N.M. Admin. Code § 7.1.20.7

Current through Register Vol. 35, No. 21, November 5, 2024

Section 7.1.20.7 - DEFINITIONS

In addition to the definitions in the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, the following definitions apply for purposes of this rule.

A.Access level means a set of information or data maintained as part of the health information system which may be released to requestors pursuant to this rule, including:

(1) aggregate analysis;

(2) consumer health information report;

(3) research database;

(4) analytical database;

(5) linking database.

B.Aggregate analysis means information in report form that contains data combined in a manner which precludes specific identification of a single patient or health care provider.

C.Analytical database means a set of annual permanent data based on individual patient hospital discharge abstract data or any other database collected under the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, that excludes all identifiers of individual patients and health care professionals.

D.Annual permanent database means one calendar year of permanent hospital inpatient discharge data or any other database collected under the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, that is deemed complete by commission staff.

E.Consumer health information report means a report that provides the public with information on which to base health care purchasing decisions, published by the commission pursuant to Sections 24-14A-3 D(11) and 24-14A-3.1D(2) of the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, and 7 NMAC 1.22 [now 7.1.22 NMAC].

F.Data provider means a data source that has provided data to the health information system on a regular basis.

G.Data source has the meaning given in Section 24-14A-2 of the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, and includes those categories of persons or entities that possess health information, including any public or private sector licensed hospital, health care practitioner, primary care clinic, ambulatory surgery center, ambulatory urgent care center, ambulatory dialysis unit, home health agency, long-term care facility, pharmacy, third-party payer and any public entity that has health information.

H.Director means the director of the commission.

I.Federal agency means any agency, department, bureau, board, commission, institution or other organization of the United States government.

J.Governing agreement means either a joint powers agreement or a contract signed by the director with approval of the commission.

K.Health care means any care, treatment, service or procedure to maintain, diagnose or otherwise affect an individual's physical or mental condition.

L.Health care professional means any individual licensed, certified or otherwise authorized or permitted by law to provide health care in the practice of a profession.

M.Health care provider means any individual, corporation, partnership, organization, facility, institution or other entity licensed, certified or otherwise authorized or permitted by law to provide health care in the ordinary course of business or practice of a profession.

N.HEDIS® data elements means the rate, numerator, denominator, size of the eligible population and data collection methodology for non-tabular measures that are reported as percentages and are contained in the health plan employer data and information set published by the national committee for quality assurance (NCQA). NCQA registered trademark.

O.Health information system or HIS means the health information system established by the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978.

P.HIS advisory committee means the committee the commission establishes pursuant to Section 24-14A-3.1 of the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978.

Q.Hospital inpatient discharge data (HIDD) clinical file means the subset of reported hospital inpatient discharge data containing demographic, medical, inpatient stay and payer information.

R.Hospital inpatient discharge data (HIDD) confidential file means the subset of reported hospital inpatient discharge data containing identifiers of individual patients and health care professionals.

S.Identifier means any information that reveals the identity of, or could reasonably be used to reveal the identity of, a single patient, data provider or health care provider, but does not include a number assigned to a single patient for the purpose of conducting longitudinal or linking studies.

T.Linked file means the data that results from the co-joining of the linking database with another database.

U.Linking database means the available set of permanent hospital inpatient discharge data based upon individual patient hospital discharge abstract data or any other database collected under the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, that may contain specific patient or health care provider demographic and clinical information. The linking database also includes identifiers used solely in accordance with 7.1.20.13 NMAC for the purpose of linking to other existing health data.

V.Patient means a person for whom health information is contained in the health information system.

W.Permanent hospital inpatient discharge data means hospital inpatient discharge data contained in a data set created by the commission after the submitting data provider has either (1) reviewed and approved a commission statistical report based on the data provider's patient discharges, or (2) been provided a 30 day period to review the commission's statistical report.

X.Proprietary information means confidential technical information, administrative information, and/or business methods that are the property of the data provider and are perceived to confer a competitive position in the health care market by not being openly known by competitors.

Y.Requestor means a person who makes a request for access to health information system data or reports pursuant to this rule.

Z.Research database means a set of annual permanent data based on individual patient hospital discharge abstract data or any other database collected under the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, that excludes all identifiers of individual patients, health care providers, and third-party payers of health care.

AA.Research organization means an organization that conducts health-related research and that is recognized by the commission as a source for information that is useful for consumer health care decision making or for development of public policy related to health.

BB.Routine report means a report that contains information of use to the general public that is issued by the commission on its own initiative and not in response to a specific, individualized request.

CC.State agency means any agency, department, bureau, board, commission, institution or other organization of a state government, including state educational institutions and political subdivisions. "State agency" does not include any health care facility operated by a state agency.

N.M. Admin. Code § 7.1.20.7

8/30/1997; 7.1.20.7 NMAC - Rn & A, 7 NMAC 1.20.7, 3/31/2008