Updated January 2018

 

Symptom Management - ESAS-r

Entity
Data Element
Definition
Format
Valid Values
Purpose and Use
Changes

ESAS-r

Medical Record Number

Patient identifier code that is unique within the healthcare facility.

CHAR 10 Alpha-numeric.

Consistent with CIHI NACRS and DAD definition and format.

Uniquely identifies a patient within an RCC.  Necessary to determine case. Foundational to most measures and indicators.

 

ESAS-r

 

CIHI Master Number

MOHLTC Master Number identifying the hospital site where this visit occurred.

CHAR 4 Numeric.

Same as CIHI's Institution Number for NACRS or DAD submissions, but does not include CIHI's provincial identifier digit. For current valid MOHLTC facility numbers, see Appendix A.

Uniquely identifies the hospital reporting this patient. Data element is configured when new sites are created on ISAAC.

 

ESAS-r

 

Health Card Number

Patient's most recent health insurance number assigned by their provincial government of residence.

CHAR 10 Alpha-numeric.

The following values are only to be used when unable to provide a Health Card Number.

0 - insured resident of reporting province, but HCN not available.

1 = not applicable, includes: out of province resident with unavailable HCN,

out of country, no health insurance coverage from province of residence.

Used to further identify unique patients and link to existing databases as well as determine if same patients are being treated across CCACs and cancer centres. Will facilitate the linkage of the CCAC and hospital results. In addition, CCACs may use this number as their unique patient identifier.

 

ESAS-r

 

Assessment Date

Date assessment completed.

YYYYMMDD

Valid dates only.

Necessary to track patient changes over time.

 

ESAS-r

 

Pain

Patient perception of pain.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

 

 

ESAS-r

 

Tired

Patient perception of tiredness.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

 

 

ESAS-r

Drowsy

Patient perception of drowsiness.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

   

ESAS-r

 

Nausea

Patient perception of nausea.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

 

 

ESAS-r

Appetite

Patient perception of appetite.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

   

ESAS-r

Dyspnea

Patient perception of shortness of breath.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

   

ESAS-r

 

Depression

Patient perception of depression.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

 

 

ESAS-r

 

Anxious

Patient perception of anxiety.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

 

 

ESAS-r

 

Well Being

Patient perception of well being.

CHAR 2 Numeric.

0,1,2,3,4,5,6,7,8,9,10

 

 

ESAS-r

 

Assessment Location

Location where ESAS-r assessment took place.

CHAR 2 Alpha-numeric.

CP - Clinic - Paper

CT - Clinic - Telephone

CO - Clinic - Other

HE - Home - Electronic

CE - Clinic - Electronic

Required to measure where assessments are occurring for planning for electronic tool. HE and CE are automatically generated by the system.

 

ESAS-r

CPSO number

Physician identifier code used by the hospital, which is an optional entry upon registration on ISAAC.

 

Numeric (5 numbers)

MD-level reporting, aggregate reports

Fiscal 2018/19