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Navy Medical Data Quality Management Control Program. DQMCP Conference February, 2007. Objectives. Understand DQMCP Components Comprehend DQ Statement parameters and metrics Recognize Navy Tier Roles and Responsibilities Identify DQ process flow and deadlines. Why DQ ?.

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Presentation Transcript
objectives
Objectives
  • Understand DQMCP Components
  • Comprehend DQ Statement parameters and metrics
  • Recognize Navy Tier Roles and Responsibilities
  • Identify DQ process flow and deadlines

DQMCP Conference, February, 2007

why dq
Why DQ ?
  • Finger of blame – systems issue ?
  • Non – IT Problems
    • Lack of standard business rules and policies
    • Inconsistent coding patterns, weights and algorithms
    • Lack of training/education
    • Failure to set/enforce performance expectations

DQMCP Conference, February, 2007

critical dq components
Critical DQ Components
  • Critical Staff: Commanding Officer/ESC, Data Quality Manager, Data Quality Assurance Team
  • DQMC Review List: Internal tool to identify and correct financial/clinical workload data and processes
  • Commander’s Monthly Data Quality Statement: Monthly statement forwarded through Regions to BUMED and TMA.

DQMCP Conference, February, 2007

review list
Review List

DQMCP Conference, February, 2007

data quality statement
Data Quality Statement
  • 10 Categories, 35 Elements
  • Submitted monthly to BUMED via Regions and NMSC
  • Signed by Commanding Officer
  • Reporting month evaluates data 2 months prior
    • Example: February reporting month evaluates December data

DQMCP Conference, February, 2007

end of day eod
End of Day (EOD)
  • 24/7 clinics/ER EOD by 0600 following day
  • Automated through NMIMC DQ Website

DQMCP Conference, February, 2007

coding timeliness
Coding Timeliness
  • SADR = Three BUSINESS days
  • APV = 15 calendar days
  • Inpatient = 30 calendar days

DQMCP Conference, February, 2007

required actions
Required Actions
  • MEWACS (MEPRS Early Warning and Control System) review: “Has the MTF DQ or MEPRS Manager reviewed information presented in the CURRENT version MEWACS report?”
  • DQ Review month data is not the requirement here

DQMCP Conference, February, 2007

timely data submission
Timely Data Submission
  • MEPRS – EOM + 30 days (Navy)
  • SIDR – EOM + 5 working days
  • SADR – Daily
  • WWR – EOM + 10

DQMCP Conference, February, 2007

professional services encounters
Professional Services Encounters
  • New for FY-07
  • Requires coding quality checks on IBWA (inpatient professional services) encounters

DQMCP Conference, February, 2007

outpatient records
Outpatient Records
  • Random audit

DQMCP Conference, February, 2007

ambulatory procedure visits
Ambulatory Procedure Visits
  • Change for FY-07 in 7 (b). E&M codes no longer required for APVs

DQMCP Conference, February, 2007

workload comparison
Workload Comparison
  • SADR should be greater than or equal to WWR
  • If EAS not processed, use WAM data to complete metrics in this section

DQMCP Conference, February, 2007

ahlta sadr encounters
AHLTA / SADR Encounters
  • “B” accounts only
  • Excludes APV data
  • Excludes BIA (Emergency Room)

DQMCP Conference, February, 2007

roles responsibilities
Roles/Responsibilities

DQMCP Conference, February, 2007

navy dq issue process
Navy DQ Issue Process

Issue resolved

At MTF ?

N

MTF issue

identified

Investigate MTF

issue impact

File DQ

trouble ticket

Issue logged at

NMIMC

Y

Region

notified

Issue forwarded

To SME

Issue resolved

Resolution requires

MHS tier

support?

N

Submitter

notified

Issue

resolved

Issue solution

proposed

SME reviews

issue

Y

MHS trouble

ticket filed`

Issue solution

proposed

DQMCP Conference, February, 2007

fy 07 improvement goals
FY-07 Improvement Goals
  • Improve NMIMC website data. Identify MTF variances and standardize report formats
  • Electronic Data Quality Statement (EDQ)
  • Identify trouble ticket issues. Communicate and expedite resolution
  • Improve coding quality
    • Identify top three issues
    • Conduct a program assessment
    • Develop POA&M

DQMCP Conference, February, 2007

challenges
Challenges
  • DQMC website data
  • Trouble ticket status and resolution
  • Training
    • DQ Manual updates
    • New DQ Manager training
  • System/table upgrade coordination

DQMCP Conference, February, 2007

points of contact
Points of Contact

DQMCP Conference, February, 2007

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