6. Core data elements

This section outlines the minimum set of data needed to use the Value Points tool. This data set can be used on any software system and lists the data elements relevant for service delivery and for populating indicators and performance metrics. Figure 1 is a schematic drawing that describes process of data capture, calculation of new datapoints, data transformation of developing performance metrics and calculation of performance indicators.

Highlighted in green are the data elements which are expected to be available for the implementation of the VP tool. These are obtained during the process of registration of the mother and at each following MNCH visit (ANCs, delivery, PNCs). These required data elements are a subset of the full list of data elements described in “Digital Adaptation Kit for Antenatal Care: Operational requirements for implementing WHO recommendations in digital systems”. These required data elements are listed in the table Core data elements – One time collection at registration and Core data elements – Repeat collection during each visit.

Highlighted in purple are data elements calculated based on the core data elements to construct the patient information table Fig. 3 and patient timeline table Fig. 2. These calculated data elements are listed in Table 2.

Highlighted in orange is the step where the value points per patient are calculated. The data elements added to facilitate this data transformation are excluded from this DAK (and thus not in Table 1) as they are not relevant for the end-user. More details on these this step can be found in L3.

Highlighted in Yellow are the data elements calculated for the risk table and for allocation of value points to clinics. This is further described in “Indicators and performance metrics” section.

Core data elements – One time collection at registration

Data element ID	Data element name	Description and definition
Patient_id	Patient ID	Unique identifier of a patient.
birth_date	Date of birth	Birthday of the patient.
EDD	Estimated date of delivery	The estimated date of delivery for the current pregnancy.
Gravidity	Previous pregnancy	Whether a mother has had a previous pregnancy or not.
Gestational_history	Previous complications	Any complications that occurred during a previous pregnancy.
Clinical_history	Current health conditions	Any health conditions the mother currently has.

Table 1. Core data elements – Repeat collection during each visit

Data element ID	Data element name	Description and definition
Patient_id	Patient ID	Unique identifier of a patient.
Encounter_id	Encounter ID	Unique identifier of an encounter.
visit_provider_id	Provider / clinic ID	Unique identifier of a provider/clinic.
visit_provider_name	Provider / clinic name	Name of a provider/clinic.
event_time	Event time	Date and time when the event happened.
code	Service ID	Identifier of provided service.
system	System	Global standard used for code.
type	Event type	Event type.
description_name	Event description	Event description.
visitType	Visit type	Visit type, being ANC, Delivery, PNC, Immunization, or Other.
visit_type_code	Visit type unique ID	SNOMED code for the visit type (ANC, Delivery, PNC, Immunization, or Other).
account_id	Account ID	TBD
value_date_time	Value date time	TBD Observation result in date format.
value_string	Value string	TBD Observation result in text format. So positive/negative for a test, or a number when measuring something.

Table 2. Calculated data elements for the patient timeline table and patient information table

Calculated data element label	Data element description	Core data elements used for calculation (i.e. the variables)
Patient information table
Age at enrolment	The age of the mother at the date of enrolment. This age is used for age classification.	Date of birth - Current date
Patient timeline table, data element calculated per event
Visit number	The accumulated number of visits to a specific clinic at that event.	Encounter ID
Visit type number	The accumulated number of visits of the type of visit during this event. E.g. the total number of ANC type visits after an event that was an ANC visit.	Encounter ID - Visit type code
Gestation week	Gestational week on the date of the event.	EDD - Current date

The patient timeline table

To use the VP tool, the patient’s journey over time needs to be tracked. This means that most important information is captured in a table that tracks each procedure, treatment, or diagnosis that a patient receives over time. This is the patient timeline table (Fig. 2). The patient timeline table is created based on the following FHIR resources: Patient, Procedure, Condition, Encounter, Observation, Organization.

Each row in the table represents an unique event that occurred for the patient, for example the diagnosis of a condition or provision of a procedure. As such, multiple events can occur during a single visit of a mother to a clinic. Events are organised in chronological order. The data elements within the green box are part of the core data elements, meaning they are expected to be obtained during the registration process or during a visit. The data elements within the purple box are calculated based on the core data elements.

The patient information table

The patient information table mostly shows data elements part of the core data elements list. Based on these data elements, what is calculated in the age at enrolment. The data elements within the purple box are calculated based on the core data elements. Figure 3: The Patient Information Table

Additional considerations for adapting the data dictionary

[CHRIS AND NEEMA TO CHECK IF THERE ARE ANY OTHER CONSIDERATIONS]