Maine CODES Project Crash Outcome Data Evaluation System

1
Maine CODES Project(Crash Outcome Data
Evaluation System)

• Rules on Access to Maine CODES Linked Data and
  Summary Reporting

2
Maine CODES Linked Data Access Process Background

• CODES Linkage
• Unit record police crash file information
  identifying individuals involved in Maine crashes
  are linked to unit record medical data files.
  Resulting CODES data base contains personal
  identifiers.
• Linkage is performed at ODRVS, with consultation
  from MHIC, using CODES2000 software provided by
  NHTSA.
• For special projects for NHTSA, linkage is also
  performed at the MHIC using CODES2002 software
  using imputation techniques required by NHTSA.
• Maine rulings related to access to unit record
  medical data
• 90-590 Maine Health Data Organization, Chapter
  125 Health Care Information That Directly
  Identifies an Individual
• 90-590 Maine Health Data Organization, Chapter
  120 Release of Data to the Public
• 10-146 Office of Data, Research and Vital
  Statistics, Chapter 4 Public Access to Vital
  Records

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Maine CODES Linked Data File Users
Maine State Police MCRS with VIN
Office of Data, Research, and Vital Statistics
(ODRVS) Death Certificates
Maine EMS EMS files - prepared by MHIC
Maine Department of Transportation(MDOT) Crash
files
Maine Health Data Organization (MHDO) Inpatient
Outpatient Claims Data Bank
ODRVS Restricted Unit-Record Linked CODES Data
File (includes personal identifiers in health
care and crash data)
Key Organizations / Users 1. Maine Users -
Advisory Committee MHIC, MDOT, Public Safety,
MHDO, ODRVS, MMC-Dr. Clark, Bureau of Motor
Vehicles, Maine Injury Prevention Program 2.
National Highway Traffic Safety Administration
(NHTSA) 3. Maine Health Information Center
(MHIC)
SUMMARY REPORTS a) with geographical
restrictions b) without geographical restrictions
ODRVS Unrestricted Unit-Record Linked CODES Data
File (no personal identifiers in health care and
crash data)
4
CODES Restricted Data Elements
5
Maine CODES Linked Data Request Process
ODRVS Unrestricted Unit-Record Linked CODES Data
File (no personal identifiers)
ODRVS Restricted Unit-Record Linked CODES Data
File (includes personal identifiers)
Request for access to restricted unit-record
CODES data file a) Requestor defines in writing
uses of restricted unit record data, identifies
individuals using the data, and receives approval
from each agency providing medical data (ODRVS,
MHDO, EMS). Signatures of users required. b)
Linked data is provided to requestor by ODRVS and
members of the CODES Advisory Committee are
notified of request. A charge for the data is at
the discretion of ODRVS. c) Data cannot be
re-released to any other individual or entity.
Request for access to unrestricted unit record
CODES data file a) Requestor completes CODES
Unrestricted Unit Record Request Form. Form is
sent via email to ODRVS, MHDO, EMS, and the other
members of Maine CODES Advisory Committee. b) If
no objections are registered by ODRVS, MHDO or
EMS within 10 days, data is provided to requestor
by ODRVS. A charge for the data is at the
discretion of ODRVS. c) Data cannot be
re-released to any other individual or entity.
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Maine CODES Summary Reporting Restrictions

• Summary Reports
• Summary reports may not be generated that
  indirectly identify individuals.
• Geographical reporting restrictions when the
  count is 1
• Reporting by county or hospital service area is
  permitted.
• Reporting a count of 1 by place of residence is
  prohibited based on Chapter 120 to when the
  place of residence is coded at a level that
  includes populations of 20,000 persons or less,
  except to the extent that the MHDO may, by order,
  approve the use of health planning, regulatory,
  or research areas containing smaller populations.
• Portland, Lewiston, Bangor, South Portland,
  Auburn, Brunswick, Biddeford, Sanford meet the
  20,000 criteria all other Maine communities must
  have a count of 2 or more to be reported.
• While no rules exist concerning the geographical
  location of the crash because that is not part of
  a medical record, once it is linked to a medical
  record it may lead to the indirect identification
  of the patient. Therefore, the same restrictions
  for reporting by patient residence must be
  applied to the reporting by geographical location
  of the crash.

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Meeting NHTSAs Requests

• NHTSA is a public health authority
• NHTSA published notice to inform hospitals and
  other organizations of its status as a public
  health authority under the medical privacy
  requirements of the Health Insurance Portability
  and Accountability Act of 1996. Federal
  Register, Vol. 68, No. 59, Thursday, March 27,
  2003 notices page 15039.
• As a public health authority, NHTSA is entitled
  to receive protected health information from
  hospitals and other health care organizations,
  without written consent or authorization.
• NHTSAs access to Maine CODES data
• NHTSA has contracted with the MHIC as part of the
  national CODES Data Network projects to provide
  CODES reports and data.
• NHTSA requests require linkage using imputation
  techniques. These techniques are done at the
  MHIC but not at ODRVS.
• NHTSA will be required to prepare a request to
  ODRVS, MHDO, and EMS if NHTSA needs access to the
  restricted unit-record data. MHIC will be
  responsible for providing NHTSA with approved
  copies of the linked data set.
• The MHIC will inform the Advisory Committee
  (which includes the data source agencies) of
  NHTSA data requests and results.