stanforddams/va

Dataset Card for CCOMP

CCOMP is a patient-program dataset for tracking and analyzing patient flow across VA Mental Health programs. It records which Veterans received care in which programs, in which quarters, and at which locations, covering 15 programs across 5 organizational levels from national down to individual patient.

Dataset Details

Dataset Description

The VA Mental Health continuum of care is clinically effective but not well optimized for population-level throughput or cost. VA workload projections show a need for more mental health treatment capacity, but simply adding staff isn't feasible at scale. In practice, a focus on quality within individual programs has created bottlenecks across levels of care that slow patient movement to appropriate settings.

CCOMP was built to use data and analytics to:

• Shift resources, clinical practice strategies, and processes
• Support a stepped-care approach that increases capacity and improves efficiency
• Maintain or improve patient outcomes

The dataset powers a program flow interface that shows patient transitions between programs, cohort sizes, staffing ratios, and treatment patterns across 15 VA mental health programs.

• Curated: Elliot Fielstein, Director of Clinical and Data Analytics, Informatics Section of Mental Health Service, Department of Veterans Affairs Central Office, Washington DC
• Funded: Department of Veterans Affairs
• Language: English
• License: MIT

Dataset Sources

• Active Table: OMHSP_PERC_MDSDev.CCOMP.PatientProgram (SQL Server, current quarters: FY25Q4, FY26Q1)
• Historical Table: OMHSP_PERC_MDSHistorical.Staffing.CCOMP_PatientProgram_FY[YY] (one table per completed fiscal year)

Uses

Direct Use

CCOMP is built for mental health program administrators, clinical leads, and operational planners at the VA. Typical uses include:

• Tracking patient movement between mental health programs (inflow/outflow counts by program pair)
• Monitoring cohort sizes by program, quarter, and organizational level
• Spotting bottlenecks where patients are not moving to appropriate levels of care
• Comparing staffing ratios, treatment volume, duration, and frequency across programs
• Running quarter-over-quarter or year-over-year comparisons of care utilization

The recommended primary analytical focus is GMH & PC. A secondary focus is GMH & PTSD.

Out-of-Scope Use

• Individual clinical decision-making for specific patients
• Use outside of VA Mental Health program administration contexts
• Any system not operating under VA data governance and privacy frameworks
• Re-identification of patients or sharing of protected health information beyond authorized VA data access agreements

Dataset Structure

Schema

Each row represents a unique patient x program x Fiscal Year Quarter (FYQ) x location of care (ChecklistID) combination. A patient has a row for a given program only if they had a visit there or were assigned to a team during that FYQ.

Variable	Type	Definition
FYQ	string	Fiscal Year Quarter of the visit or team membership (e.g., FY25Q4)
DateRun	date	Most recent quarterly extraction date
MVIPersonSID	integer	Unique patient identifier (Master Veteran Index)
PatientSID	integer	Patient identifier
PatientName	string	Patient name
ChecklistID	string	Location of enrollment or care: • BHIP/PACT: enrollment site • Community care: IVC-identified site • Programs: where the visit occurred • CRH: the hub providing care • Inpatient: bedsection location
STA6A	string	Medical Center Facility where care occurred
Program	string	MH program or BHIP/PACT team designation
Team	string	Team name within a program (BHIP/PACT teams, inpatient teams, or community care SEOC)
StartDate	date	• Date of first program visit (can be an earlier quarter) • Date of BHIP/PACT team enrollment • Date of inpatient/residential admission
EndDate	date	• Date of last program visit in quarter • Date of BHIP/PACT team de-enrollment • Date of inpatient/residential discharge
Visits	integer	Number of program visits in the quarter
PriorQuarter	boolean	Patient had visits or enrollment in the prior quarter for this program/team
Homestation	string	Patient's homestation from IMF (ChecklistID in IMF)

Programs

Program	Full Name	Description
BHIP	Behavioral Health Interdisciplinary Program	Team-based outpatient care; patients enrolled into a team
CommCare	Community Care	MH standardized episodes of care only
ED	Emergency Department	MH encounters only
GERI	Geriatric	Geriatric mental health
GMH	General Mental Health	BHIP clinic; central hub in the continuum
ICMHR	Intensive Community Mental Health Recovery	Assertive community treatment for severe, chronic mental illness
MHBed	Mental Health Bedsections	Acute inpatient, residential, and CLC admissions
PACT	Patient Aligned Care Team	Primary care team membership; patients enrolled into a team
PAIN	Pain	MH encounters only
PC	Primary Care	MH encounters only
PCMHI	Primary Care-Mental Health Integration	Behavioral health consultants embedded in primary care
PRRC	Psychosocial Rehabilitation and Recovery Center	Recovery-oriented skills and community reintegration
PTSD	PTSD Clinical Team	Specialty PTSD treatment
SUD	Substance Use Disorder	Specialty addiction treatment
VOCR	Vocational Rehabilitation	Vocational and employment rehabilitation

Team Variable Breakouts

The Team field provides sub-program granularity depending on Program:

• BHIP: individual BHIP team names
• PACT: individual PACT team names
• MHBed: type of bedsection (acute inpatient, residential, CLC)
• CommCare: MH Standardized Episodes of Care (SEOCs)
• Specialty / GMH: CRH (telehealth hub) and homestation breakouts

Organization Levels

Data can be aggregated at five hierarchical levels. Selecting a higher level includes all subordinate units.

Level	Description	Key Field(s)
National	All VA facilities nationwide	(none)
VISN	Veterans Integrated Service Network; one VISN at a time	VISN identifier
Facility	VA Medical Center or facility	STA6A
Team	Clinical team within a facility	Team / ChecklistID
Patient	Individual patient record	MVIPersonSID / PatientSID

Sample Cohort Sizes

The following figures come from the reference flow diagram and reflect a sample reporting period. GMH is the largest program by far and acts as the central node in the continuum.

Program	Approx. Cohort Size
GMH	840,000
PCMHI	179,000
SUD	51,000
PTSD	33,000
VOCR	15,000
GERI	15,000
PRRC	5,000
ICMHR	5,000

Sample inter-program flows for the same period:

Flow	Patient Count
PCMHI to GMH	~211,000
GMH to PCMHI	~118,000
GMH total inflow	~696,000
GMH total outflow	~732,000

Dataset Creation

Curation Rationale

Individual VA programs track quality within their own walls, but there has been no unified view of how patients move between programs across the continuum. CCOMP fills that gap by capturing patient-level program participation across quarters, making it possible to measure inter-program flow, identify where patients are stuck, and plan staffing and capacity accordingly.

Source Data

Data Collection and Processing

Data are extracted quarterly from VA administrative and clinical systems:

• Active Table: OMHSP_PERC_MDSDev.CCOMP.PatientProgram (the two most recent fiscal year quarters: FY25Q4, FY26Q1)
• Historical Table: OMHSP_PERC_MDSHistorical.Staffing.CCOMP_PatientProgram_FY[YY] (one table per completed fiscal year)

FYQ format is FY[YY]Q[Q] (e.g., FY25Q4). The DateRun field records when the quarterly extraction ran.

Who are the source data producers?

Data come from VA clinical and administrative systems reflecting real encounters between Veterans and VA Mental Health staff across all 15 programs. The Informatics Section of Mental Health Service at VA Central Office maintains the data.

Annotations

Annotation process

No human annotations. Program, team, and organizational assignments come directly from VA administrative records (enrollment systems, scheduling systems, and inpatient admission records).

Who are the annotators?

N/A

Personal and Sensitive Information

This dataset does not contain protected health information (PHI) but includes:

• Patient Identifiers (MVIPersonSID, PatientSID, PatientName)
• Treatment History
• Facility

Access is governed by VA data use agreements and applicable federal privacy law. Do not share, publish, or use this dataset outside of authorized VA data environments.

Bias, Risks, and Limitations

• VA-only population: Data reflect Veterans enrolled in VA care and do not generalize to non-VA mental health populations or community providers (except for CommCare episodes).
• Program participation as proxy: A row in this dataset means a patient had a visit or enrollment, not that they received a particular diagnosis or level of care quality.
• Quarterly granularity: FYQ-level data can miss within-quarter transitions or short episodes.
• Historical gaps: Cross-year analyses require joining across multiple historical tables.
• Clog dynamics: High volumes in intensive programs (e.g., PRRC, ICMHR) may reflect system stasis rather than clinical appropriateness.

Recommendations

Work within VA data governance frameworks. Any analysis using PatientName, MVIPersonSID, or PatientSID must comply with VA privacy and security policies. Aggregate program-level analyses that strip individual patient identifiers are preferred for operational reporting.

Citation [optional]

BibTeX:

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Glossary

Term	Definition
FYQ	Fiscal Year Quarter, formatted as FY[YY]Q[Q] (e.g., FY25Q4 = Q4 of Fiscal Year 2025)
VISN	Veterans Integrated Service Network, the regional administrative grouping of VA facilities
STA6A	VA facility station code identifying a Medical Center or site of care
ChecklistID	Location identifier used for enrollment (BHIP/PACT), visit site, or bedsection depending on program
IMF	Identity Management Function, the VA system from which homestation is derived
SEOC	Standardized Episode of Care, the unit of community care authorization
CRH	Community Resource and Referral Hub, a telehealth hub providing care to remote Veterans
CLC	Community Living Center, a VA long-term care setting
RRTP	Residential Rehabilitation Treatment Program
MHICM	Mental Health Intensive Case Management (see also ICMHR)
PHI	Protected Health Information

More Information

VA Mental Health Continuum of Care

CCOMP covers the full VA mental health care continuum, organized into seven levels:

1. Self-Help and Technology: self-help apps (stress, PTSD, insomnia) and the Veterans Crisis Line (24/7)
2. Primary Care Integration (Mild to Moderate Needs): PCMHI and telephone-based care management
3. Outpatient Care (Moderate to Severe Needs): General Mental Health Clinics, BHIP, and specialty clinics (PTSD, SUD, Peer Support)
4. Intensive Outpatient and Community-Based Care: IOP, ICMHR/MHICM, and PRRC
5. Residential Services (Live-in, Highly Structured): RRTP and Domiciliary Care
6. Acute Inpatient Care (Immediate Safety and Stabilization): 24-hour hospital care at VAMCs or via community providers
7. Community and Specialized Care: Vet Centers and Family and Couple Services

Interface Design Reference

The dataset drives a program flow visualization interface. Three reference diagrams capture the intended design:

Program Node and Flow Structure

Core visual conventions:

• Program nodes are labeled rectangles; border color encodes care tier (blue = primary care, gold = GMH/BHIP, red = specialty, teal = inpatient/residential)
• Directional arrows show inter-program patient flow; arrow weight encodes volume; thick orange arrows indicate high-volume bidirectional flow (e.g., PCMHI and GMH)
• Team sub-structure is revealed on node expand (e.g., Primary Care shows Team A/B/C; BHIP shows named teams)
• Layout: PCMHI on the left, GMH as the central hub, specialty programs to the right, inpatient/residential on the far right

Quantitative Flow Diagram

Numeric display conventions:

• Cohort size shown on each node (e.g., GMH = 840k, PCMHI = 179k, PTSD = 33k, SUD = 51k)
• Flow connectors carry a current-period count (black) and a prior-period count (red italic)
• Node-level totals shown above-left (inflow) and above-right (outflow), e.g., GMH: 696k inflow, 732k outflow
• The specialty cluster (PTSD, SUD, PRRC, ICMHR, VOCR, GERI) is grouped in a red-bordered region with labeled bidirectional flow to/from GMH

Topology Graph Style Reference

Style reference (from CamelBee, unrelated to VA) for a force-directed interactive graph: color-coded node cards, directed labeled edges, left-to-right layout reflecting the care continuum, and clickable nodes that surface program-level detail without cluttering the main view.

Interface Metrics

Tier 1: Core Flow View (always displayed on the diagram)

Metric	Description
Program Cohort Size	Total unique patients active in a program for the selected period. Displayed on or near each program node.
Inter-Program Patient Flow	Patients moving into and out of each program from/to every other program. Displayed on directional connectors; current and prior-period values shown separately.

Tier 2: Program Detail (accessible on node click/expand)

Metric	Description	Build Status
Staffing Ratio	Staff-to-patient ratio per program.	Existing infrastructure available
Patient Treatment Volume	Treatment encounters (visits) within a program for the selected period.	Needs to be built
Patient Treatment Duration	Days from StartDate to EndDate per patient per program.	Needs to be built
Patient Treatment Frequency	Average visits per patient per unit time.	Needs to be built
Treatment Quality Process Metrics	Standardized MH process quality measures from MHIS_home.aspx.	Link to existing report

Interface Parameters

Two global filters apply across all views (stored in src/data/):

• FYQ (src/data/fyq.json): single or multi-quarter selection; current and prior quarter selected by default
• Organization Level (src/data/organizations.json): hierarchical dropdown from National down to Patient

Dataset Card Authors

Elliot Fielstein Director of Clinical and Data Analytics, Informatics Section of Mental Health Service Department of Veterans Affairs Central Office, Washington DC

Dataset Card Contact

Elliot Fielstein Director of Clinical and Data Analytics, Informatics Section of Mental Health Service Department of Veterans Affairs Central Office, Washington DC