diabetes prevention program dataset – session 2 of 2 special diabetes program for indians diabetes...

Diabetes Prevention Program Dataset – Session 2 of 2

SPECIAL DIABETES PROGRAM FOR INDIANS Diabetes Prevention Program: Year 5 Meeting 1

July 29, 2009


Overview• Close-Out Submission• Three Participant Groups• New Forms• Transition Group Forms• Transition Year Submission Instructions• Exercise: Using the new forms


July 28, 2009 – OMEGA, NO SUBMISSION August 4, 2009 – GAMMA, NO SUBMISSION

August 11, 2009 – OMEGA, CLOSE-OUT SUBMISSIONAugust 18, 2009 – GAMMA, CLOSE-OUT SUBMISSION

August 25, 2009 – OMEGA, FIRST NEW FORMSSept. 1, 2009 – GAMMA, FIRST NEW FORMS

Upcoming Submissions


Close-Out Submission Instructions

• Submit ALL forms that were completed before August 1, 2009 (if possible).

• Submit partial I2/I3 forms for all participants included on Close-Out list. (The Close-Out list will be emailed to grant programs on 7/30/09.)

August 11 or 18


Close-Out Submission Instructions• Track all of the forms you are submitting

(not including partial I2/I3 forms) on the current Tracking Logsheet – B1/B2/B3, F1/F2/F3, A1/A2/A3, and M1 forms.

• The Close-Out list will serve as the Tracking Logsheet for the partial I2/I3 forms


Close-Out Submission Instructions• Use the current submission process

(email subject line with Registry_log, HIPAA certification statement in body, etc.) EXCEPT:1) Do not attach the Excel Registry

2) Attach both the Tracking Logsheet and the Close-Out list


• The Close-Out list is a list of all participants who have not been changed to inactive status as of July 31, 2009. (That is, no I3 form has been submitted to change the participant’s status from active to inactive.)

Close-Out List - Defined Close-Out Submission Instructions


• Submit Page 1 of the I2 form for all participants on the Close-Out list.

• Submit other pages of the I2 form only if the pages contain information on attendance for any time between January 2009 through July 2009.

Partial I2/I3 forms Close-Out Submission Instructions


• Do NOT submit the I3 form unless: 1) The participant has become inactive, then submit pages 3 and 4 AND/OR 2) There are new retention efforts listed in the retention table from January 2009 through July 2009, then submit only those pages listing new retention efforts.

Partial I2/I3 forms Close-Out Submission Instructions


Three Participant Groups: Who Uses Which Form?

Transition Group Original Group New Group

Participants enrolled prior to August 1, 2009, with at least one annual assessment by July 31, 2009, will use the new forms as of August 1, 2009.

Participants enrolled prior to August 1, 2009, with no follow-up and/or annual assessment by July 31, 2009, will remain on the old forms through the completion of their first year annual assessment, then switch to the new forms.

Participants enrolled on or after August 1, 2009, will use the new forms only.


New FormsVisit Form(s)

Baseline C1C2

Ongoing (Attendance) P1.D

Post-DPP Class C1C2

Annual C1C2

Mid-Year M1.D

As needed (Retention) P2.D


Transition Group Forms

Visit Form(s)

Follow-Up Assessment F1.D.03F2.D.03F3.D.03

Ongoing (Attendance) P1.D

Year 1 Annual(After Year 1 use new forms)

A1.D.03A2.D.03A3.D.03

As needed (Retention) P2.D


Transition Year Submission Instructions

• E-mail is required - no attachments• NO EXCEL REGISTRY• Important – Use correct e-mail subject line

• NDPID#.Site# E_SUB MM.DD.YYYY• Example: 55101.1 E_SUB 09.01.2009

• Body of the e-mail only needs a statement that you have nothing to submit

If you DO NOT have any forms to submit:



Transition Year Tracking Logsheet•Left side – New forms for New AND Original participants•Right side – Original forms for Transition participants

If you DO have forms to submit:



Important note about the P1 (Attendance) form:•Submit the P1 form with each Post-DPP Class Assessment and Annual Assessment for New or Original Participants

•Submit the P1 form with each Follow-Up Assessment and Year 1 Annual Assessment for Transition participants




Important note about the P2 (Retention) form: •The P2 form is only submitted when a participant becomes inactive or when an inactive participant returns to the DP Program•Whenever a P2 form is submitted, also submit the P1 (Attendance) form



Email submission•E-mail subject line: 55101.1 E_Sub 09.01.2009•Attach the Transition Year Tracking Logsheet to your e-mail – NO EXCEL REGISTRY•Ask another staff member to check the forms and make sure they have been de-identified. •That staff member should then add a certification statement to the e-mail stating he/she found no PHI•Send the submission email with the certification to the Coordinating Center on your scheduled dates

Transition Year Submission InstructionsIf you DO have forms to submit:


Package Preparation•Double-check that the forms to be submitted match those listed on the printed Transition Year Tracking Logsheet.•Mail the package containing the de-identified forms and a copy of the Tracking Logsheet to the Data Coordinator at the Coordinating Center. • Do NOT send blank tracking logsheets – only send a package if you have completed forms to submit.

Transition Year Submission InstructionsIf you DO have forms to submit:


Transition Submission Instructions

• HIPAA B disclosure form is required and must be signed by each participant

• HIPAA Violations occur when Protected Health Information (PHI) is sent to the Coordinating Center

HIPAA


Transition Submission Instructions

• Most Common PHI/HIPAA Violations to AVOID:• Full date of death or birth• Participant names written on forms• Lab print outs with participant names• Participant names in the file path of the footers• Sticky notes with participant names• Participant signatures

HIPAA: PHI


Learning Exercise – Practice Using the New Forms!


Q & A

diabetes prevention program dataset – session 2 of 2 special diabetes program for indians diabetes...

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