2010 ubo/ubu conference navy medicine dqmc breakout session fy11 dq guidance and fy12 preview
TRANSCRIPT
2010 UBO/UBU Conference
Navy Medicine DQMC Breakout Session
FY11 DQ Guidance and FY12 Preview
Objectives Overview of the Navy Medicine Data Quality
Management Control Program
Orientation of the eDQ
Discuss FY11 DQMC Guidance Policy and Expectations
2
Why Have a Program? Mandated: DoDi 6040.40 Funding
• Prospective Payment System (PPS)• Medicare-Eligible Retiree Health Care Fund (MERHCF)
Budgeting Business Planning Congressional Inquiries Business Case Analysis Special Studies
3
Significant FY12 Changes
New DQMC Review List ProcessComplete Migration to the SharePoint
DQ Community SiteCentralized Coding Audit Pull ListsChanges in MEPRS (EAS) ProcessingDQMC Review List Briefing
FOR OFFICIAL USE ONLY4
Navy Medicine DQMC FY11 DQMC Goals Improve data transmission metrics to meet deadline 100% for
10 of the 12 reporting months. Improve DD FM 2569 collection in all three medical record
categories. Achieve 95% in all DQMC Readiness Categories by the March
2011 data month. Region command DQMC submission will improve to be 100%
compliant 10 of the 12 reporting months.
5
DQMC Program Components Critical MTF Staff:
• Commanding Officer / ESC, Data Quality Manager, Data Quality Assurance Team (DQAT)
6
DQMC Review List: • Internal tool to identify and
correct financial / clinical workload data and processes
Monthly DQMC Commander’s Statement: • Monthly statement forwarded
through the MTF Regional Command to BUMED and TMA
The Data Quality Assurance Team
Meets Regularly With DQMC Manager Acts as Subject Matter Experts Identifies / Resolves Internal DQMC Issues Team Membership (minimum):
• MEPRS• Coding / PAD / Medical Records• CHCS, AHLTA, and ADM Experts• Physician / Provider Champion• Executive Link• Business Analysts
7
The Review List
Leadership commitment and DQMC structure
Timely and accurate
distribution (EAS, WWR, SADR, SIDR,
DMHRSi)
Ensure accurate,
complete and timely data
into systemsIA, access
breach
Organizational Factors
Data Input
Data Output
Security
System administrator
ID, IT business
processes
System Design and Training
Leadership commitment and DQMC structure
Ensure accurate, complete
and timely data entry
into systems
Timely and accurate
distribution (EAS, WWR,
SADR, SIDR,
DMHRSi)
IA, access breach
System administrat
or ID, IT business processes
8
Commander’s Statement Overview 19 Questions, 51 + 2 Individual Elements
Submitted monthly to BUMED via the Regional Commands (and sent to TMA via BUMED)
Signed and reviewed by the Commanding Officer
The month reported on the statement is two months behind the current month (April’s submission is for February data)
When a system-wide issue prevents completing an element of the eDQ, BUMED will provide a standard response for the MTFs to use.
9
Things to Remember Accurate Data is essential
• Red is not bad, it identifies an issue that requires attention• Need to apply DQ to the DQ Statement
Comments are as important as the metric• Provides the information required to take action• Need to use the correct format
Incorrect submissions will be rejected• Delays reporting to TMA (10th calendar day)• Revised statement will need to be re-signed by CC
10
DQMC Submissions are reviewed by senior leadership at all levels, including the Region, BUMED & TMA
End of Day
11
94%
95%
96%
97%
98%
99%
100%
EOD
Goal (Compliance)
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
Oct 09 Nov 09 Dec 09 Jan 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10
Inpatient (2C)
Inpatient (9B)
Goal (Compliance)
Threshold (Minimum)
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
Oct 09 Nov 09 Dec 09 Jan 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10
Outpatient (2A)
APV (2B)
Inpatient (2C)
Goal (Compliance)
Threshold (Minimum)
Coding Timeliness
12
Outpatient = 3 Business DaysAPV = 15 Calendar DaysInpatient = 30 Calendar Days
MEPRS/EAS & Sub Systems
14
99%
100%
101%
Oct 09 Nov 09 Dec 09 Jan 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10
Financial Reconciliation (3A)
MEWACS (3B)
DQMC Submissions are reviewed by senior leadership at all levels, including the Region, BUMED & TMA
MEPRS/EAS & Sub Systems
15
87.00%
89.00%
91.00%
93.00%
95.00%
97.00%
99.00%
OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP
Medical Center FY 2010 DMHRSi Statistics
NMC San Diego- Approval NMC San Diego- DQ NNMC Bethesda-Approval
NNMC Bethesda - DQ NMC Portsmouth-Approval NMC Portsmouth-DQ
60%
65%
70%
75%
80%
85%
90%
95%
100%
Oct 09 Nov 09 Dec 09 Jan 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10
MEPRS/EAS (4A)
SIDR (4B)
WWR (4C)
SADR (4D)
Goal (Compliance)
Threshold (Minimum)
Transmission Timeliness
16
MEPRS = 45 Calendar DaysSIDR = 5 Business Days*WWR = 10 Calendar Days*SADR = 1 Calendar Day
* Navy Medicine = 4 Calendar Days
Coding Compliance
17
75%
80%
85%
90%
95%
100%
Oct 09
Nov 09
Dec 09
Jan 10
Feb 10
Mar 10
Apr 10
May 10
Jun 10
Jul 10
Aug 10
Sep 10
DRG
DRG (5A)
Goal (Compliance)
Threshold (Minimum)
Coding Compliance
18
75%
80%
85%
90%
95%
100%
Oct 09
Nov 09
Dec 09
Jan 10
Feb 10
Mar 10
Apr 10
May 10
Jun 10
Jul 10
Aug 10
Sep 10
E&M
IPSR (5B)
Outpatient (6B)
Goal (Compliance)
Threshold (Minimum)
Coding Compliance
19
75%
80%
85%
90%
95%
100%
Oct 09
Nov 09
Dec 09
Jan 10
Feb 10
Mar 10
Apr 10
May 10
Jun 10
Jul 10
Aug 10
Sep 10
ICD-9
IPSR (5C)
Outpatient (6C)
APV (7B)
Goal (Compliance)
Threshold (Minimum)
Coding Compliance
20
75%
80%
85%
90%
95%
100%
Oct 09
Nov 09
Dec 09
Jan 10
Feb 10
Mar 10
Apr 10
May 10
Jun 10
Jul 10
Aug 10
Sep 10
CPT
IPSR (5D)
Outpatient (6D)
APV (7C)
Goal (Compliance)
Threshold (Minimum)
DD Form 2569
FY 2010 FY 2011
Minimum Sample Size = 30 Minimum Sample Size = 30 Non AD
Sample Tied to Coding Audit (UBU driven) Sample Separate from Coding Audit (UBO driven)
Hint: The Denominator for the Complete/Current = Numerator of PII
NO CHANGE
21
DQMC Submissions are reviewed by senior leadership at all levels, including the Region, BUMED & TMA; These metrics are a 2011 BUMED Focus Area
System Workload Comparisons
22
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
Oct 09 Nov 09 Dec 09 Jan 10 Feb 10 Mar 10 Apr 10 May 10 Jun 10 Jul 10 Aug 10 Sep 10
SADR/WWR (9A)
SIDR/WWR (9B)
EAS/WWR Visits (9C)
EAS/WWR Dispositions (9D)
IPSR/WWR (9E)
Goal (Compliance)
Threshold (Minimum)
A - D: 103% = 97%E: 103% = 103%
AHLTA Penetration
23
75%
80%
85%
90%
95%
100%
Oct 08 Nov 08 Dec 08 Jan 09 Feb 09 Mar 09 Apr 09 May 09 Jun 09 Jul 09 Aug 09 Sep 09
AHLTA/Total SADRS (10A)
FY11 Goal (Compliance)
FY10 Goal (Compliance)
Duplicate Patient Records
Question 11a on the DQ Statement Only MTFs that are CHCS hosts report this
metric Metric is based upon all duplicate records on
the silo, including Army and Air Force Facilities Starting in 2011, all DMIS IDs included in this
metric must be reported in the comments section.
24
0
50
100
150
200
250
300
350
Oct 08
Nov 08
Dec 08
Jan 09
Feb 09
Mar 09
Apr 09
May 09
Jun 09
Jul 09
Aug 09
Sep 09
DQ Hint: Sometimes, commands forget to select “yes” on the eDQ; if the answer is truly “no”, there must be a reason identified in the comments section.
Commander’s Acknowledgement
Question 12a on the DQ Statement This question is the linchpin in the Data Quality Program; it
certifies that the senior leader at the MTF is aware of what is going on and is taking steps to correct deficiencies.
25
Operational Personnel Readiness
Questions 1 through 7 (a & b) on the DQ Statement These are Navy Medicine unique metrics All Commands must complete this portion of the eDQ The following systems are gauged for completeness and accuracy:
• MRRS• EMPARTS• FLTMPS• DMHRSi
Successful management of these systems are critical for military readiness; Navy Medicine goal is 95% compliance for all questions by the March 2011 data month
26
Comments and Corrective Actions
All metrics that are non-compliant (less than 95% or 80% for 9e) require a comment
Starting in FY11, comment grouping not allowed Comments must be in correct format
27
ITEM: 2a, TT# (if applicable), ISSUE: XX% encounters from ER did not meet the 3-day deadline due to staffing issue. CORRECTIVE ACTION: Effective 1 January, temporarily reassign military staff until civilian/contract hiring process can be completed. CORRECTION DATE: January DQS.
Commands that report a Metric that is non-compliant for 3 (or more) consecutive months must develop and report the status of a POA&M
Summary
It is important to understand both the current policy as well as the data that is being reported when accomplishing the DQMC CC Statement.
Monthly DQMC submissions are official reports that are reviewed by senior leadership at the Region, BUMED and TMA.
The comments provided within the submission are just as important as the metrics that are reported.
28
FOR OFFICIAL USE ONLY29
• NME
• NMW
• NCA
• NMSC
Regional Points of Contact
FOR OFFICIAL USE ONLY30
• Government POC
• CAI Team
BUMED Points of Contact
Questions
FOR OFFICIAL USE ONLY31