What Do States What Do States Want in Web-Want in Web-

MICAR?MICAR?

Donna Glenn & Steven Donna Glenn & Steven RushingRushing

National Center for Health National Center for Health StatisticsStatistics

July 2006July 2006

What is Web-MICAR?What is Web-MICAR?

• Web-MICAR is the planned Web-MICAR is the planned (re-)development in the MMDS software (re-)development in the MMDS software which brings the MMDS suite more in which brings the MMDS suite more in sync with current (or recent) sync with current (or recent) technologies by integrating web-based technologies by integrating web-based functions with the current MMDS functions with the current MMDS functionality.functionality.

• Web-MICAR is currently in the design Web-MICAR is currently in the design stage and so many different ideas are stage and so many different ideas are being discussed and examined.being discussed and examined.

So, what are we talking So, what are we talking about?about?

• The range of options being discussed is fairly The range of options being discussed is fairly broad.broad.

• Some ideas call for Some ideas call for small stepssmall steps, relatively , relatively minor additions which will not require drastic minor additions which will not require drastic changes in operation or (hopefully) lengthy changes in operation or (hopefully) lengthy amounts of programming time but will produce amounts of programming time but will produce noticeable improvements in use of the systemnoticeable improvements in use of the system

• Other ideas include Other ideas include huge leapshuge leaps, which will , which will substantially change many MMDS features and substantially change many MMDS features and require extensive programming and resources.require extensive programming and resources.

Examples! Give us some Examples! Give us some examples!!examples!!

• The following are some ideas we are The following are some ideas we are working on.working on.

• Please keep in mind, these are just Please keep in mind, these are just ideas at this stage. They are notions ideas at this stage. They are notions in design stage, so details will be in design stage, so details will be likely to change somewhat as actual likely to change somewhat as actual work gets underway.work gets underway.

• They will also change as the result of They will also change as the result of input from people like you.input from people like you.

Small Step: Send to Small Step: Send to NCHSNCHS

• This change would add a Send to NCHS This change would add a Send to NCHS menu item which would actually, in fact, menu item which would actually, in fact, send the batch to NCHS using the web. send the batch to NCHS using the web.

• It would be a transfer similar to the current It would be a transfer similar to the current SDN method, utilizing similar levels of SDN method, utilizing similar levels of protection and encryption for security, but protection and encryption for security, but would automatically handle a lot of the input would automatically handle a lot of the input such as which file to be sent and so forth.such as which file to be sent and so forth.

• A log would be generated noting the date A log would be generated noting the date and time the file was sent, and likely kept and time the file was sent, and likely kept with the file.with the file.

Small Step: Retrieve FileSmall Step: Retrieve File

• This feature would be added to MMDS This feature would be added to MMDS as a menu item. It would automate the as a menu item. It would automate the process of retrieving files such as process of retrieving files such as TRANSAX files from NCHS.TRANSAX files from NCHS.

• Again, much of the functions and Again, much of the functions and security of the current SDN would be security of the current SDN would be included, just made easier and included, just made easier and integrated with the already existing integrated with the already existing MMDS paths setup.MMDS paths setup.

Small Steps: Automatic Small Steps: Automatic UpdatesUpdates

• This feature would automate the distribution This feature would automate the distribution and installation of new MMDS versions.and installation of new MMDS versions.

• Your system would automatically notice new Your system would automatically notice new releases, likely prompt you to confirm you releases, likely prompt you to confirm you want to update, and then install the updates want to update, and then install the updates for you, without the need of a CD release for you, without the need of a CD release and all that hassle.and all that hassle.

• It might also read your current configuration It might also read your current configuration and setup the new installation to use a and setup the new installation to use a similar installation, prompting you to similar installation, prompting you to confirm.confirm.

Small Step: Web-based Small Step: Web-based InstallsInstalls

• This is similar to the automatic updates but This is similar to the automatic updates but would be designed for installing the MMDS would be designed for installing the MMDS system on a new PC using the web.system on a new PC using the web.

• We are already planning to move now to We are already planning to move now to releasing new versions using the web and releasing new versions using the web and our web site at our web site at http://www.cdc.gov/nchs/about/major/dvs/medsof.hhttp://www.cdc.gov/nchs/about/major/dvs/medsof.htmtm which is how MMDS 2006.03 which is how MMDS 2006.03 (ACME only update) was released and likely (ACME only update) was released and likely how 2007.01 will be released as well.how 2007.01 will be released as well.

Small Step: Small Step: Troubleshooting LogTroubleshooting Log

• This will add a menu item which will This will add a menu item which will automatically email a file to our help automatically email a file to our help desk desk MICAR@CDC.GOVMICAR@CDC.GOV containing containing useful info we can use to help diagnose useful info we can use to help diagnose any problems you have with the MMDS any problems you have with the MMDS system.system.

• This should speed things up in terms of This should speed things up in terms of figuring out what went wrong and why, figuring out what went wrong and why, in those, obviously, rare (very rare in those, obviously, rare (very rare actually, almost never happens) actually, almost never happens) moments when MMDS has problems. moments when MMDS has problems.

Small Steps: FastTRAXSmall Steps: FastTRAX

• This feature would produce a partial This feature would produce a partial TRANSAX file right away, filled with the TRANSAX file right away, filled with the records the system processes automatically records the system processes automatically without need for manual coding.without need for manual coding.

• Currently, the typical file has between 80-85% Currently, the typical file has between 80-85% of its records process automatically without of its records process automatically without needing reject coding for Underlying cause or needing reject coding for Underlying cause or Multiple causes. Those “good records” stay Multiple causes. Those “good records” stay with the rejects until all the records are coded.with the rejects until all the records are coded.

• Using FastTRAX, states could get their 80-85% Using FastTRAX, states could get their 80-85% right away and only wait for NCHS to return right away and only wait for NCHS to return the rejects.the rejects.

Small Steps: Unified Small Steps: Unified TRANSAXTRANSAX

• This feature would involve a revised record This feature would involve a revised record format, but it would incorporate the format, but it would incorporate the SuperMICAR literals all through the system. SuperMICAR literals all through the system.

• The final TRANSAX file would include then The final TRANSAX file would include then both the original literal text from both the original literal text from SuperMICAR and the ICD codes already in SuperMICAR and the ICD codes already in TRANSAX.TRANSAX.

• This one unified file would make searching This one unified file would make searching and querying the records much simpler in and querying the records much simpler in practice.practice.

Huge Leap: Record Huge Leap: Record ProcessingProcessing

• This revision would step away from batch This revision would step away from batch processing, treating each record individually processing, treating each record individually and automating most of the transfer of data and automating most of the transfer of data to totally behind the scenes.to totally behind the scenes.

• One record would be flowing through the One record would be flowing through the system while the next record was being system while the next record was being entered.entered.

• Records needing manual intervention would Records needing manual intervention would pop-up to specified users almost like pop-up to specified users almost like receiving an email that they would then open, receiving an email that they would then open, code, send and move on to other things.code, send and move on to other things.

Huge Leap: Truly Webbed Huge Leap: Truly Webbed MICARMICAR

• This revision would eliminate the need, but This revision would eliminate the need, but not the option, to have a large MMDS suite not the option, to have a large MMDS suite installed on your system. installed on your system.

• A smaller system would be installed and it A smaller system would be installed and it would rely on web access to an MMDS server would rely on web access to an MMDS server for most processing functions. In case of for most processing functions. In case of internet outage, files would be cached until internet outage, files would be cached until access was restored.access was restored.

• Another option would be for you to use no Another option would be for you to use no MMDS system on your PC and simply point a MMDS system on your PC and simply point a browser to an NCHS server, where you could browser to an NCHS server, where you could log in and do data entry and perhaps coding. log in and do data entry and perhaps coding.

The Big QuestionThe Big Question

•What Do You Want?What Do You Want?• We have some ideas, as you have We have some ideas, as you have

seen, but first tell us what you want.seen, but first tell us what you want.• Which of these features would be of Which of these features would be of

use to you?use to you?• Which ones would concern you?Which ones would concern you?• What ideas other than these do you What ideas other than these do you

have?have?

How do you tell us what you How do you tell us what you want?want?

• You can fill out the questionnaire we have You can fill out the questionnaire we have provided to you today and return it to us provided to you today and return it to us here at the conference.here at the conference.

• You can take it home and mail it back to You can take it home and mail it back to us at NCHS. Address follows on the next us at NCHS. Address follows on the next slide.slide.

• You can download a copy from the web You can download a copy from the web site at site at http://www.cdc.gov/nchs/about/major/dvs/medsof.htmhttp://www.cdc.gov/nchs/about/major/dvs/medsof.htm

and email it to use at MICAR@CDC.GOVand email it to use at MICAR@CDC.GOV

Our Mailing AddressOur Mailing Address

• Send physical “snail mail” toSend physical “snail mail” to

Steven RushingSteven Rushing

NCHSNCHS

PO Box 12214PO Box 12214

Research Triangle Park, NC 27709Research Triangle Park, NC 27709

Join the DiscussionJoin the Discussion

• You can download this slide You can download this slide presentation at our website along presentation at our website along with the questionnaire at with the questionnaire at http://www.cdc.gov/nchs/about/major/dvs/medsofhttp://www.cdc.gov/nchs/about/major/dvs/medsof.htm.htm

• You can also engage in or observe You can also engage in or observe ongoing discussion at our Web-ongoing discussion at our Web-MICAR Yahoo group at MICAR Yahoo group at http://groups.yahoo.com/group/Webhttp://groups.yahoo.com/group/WebMICAR/MICAR/