A Framework and Standardized Methodology for Developing Minimum
Clinical Datasets
Piper A. Svensson-Ranallo, MHI1, Terrence J. Adam, MD, PhD1,2, François Sainfort,
PhD1,3
1Institute for Health Informatics, University of Minnesota, Minneapolis, MN;2College of
Pharmacy, University of Minnesota, Minneapolis, MN; 3School of Public Health, University
of Minnesota, Minneapolis, MN
Abstract related to a single clinical condition,2,3 procedure,4,5
specialty,6-8 discipline1,9 or healthcare process;10,11 to
The concept of the minimum dataset (MDS) is taking
that of a comprehensive and inclusive set of data
on an increasingly important role in healthcare. In
elements related to an entire domain of healthcare
the current environment of health information
(e.g.: the United States’ Long Term Care Minimum
exchange and universal implementation of electronic 12 the UK’s Mental Health Minimum,Dataset
health records, work related to the development of 13
Dataset, and New Zealand’s General Practice
one specific type of MDS, the minimum clinical 14).Minimum Dataset
dataset (MCDS), is beginning to permeate the
literature. While there is currently no unified This paper focuses on the subset of MDSs developed
definition of either an MDS or an MCDS, an MDS is for collecting data during the routine process of care:
generally agreed to be a coherent set of explicitly the minimum clinical dataset, or MCDS. Using
defined data elements. Despite the growing body of Berwick’s15 framework of quality, we define a
literature on MCDSs, very little empirical evidence MCDS as an MDS developed for, used by, and
exists in the literature related to best methods for targeting actions that occur at the ‘microsystem’ level
developing them. The primary objective of the of healthcare. According to Berwick, quality can be
current study is to fill this gap. By presenting a achieved by addressing processes at four levels: that
streamlined approach to the development of MCDSs of the patient (level A); that of the microsystem, or
the current study attempts to provide individuals and small units of care delivery (level B); that of the
organizations with a coherent methodology and organization (level C); and that of the larger physical,
framework for developing a high quality MCDS. social, economic and political environment (level D).
Introduction For the current study, we define an MCDS as a) a
coherent, explicitly articulated set of standardized
The term ‘minimum dataset’, or MDS, is a commonly
data elements; b) developed using an explicit,
used, but poorly defined term in the healthcare
literature. Conceptualizations of the MDS range from empirically based approach to defining and naming
that of an essential1 or pertinent set of data elements relevant clinical constructs; c) designed to optimally
Table 1: Differences between a Minimum Dataset and a Minimum Clinical Dataset
Minimum Dataset (MDS) Minimum Clinical Dataset (MCDS)
Primary Provision of the highest quality of care as Provision of personalized, high quality care as
Objectives defined by population averages, and defined by the ability to achieve the outcomes
constrained by the need to balance multiple- desired by individual patients
stakeholder objectives
Construct Constructs related to organizations and/or Constructs related to patient and healthcare
Focus systems (primarily Berwick’s level C,D) microsystem (primarily Berwick’s level A, B)
Data Data is rarely collected solely as part Data is collected, used, and analyzed at the
Collection routine delivery of care; typically the data microsystem level for routine care processes
collection process is MDS-specific
Data Source Multiple sources from all levels of Patient and microsystems that interface directly
healthcare system (clinical, operational, with patient
organization)
Data Use Healthcare organization and environment Patient/community and microsystem
(primarily Berwick’s level C,D) (primarily Berwick’s level A, B)
54
A Framework and Standardized Methodology for Developing Minimum
Clinical Datasets
Piper A. Svensson-Ranallo, MHI1, Terrence J. Adam, MD, PhD1,2, François Sainfort,
PhD1,3
1Institute for Health Informatics, University of Minnesota, Minneapolis, MN;2College of
Pharmacy, University of Minnesota, Minneapolis, MN; 3School of Public Health, University
of Minnesota, Minneapolis, MN
Abstract related to a single clinical condition,2,3 procedure,4,5
specialty,6-8 discipline1,9 or healthcare process;10,11 to
The concept of the minimum dataset (MDS) is taking
that of a comprehensive and inclusive set of data
on an increasingly important role in healthcare. In
elements related to an entire domain of healthcare
the current environment of health information
(e.g.: the United States’ Long Term Care Minimum
exchange and universal implementation of electronic 12 the UK’s Mental Health Minimum,Dataset
health records, work related to the development of 13
Dataset, and New Zealand’s General Practice
one specific type of MDS, the minimum clinical 14).Minimum Dataset
dataset (MCDS), is beginning to permeate the
literature. While there is currently no unified This paper focuses on the subset of MDSs developed
definition of either an MDS or an MCDS, an MDS is for collecting data during the routine process of care:
generally agreed to be a coherent set of explicitly the minimum clinical dataset, or MCDS. Using
defined data elements. Despite the growing body of Berwick’s15 framework of quality, we define a
literature on MCDSs, very little empirical evidence MCDS as an MDS developed for, used by, and
exists in the literature related to best methods for targeting actions that occur at the ‘microsystem’ level
developing them. The primary objective of the of healthcare. According to Berwick, quality can be
current study is to fill this gap. By presenting a achieved by addressing processes at four levels: that
streamlined approach to the development of MCDSs of the patient (level A); that of the microsystem, or
the current study attempts to provide individuals and small units of care delivery (level B); that of the
organizations with a coherent methodology and organization (level C); and that of the larger physical,
framework for developing a high quality MCDS. social, economic and political environment (level D).
Introduction For the current study, we define an MCDS as a) a
coherent, explicitly articulated set of standardized
The term ‘minimum dataset’, or MDS, is a commonly
data elements; b) developed using an explicit,
used, but poorly defined term in the healthcare
literature. Conceptualizations of the MDS range from empirically based approach to defining and naming
that of an essential1 or pertinent set of data elements relevant clinical constructs; c) designed to optimally
Table 1: Differences between a Minimum Dataset and a Minimum Clinical Dataset
Minimum Dataset (MDS) Minimum Clinical Dataset (MCDS)
Primary Provision of the highest quality of care as Provision of personalized, high quality care as
Objectives defined by population averages, and defined by the ability to achieve the outcomes
constrained by the need to balance multiple- desired by individual patients
stakeholder objectives
Construct Constructs related to organizations and/or Constructs related to patient and healthcare
Focus systems (primarily Berwick’s level C,D) microsystem (primarily Berwick’s level A, B)
Data Data is rarely collected solely as part Data is collected, used, and analyzed at the
Collection routine delivery of care; typically the data microsystem level for routine care processes
collection process is MDS-specific
Data Source Multiple sources from all levels of Patient and microsystems that interface directly
healthcare system (clinical, operational, with patient
organization)
Data Use Healthcare organization and environment Patient/community and microsystem
(primarily Berwick’s level C,D) (primarily Berwick’s level A, B)
54
