Navy medical data quality management control program
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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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Navy medical data quality management control program

Navy Medical Data Quality Management Control Program

DQMCP Conference

February, 2007


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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