Request Non-Identifying Data

Overview
Application Process
Detailed Instructions for Form DOH-4395
Download Non-Identifying Data Overview and Instructions (DOC, 57 KB)
Download Non-Identifying Data Request Form (DOC, 87KB)


Overview

This request process is for data sets that contain only Non-Identifying data elements. Non-Identifying data elements are those elements contained in the requested data set (inpatient, outpatient, PRI) and not defined as identifying/deniable data elements in SPARCS regulation (NYCRR Title 10 §400.18).

All requests for identifying/deniable data elements must be approved by the Data Protection Review Board (DPRB).

Application Process

  1. Visit our Output Data Dictionaries to review available data elements.
  2. Complete SPARCS Non-Identifying Data Request Form (DOH-4395), answering all questions. Please follow the detailed instructions below. All pages of the application MUST be submitted. If a question on a page is not applicable to your request, you MUST still complete it and indicate "N/A" - not applicable.
  3. Send application to:
    SPARCS Operations
    New York State Department of Health
    Office of Quality and Patient Safety
    Bureau of Health Informatics
    Empire State Plaza
    Corning Tower, Room 878
    Albany, New York 12237
    Phone: (518) 473-8144
    DPRB@health.state.ny.us
  4. A decision letter will be sent to the applicant.

Detailed Instructions for Form DOH-4395 (For each line item)

  1. ORGANIZATION AND INDIVIDUAL REQUESTING USE OF DATA
    1. Project Director and Title: Provide the name and title of the individual who is primarily responsible for conducting the study/project.
    2. Organizational: List the organization with which the project director is associated while conducting the project/study. This may be a hospital, college/university, association, contractor/vendor, etc. In the case of a student request, the associated school would be the organization, and the affidavit would contain their information including the appropriate signature. A private individual request should list 'Private Individual Request' here.
    3. Contact Person: List the individual who is responsible for application questions. This may or may not be the project director.
    4. Street Address or P.O. Box: List the address of the individual who will receive all correspondence regarding this application.
    5. City/State/Zip Code: List the address of the individual who is to receive all correspondence regarding this application.
    6. Telephone: List the telephone number of the contact person.
    7. E-mail: List the e-mail of the contact person.
    8. Signature: By signing, the project director attests that this data will be used for the sole purpose of the research study/project identified in the data application and that this data will not be shared with any person or entity not covered by this application.
  2. SUMMARY OF STUDY PROPOSAL AND PROJECT ACTIVITIES

    1. Title of Study/Project: List the title of the study/project. It does not have to be a formal title, but should provide a label for referring to the request.
    2. Summary of Study Proposal and Project Activities: This study proposal section should be able to stand alone without any appendices. You may submit additional documentation; however, items must be answered succinctly in the body of this application. Applications may be disapproved if insufficient detail is not provided in this section.

      1) How the requested data will be used: The specific health or medical conditions to be examined listed here will determine the only purpose for which the SPARCS data may be used. The approved data release can only be used for the primary purpose stated in this section.
      2) Matching, if any, with other data files, specifying the type and source of these files:

      Matching/linkage of SPARCS data with other data sources must be identified. Identify the data elements in SPARCS that will be used to link with the other data source(s) and describe the data elements from the other data source to be linked to the SPARCS data. The data provided may not be linked with any data that contains additional identifying data/patient information.
    3. Output Produced from this Project/Study: Describe the format of any information you anticipate releasing. Only aggregated information can be released to anyone other than those who have signed data use affidavits and then only in a format which does not allow identification of individuals.
  3. TYPE AND FORMAT OF DATA REQUESTED

    Select the specific data files: Inpatient, Outpatient (full file, ambulatory surgery or emergency department) and the format (record length) desired. Indicate the data years requested. De-identified linked SPARCS/Vital Records data are not currently available, but will be in the future.

    The SPARCS Inpatient Data File contains all inpatient discharges for Article 28 facilities as per NYCRR Title 10 §400.18.

    SPARCS Outpatient Data Files contain ambulatory surgery data and emergency department data. The SPARCS Outpatient file has three versions. One version consists of both ambulatory surgery and emergency department services discharges. Another version contains only ambulatory surgery discharges. A third version contains only emergency department services discharges.

    SPARCS Ambulatory Surgery Data is defined in NYCRR Title 10 §755.1. It is a surgical procedure performed in an operating room on an anesthetized patient with a stay less than 24 hours. Procedures which can be performed safely in private physician's office or outpatient treatment room are not collected by SPARCS.

    Emergency Department Services are defined as those services having a revenue code of 045X.

    Note: The SPARCS data elements definition along with its codes, values and edit applications can be found in the Inpatient Output Data Dictionary and Outpatient Output Data Dictionary.

  4. CONFIDENTIALITY OF DATA/DATA RETENTION
    1. Describe how you will maintain the confidentiality of the provided SPARCS data. Include an explanation of how and where data is stored and how it will be disposed of upon completion of your study.

      Data is released for a 2-year time period after the files are considered complete, contact SPARCS as to when specific year files are complete. If an extension will be required, include a justification with the original application. The disposition of expired supplied data is the responsibility of the requestor. If data is not returned, a letter indicating that it has been destroyed and how it was destroyed must be provided. Describe safeguards to ensure that data will be used solely for the described purpose. Will data be stored and used at the organization location? If not, a second Organizational Affidavit needs to be completed and Individual Affidavits for every person having access to the unit record file from this additional organization.
    2. Identify every individual who will have access to the supplied file. All those listed must have affidavits included with the application.

Organizational Affidavit (DOH-4395, pages 4-5)

Supply the following information for the organization making the request. If a student request, an organizational affidavit is required from the educational institution. If a private individual, no organizational affidavit is required.

Please complete the affidavit with the appropriate signatures and notarization. If this affidavit is not applicable to your request, you MUST still complete the form by indicating "N/A" - not applicable.

NOTE: Please make additional copies as needed.

Individual Affidavit (DOH-4395, pages 6-7)

Individual Affidavits MUST be completed for all individuals who will have access to patient level data provided as a result of this request. This includes all appropriate off-site processing individuals. Only those individuals submitting signed, notarized affidavits can have access to the supplied data files.

Please complete the affidavit with the appropriate signatures and notarization. If this affidavit is not applicable to your request, you MUST still complete the form by indicating "N/A" - not applicable.

NOTE: Please make additional copies as needed.