspected diseases and conditions as the main problem. The patient presented with a symptom (fever) and the physician documented the diagnosis in terms of suspected COVID-19. COVID-19 was ruled out with the negative COVID-19 lab result, and another underlying condition as the cause of the sign (fever) was not documented. The 3 criteria, per the Admission for Observation coding standard, have been met:

    • The suspected condition (COVID-19) was ruled out; and
    • There is no documentation to support that further investigation is required; and
    • Another underlying condition is not identified.

    Which code is assigned when multiple COVID-19 lab results are negative for COVID-19 but the physician documents the final diagnosis as “possible COVID-19”?

    The case should be discussed with the physician to determine whether 

    • They documented the final diagnosis before the COVID-19 lab results were back and they have to adjust the final diagnosis accordingly; or 

    • They are aware of the negative COVID-19 lab results, feel the lab results are inconclusive and still suspect COVID-19. 

    U07.2 COVID-19, virus not identified is assigned when COVID-19 is diagnosed clinically or epidemiologically but lab results are inconclusive.

    Is U07.1 COVID-19, virus identified assigned when the patient is transferred from one hospital to another for convalescence following treatment for COVID-19?

    Yes, per the Admission for Convalescence coding standard, assign a code from category Z54 Convalescence as the most responsible diagnosis and assign an additional code, mandatory, as a diagnosis type (3) to indicate the condition for which convalescence is required. In this case, U07.1 (3) COVID-19, virus identified is assigned.

    Which code is assigned when there is documentation that a COVID-19 nasopharyngeal swab was taken but there is no documentation of COVID-19 status (neither suspected nor confirmed), nor is there any documentation of signs and symptoms suggestive of COVID-19?

    Flag the chart and update the code assignment when the lab results are available.

    Which code is assigned when the patient presents to the emergency department with a symptom suggestive of COVID-19 (e.g., sore throat) and a COVID-19 nasopharyngeal swab is taken?

    See the table “Main problem (MP) and other problem (OP) code assignment for emergency department COVID-19–related cases” in the bulletin ICD-10-CA Coding Direction for Suspected COVID-19 Cases. There are examples that demonstrate code assignment for various scenarios: when the patient presents with a sign or symptom and a COVID-19 nasopharyngeal swab is taken and the COVID-19 lab results come back positive, come back negative, or are inconclusive or not available.

    Is U07.1 or U07.2 always the main problem on a NACRS abstract?

    While we would expect to see U07.1 COVID-19, virus identified or U07.2 COVID-19, virus not identified as the main problem (MP) on a National Ambulatory Care Reporting System (NACRS) abstract, there may be circumstances when it is an other problem (OP). When in doubt, submit a coding question via eQuery with a copy of the pertinent de-identified clinical documentation.

    COVID-19 lab results

    Do the lab results specify COVID-19 or coronavirus?

    Coronaviruses (CoVs) are a large family of viruses that cause illness ranging from the common cold to more severe diseases; they include the Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome–associated coronavirus (SARS-CoV). COVID-19 is caused by a new strain of coronavirus. 

    When COVID-19 testing is performed, the lab results will specifically identify whether the swab was negative or positive for COVID-19. The COVID-19 lab results may be used to inform code assignment. That is, a confirmed case of COVID-19, classified to U07.1 COVID-19, virus identified, is determined by a positive COVID-19 lab result and a suspected case of COVID-19 is ruled out by a negative COVID-19 lab result. 

    The direction for coders to use COVID-19 lab results is an exception to the direction provided in the coding standard Using Diagnostic Test Results in Coding. Use the COVID-19 lab results to confirm or rule out COVID-19. When the lab results identify any other causative organism, such as coronavirus HKU or OC43, they may not be used to inform code assignment. In these circumstances, a code is assigned only when the physician documents the diagnosis as due to the causative organism identified in the lab result.

    Do we assign U07.1 COVID-19, virus identified when the COVID-19 lab results are positive for COVID-19 but there is nothing documented by the physician?

    Yes, you may use the positive COVID-19 lab result and assign U07.1 COVID-19, virus identified. Application of diagnosis/problem type will depend on the documented details for the episode of care.

    Does a continuous, uninterrupted episode of care include transfers from another facility?

    Yes, a continuous, uninterrupted episode of care starts at the point the patient first accesses the health care system and runs through the continuum of care until the patient is discharged. For COVID-19, accessing a COVID-19 assessment centre is included in the continuum. As soon as the patient is discharged, the continuous, uninterrupted episode of care ends.

    COVID-19 diagnosis typing

    Can service transfer diagnosis typing — i.e., diagnosis type (W), (X), (Y) — be applied to U07.1 COVID-19, virus identified and U07.2 COVID-19, virus not identified?

    Yes, if your facility tracks service transfers and U07.1 COVID-19, virus identified or U07.2 COVID-19, virus not identified qualifies as the service transfer diagnosis, it is appropriate to apply a service transfer diagnosis type.

    Can diagnosis type (2) be applied to U07.1 COVID-19, virus identified and U07.2 COVID-19, virus not identified?

    Yes, per the Diagnosis Typing Definitions for DAD coding standard, diagnosis type (2) is applied when a condition that arises post-admission has been assigned an ICD-10-CA code and has been determined to meet at least 1 of the 3 criteria for significance. Apply diagnosis type (2) when lab-confirmed COVID-19 or suspected COVID-19 is acquired following admission.

    When another condition such as a stroke qualifies as the most responsible diagnosis, is diagnosis type (1) applied to U07.1 COVID-19, virus identified in a patient who tests positive for COVID-19?

    Per the Diagnosis Typing Definitions for DAD coding standard, diagnosis type (M) is the one diagnosis that can be described as being most responsible for the patient’s length of stay in hospital. If there is more than one such condition, the one held most responsible for the greatest portion of the length of stay or greatest use of resources is diagnosis type (M). When a stroke qualifies as the most responsible diagnosis, diagnosis type (1) may be applied to U07.1 COVID-19, virus identified.

    COVID-19 screening

    When a patient is admitted to an acute care inpatient bed with a diagnosis such as colon cancer or acute myocardial infarction or with injuries due to a motor vehicle crash and hospital protocol is to test (screen) for COVID-19, is Z11.5 Special screening examination for other viral diseases assigned?

    Z11.5 is assigned when the sole purpose of the episode of care is to “screen” for COVID-19. We would expect to see Z11.5 on an emergency department abstract when the encounter is specific to screening for COVID-19 and not on an acute care inpatient abstract. The intent is not to identify all patients who were tested for COVID-19 and for whom the lab result is negative. Z11.5 Special screening examination for other viral diseases is not assigned when the COVID-19 lab result is negative on an acute care inpatient abstract. Code assignment is based on the physician’s documented final diagnosis.

    When a patient is admitted to an acute care inpatient bed with a diagnosis such as colon cancer or acute myocardial infarction or with injuries due to a motor vehicle crash and is tested for COVID-19 because he has a cough and the COVID-19 lab result comes back negative, is diagnosis type (1) applied to R05 Cough?

    Diagnosis type (1) is not applied to R05 Cough when the patient is tested for COVID-19 and the lab result comes back negative. See the criteria for significance in the Diagnosis Typing Definitions for DAD coding standard. A lab test is not one of the criteria for significance.

    COVID-19 follow-up

    Is U07.1 COVID-19, virus identified or Z09.9 Follow-up examination after unspecified treatment for other conditions assigned when a patient who previously tested positive for COVID-19 presents for re-testing that comes back negative for COVID-19? What if the COVID-19 lab result comes back positive again?

    Per the Admission for Follow-Up Examination coding standard, when the purpose of the examination is to assess the status of a previously treated condition and the outcome indicates no need for further treatment, assign the appropriate code from category Z09 Follow-up examination after treatment for conditions other than malignant neoplasms. When the examination reveals that the original condition still exists or has recurred, assign a code for the condition. When a patient who previously tested positive for COVID-19 presents for re-testing and the COVID-19 lab result comes back negative, assign Z09.9 Follow-up examination after unspecified treatment for other conditions. If the COVID-19 lab result comes back positive, assign U07.1 COVID-19, virus identified

    COVID-19 and palliative care

    When a patient with cancer is known to be palliative and also tests positive for COVID-19, are the codes for the cancer also assigned?

    Yes, per the Palliative Care coding standard, assign Z51.5 Palliative care and additional code(s), mandatory, to describe the palliative condition(s). 

    COVID-19 and convalescence

    When a patient is admitted for convalescence and is admitted to an isolation unit as a precaution during the COVID-19 pandemic, is a significant diagnosis type applied to Z29.0 Isolation?

    In this circumstance, Z29.0 Isolation is assigned, optionally, to flag that the patient required isolation, based on the facility’s data needs. When a patient is admitted for convalescence, significance is ascribed to the convalescence and a code is assigned, mandatory, as a diagnosis type (3) to indicate the condition for which convalescence is required.

    COVID-19 resources

    What classification resources are available for COVID-19?

    A number of resources are available on CIHI’s COVID-19 resources web page. Classification resources include the following:

    Clients can find answers to COVID-19–related questions submitted to eQuery by searching eQuery on key words “U07.1,” “U07.2” or “COVID-19.” If you require assistance with coding a specific case, submit your question and pertinent de-identified clinical documentation via eQuery.

    Send your questions about the Canadian Emergency Department Diagnosis Shortlist (CED-DxS) to nacrspicklists@cihi.ca.

Accessing Our Services

  • The first step is to create a CIHI profile, which will allow you to access our products and services. Several applications are available to everyone who has a CIHI profile, including the eQuery tool, the Learning Centre and eStore. A number of other applications, such as eReports, are restricted to only data-submitting or approved non-submitting organizations. Access to these applications depends on whether your organization is entitled to access the data and has a service agreement or licence in place with CIHI.

    Please go to our Create a Profile page to get started.

    Important

    • Please keep your CIHI profile information current to maintain your access. You can make any necessary changes by logging in and clicking Edit Profile in the left-hand navigation menu.
    • If you no longer require your CIHI profile or access to specific applications, please contact CIHI immediately.
    • CIHI profiles are for individual use and cannot be shared.
  • Once you have created a CIHI profile, you can request access to restricted CIHI applications. Log in to your CIHI profile and click Request Access: New/Revoke in the left-hand navigation menu. You can request or revoke access for yourself or others within your organization by completing the mandatory information. You will need to select the program, service, request type and role (if required). For most of our services, you will also need to provide your organization identifier(s) so we can authenticate and process your request.

    Please log in to your CIHI profile to submit a request for access, or contact us at help@cihi.ca for more information. 

  • CIHI’s Learning Centre offers a large number of educational products and services. The courses cover, among other things, how to code data, how to submit data to CIHI, how to use CIHI’s reports and how to use data for decision-making.

    CIHI delivers its education sessions through the following methods:

    • Web conferences: Live, online interactive presentations with discussion
    • Workshops: Face-to-face interactive sessions at locations across Canada
    • Self-study: Interactive elearning courses
    • Downloadable documents
    • Online web conference recordings with learning assessments (where applicable)

    Non–Core Plan users are subject to CIHI’s Learning Centre Pricing Policy.

    Visit our Events and Education page for additional information or email help@cihi.ca.

    eStore

    CIHI’s eStore offers access to CIHI’s products, publications, instruction manuals and other tools. Access to some eStore products is restricted to clients whose organizations have signed a service agreement with CIHI.

    The quantities provided through the Core Plan to health care facilities are determined by the health care facility type, the total number of beds and the annual volume of case abstracts. Some Core Plan elements are subject to confidentiality and privacy restrictions, and are provided taking into account any imposed limitation.

  • Vendor licensing

    CIHI develops products, services and tools to help inform stakeholders and improve the health and well-being of Canadians. Vendors (software developers) must sign a licence agreement to receive CIHI’s products and services. The agreement provides vendors with the CIHI products they need to develop and support their software to meet the electronic submission requirements for our data holdings. Once we receive the signed 3-year licence agreement and annual products selection form, vendors receive our products as they become available.

    For more information on becoming a licensed CIHI vendor, please email help@cihi.ca.

    Vendor testing

    CIHI requires all licensed vendors to submit test files at the beginning of every fiscal year to ensure compliance in applying all new edits for data collection. Additional information about this process is available on the Vendor Licensing page of our website.

    CIHI vendors

    View commercial vendors that have successfully completed testing for the following data holdings:

  • Access according to organization size

    Health facilities can access specific quantities of non-education Core Plan products and services according to their size (small, medium or large). Size is determined based on the total number of beds and/or the volume of case abstracts submitted to any of these CIHI data holdings: Discharge Abstract Database (DAD), National Ambulatory Care Reporting System (NACRS), National Rehabilitation Reporting System (NRS) or Continuing Care Reporting System (CCRS). More information on organization size and entitlements according to size is noted below.

    Hospitals

    Under the Core Plan, hospitals receive products and services relevant to the data holdings they submit to, as well as other health information publications and reports of general interest. A hospital’s size is determined by its total number of beds and the volume of case abstracts submitted to the CIHI data holding it participates in, as follows:

    • Small hospitals: 1 to 199 beds and a volume of no more than 50,000 case abstracts annually
    • Medium hospitals: 200 to 399 beds and a volume of no more than 100,000 case abstracts annually OR 1 to 199 beds and a volume of 50,001 to 100,000 case abstracts annually
    • Large hospitals: 400 or more beds or more than 100,000 case abstracts annually

    Continuing care and rehabilitation facilities

    Under the Core Plan, continuing care/rehabilitation facilities receive products and services relevant to CCRS (RAI-MDS 2.0 ©, interRAI LTCF ©) and NRS, as well as other health information publications and reports of general interest. A continuing care/rehabilitation facility’s size is based on its total number of beds, as follows:

    • Small facilities: 1 to 30 beds
    • Medium facilities: 31 to 99 beds
    • Large facilities: 100 or more beds

    Home care organizations

    Under the Core Plan, home care organizations receive products and services relevant to HCRS (RAI-HC ©, interRAI HC ©), as well as other health information publications and reports of general interest. Due to the home-based nature of their operations, home care organizations are deemed to be small for the purposes of receiving products under the Core Plan.

    Quantities of specific products and services provided to health organizations (according to their size), regional health authorities (or similar) and ministries of health

    Products and services Health organization: Small Health organization: Medium Health organization: Large Region Ministry of health

    * Based on a licence for 5 concurrent users.
    † Based on a licence for 100 concurrent users.

    MIS Standards* 1 1 2 1 2
    ICD-10-CA/CCI 1 1 1 1 1
    Disease/ intervention classifications derivatives 1 1 1 1 1
    Data set and grouping methodology standards tables 1 2 3 1 3
    Publications (electronic) Unlimited Unlimited Unlimited Unlimited Unlimited
    Education (participant) Unlimited (based on availability) Unlimited (based on availability) Unlimited (based on availability) Unlimited (based on availability) Unlimited (based on availability)

    In-house education services

    CIHI’s in-house education services help individual facilities and their staff better use CIHI’s various standards, databases and tools. This unique service allows clients to focus on their specific learning objectives to create an agenda that addresses these areas.

    In addition, all of CIHI’s regularly scheduled workshops can be presented as in-house sessions. Scheduling for in-house education services is subject to CIHI’s availability. For more information about CIHI’s in-house education services, visit CIHI’s Learning Centre or send an email to education@cihi.ca.

     

    RAI-MDS 2.0 © interRAI Corporation, Washington, D.C., 1995, 1997, 1999. Modified with permission for Canadian use under licence to the Canadian Institute for Health Information.

    RAI-HC © interRAI Corporation, Washington, D.C., 1994, 1996, 1997, 1999, 2001. Modified with permission for Canadian use under licence to the Canadian Institute for Health Information.

    interRAI HC © interRAI Corporation, Washington, D.C., 1994–2012. Modified with permission for Canadian use under licence to the Canadian Institute for Health Information. Canadianized items and their descriptions © Canadian Institute for Health Information, 2020.

    interRAI LTCF © interRAI Corporation, Washington, D.C., 1990–2011. Modified with permission for Canadian use under licence to the Canadian Institute for Health Information. Canadianized items and their descriptions © Canadian Institute for Health Information, 2020.

Requesting Data

Data Definitions

  • Personal health information is health information about an individual that identifies the specific individual; that may be used or manipulated by a reasonably foreseeable method to identify the individual; or that may be linked by a reasonably foreseeable method to other information that identifies the individual.

  • Aggregate-level data is summed and/or categorized data that can answer research questions about populations or groups of organizations. The data has been compiled from record-level data to a level that ensures the identities of individuals or organizations cannot be determined by a reasonably foreseeable method.

  • Record-level data is data in which each record is related to a single individual or organization.

Data Storage, Retention and Secure Destruction

  • According to the Non-Disclosure/Confidentiality Agreement, you must destroy or return all third-party data, as well as any copies made, within 1 year of publishing any work or 3 years after receiving record-level data (whichever comes first). CIHI does not require aggregate data to be returned.

  • In exceptional circumstances, it may possible to retain data for longer than 3 years. A request for an extension must be made in writing to CIHI.

  • Yes. In compliance with the Non-Disclosure/Confidentiality Agreement, recipients of CIHI data must take all reasonable measures to avoid residual disclosure of the identity of individuals or health facilities.

  • Yes. Any publications resulting from data provided by CIHI must cite CIHI as the source of the data and must indicate that the results or views expressed are those of the author(s).

  • For record-level data, the institution or organization requesting CIHI data is ultimately accountable for protecting the data and complying with the terms and conditions in Section 11 of the Non-Disclosure/Confidentiality Agreement. If, for any reason, the data is to be moved or relocated from the organization/institution, CIHI must be informed in writing prior to the move. CIHI follows up with third-party requestors to ensure secure destruction of record-level data at the end of its term.

  • Yes. The requirements for the secure destruction of CIHI record-level data are set out as part of the data request process. Question 7 of CIHI’s record-level Data Request Form requires the recipient of CIHI data to outline the approach (and/or methods) that will be used to securely destroy the data.

    At the end of the retention period, data must be securely destroyed in compliance with the Non-Disclosure/Confidentiality Agreement. Recipients of CIHI data, supervisors (in the case of GSDAP students) and ultimately the institution or organization will be asked to provide CIHI with a certificate of destruction, which certifies the completion of the secure destruction activity and sets out the date, time, location and method of secure destruction employed. A template for the certificate of destruction is available upon request from CIHI.

  • Secure destruction of record-level data refers to the destruction of the data in such a manner that reconstruction is not reasonably foreseeable in the circumstances, as defined in Section 18 of the Non-Disclosure/Confidentiality Agreement. Industry best practices for the secure destruction of data are constantly evolving; this is particularly true for data in electronic format. For general information about secure destruction methods, please review the fact sheet available from the Information and Privacy Commissioner of Ontario. This fact sheet includes suggested best practices for the destruction of personal information. More information about CIHI’s current secure destruction requirements is available upon request.

The Graduate Student Data Access Program