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2012 TMA DQ Course. AFMOA/SGAR Current as of 10 May 2012. Air Force TMA DQ Course Break-Out Session Overview. Organization Why Data Quality? MTF Engagement Guidance DQ Assurance Team CHCS Provider File Metrics Other DQ Efforts DQ Review List/Statement Guidance & Completion eDQ.

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2012 tma dq course

2012 TMA DQ Course

AFMOA/SGAR

Current as of 10 May 2012

air force tma dq course break out session overview
Air Force TMA DQ Course Break-Out Session Overview

Organization

Why Data Quality?

MTF Engagement

Guidance

DQ Assurance Team

CHCS Provider File

Metrics

Other DQ Efforts

DQ Review List/Statement Guidance & Completion

eDQ

organization1
Organization

AFMOA (Execution)

HAF/SG8Y (Policy)

organization2
Organization
  • SGA
  • SGAI
  • Info Services
  • MEPRS
  • SGAT
  • Health Benefits
  • SGAX**
  • Readiness
  • SGAR
  • Resource Mgt
  • SGAL
  • Med Logistics
  • DQ
  • SGAP
  • Manpower
  • UBO
afmoa strategic alignment
AFMOA Strategic Alignment

Experience of Care

Population Health

Readiness

Per Capita Cost

our mission
Our Mission

AFMOA Data

Quality

MAJCOMS

Air Force MTFs

  • Standardize methodology
  • Evaluate processes
  • Reduce variance

DRUs

  • Provide Comprehensive DQ Program Management to all AF MTFs
  • Provide reach-back support to MAJCOMs and DRUs
data quality dq roles and responsibilities
Data Quality (DQ) Roles and Responsibilities
  • DQ Program Manager
  • DQ Program Analyst

DQ DBA/SME

  • DQ SME
  • Focal point for MTF’s DQ Mgmt
  • Control Program/DQ Statement
  • Teams to provide policy/MTF’s
  • business practice improvements
  • Biometric data consultant
  • Measures MTF/AFMS DQ
  • performance & influences change
  • - Trains MTF DQ Managers
  • Provide CHCS Database Admin SME support
  • -- ID & assist MTFs correct: (Provider File errors, Hospital Location Files, site definable MEPRS tables, etc.)
  • Create CHCS restrictions/business rules to promote standardization
  • Develop CHCS training guides to promote MTF DQ
  • Provide Ad Hoc report assistance to support MTF’s
  • Perform MTF site visits to provide on-site technical assistance
  • Manage performance metrics to validate improvement efforts
  • Mission:
  • Provide Comprehensive DQ - Program Management to all MTFs
  • Provide reachback support to MAJCOMs and DRUs
  • Key Objectives:
  • Standardize Methodology
  • Evaluate Processes
  • Reduce Variance
  • Future Initiatives:
  • Consolidation
  • Shape MHS/AFMS DQ efforts
data quality integrated approach
Data Quality Integrated Approach
  • MEPRS
  • Personnel
  • Workload
  • Financial

Data Quality

Completeness

  • Patient
  • &
  • Provider
  • Coding
  • SIDR/SADR
  • MSDRG/RWP
  • RVU/CPT
  • UBO
  • Other Health Insurance
  • Eligibility
  • Demographics

Timeliness

Accuracy

why is data quality important
Why is Data Quality Important?

For these reasons, it is vital your data accurately reflect work performed in your MTF!

Monitor efficiency of the healthcare system

Prospective Payment System (PPS)

Base Realignment And Closure (BRAC)

Medicare Eligible Retiree Health Care Fund (MERHCF)

MTF Business Plans

Provider/Clinic Workload Productivity

Reimbursements (TPC, Coast Guard, NOAA…etc)

Enable the Leadership to make informed decisions

what could go wrong
What could go wrong?

Interface Errors

Clinical

Data Mart

Air Force

TRICARE

Ops Center

CCQAS

Worldwide Workload Report

Service Repository (BDQAS)

WWR

(Count Visits)

DoD/VA

FHIE/BHIE SHARE

MHS Data Repository

MDR

Coding Compliance

Editor

SADR

CAPER

(Encounters)

CCE

PDTS

Standard Ambulatory

Data Record

Pop Health

Portal

Pharmacy Data

Transaction

System

ADM

SADR 1/SADR 2

EAS IV

Extract

MHS Mart

M2

Essentris

EAS

Repository

TPOCS

Billable

Encounters

WAM

Count Visits & Raw Services

EAS IV

“Eligible” Encounters

CPT Codes

Units of Service

mtf dq engagement
MTF DQ Engagement
  • One-on-One Support
    • Telephone and E-mail: afmoa.dq@us.af.mil
    • Defense Connect Online (DCO) & optimize use of Vector Check
  • MTF-AMFOA DQ Teleconferences Every Other Month
    • PACAF, CONUS, USAFE (schedule on Vector Check)
    • DCO used to conduct meetings and take attendance
    • Business and training conducted at each meeting
  • Site Visits
  • AF portion of the TMA DQ Course
  • Other Conferences/Forums
defense connect online
Defense Connect Online
  • Link to meeting will be sent via email/calendar request
  • Share screen capability to maximize training
  • Chat capabilities to ask questions to all or individuals
  • To become a registered user visit: https://www.dco.dod.mil
vector check your dq toolkit
Vector CheckYour DQ Toolkit

Announcements

Calendar

Contacts

FAQs

Documents

Electronic Data Quality Application (eDQ)

Subscribe to Alerts!

vector check gaining access
Vector CheckGaining Access
  • Your Vector Check account is linked to your Knowledge Exchange (Kx) account
  • If you don’t have a Kx account, create one at https://kx.afms.milClick:
  • If you have a Kx account, verify your e-mail address is correct (then WAIT 24 Hrs prior to signing into Vector Check). Click:
vector check gaining access1
Vector CheckGaining Access
  • After you have been granted a Kx account (this may take up to 24 hours), navigate to Vector Check at: https://vc.afms.mil
  • The first time you visit the Vector Check site, you will be redirected to a registration page. The form will be pre-populated. Verify and submit the information.
vector check updating the rm master roster
Vector CheckUpdating the RM Master Roster
  • Update your POC information on the RM Master Roster at: https://vc.afms.mil/AFMOA/SGA/SGAR/Lists/Resource%20Management%20Master%20Roster%20Updates/Summary%20View.aspx
  • Select “New” to add a new POC, or select “Actions / Edit in Datasheet” to edit POCs. The contact information for these positions must always be kept current:
    • MDG CC
    • MDG Deputy CC
    • MDSS Commander
    • Administrator
    • RMO
    • RMO NCOIC
    • DQ Manager
    • DQ Alternate
vector check documents training material on vc
Vector Check DocumentsTraining Material on VC
  • Review training materials posted on Vector Check
    • “Alerts, Timeliness and Accuracy, and TUG”
    • Pathway: Vector Check > AFMOA > SGA > SGAR > SGAR – Data Quality > Documents > Training > Administrative
    • All DQ Review List and Statement Training Slides
    • Pathway: Vector Check > AFMOA > SGA > SGAR > SGAR – Data Quality > Documents > Training > DQ Review List and Statement Training Slides
    • Review the latest DQ Teleconference Notes
    • Pathway: Vector Check > AFMOA > SGA > SGAR > SGAR – Data Quality > Documents > Data Quality Meeting Minutes-Notes
overview
Overview
  • DoDI 6040.40
    • DQ Mgmt Control (DQMC) Procedures
    • DQMC Review List
    • Data Quality Statement
    • Annual Updates – TMA Led
    • Recommends Data Quality Assurance Team (DQAT) Composition
health services inspection hsi
Health Services Inspection (HSI)
  • 2012 HSI Checklist, OM.3.2.2
  • The Data Quality Assurance Team (DQAT) met monthly:
  • Completed DQMC Review List
  • Briefed Executive Committee on all Review List performance that was not compliant
  • There was evidence corrective action plans were created, monitored and progressing to address non-compliant or underperforming DQMC items
health services inspection hsi1
Health Services Inspection (HSI)
  • 2012 HSI Checklist, OM.3.2.2
  • Documents Required for Review:
  • Current and past year’s
    • DQM reports
    • DQAT meeting minutes
dq assurance team1
DQ Assurance Team
  • DoDI 6040.40 Recommended Team Composition:
    • DQ Manager
    • Directors of Clinical Activities
    • MEPRS/EAS Coordinator
    • Budget/Accounting
    • Medical CIO
    • Health Information Manager
    • CHCS Administrator
    • Group Practice Managers
    • Patient Administration
  • Additional team members recommended in Data Quality Team User’s Guide:
    • Coder/coding auditor
    • AHLTA Trainer
    • Ancillary services representative
    • Defense Medical Human Resources System – internet (DMHRSi) personnel (i.e., DMHRSi Manager, contract liaison, civilian liaison, volunteer liaison, and Command Support Staff (CSS) personnel)
    • UBO Manager
    • Clinic support staff representative
    • Resource Management Flight CC

Red indicates required members when AFI 41-120 is published

  • The Data Quality Assurance Team (DQAT) or other designated structure met during the reporting month to complete the DQMC Review List.
primary effects of chcs provider file errors
Primary Effects of CHCS Provider File Errors

Revenue

Patient Safety

Data Integrity

Workload

chcs provider file continuity guide
CHCS Provider FileContinuity Guide
  • Comprehensive reference for issues related to CHCS provider file maintenance
  • Nearing completion – release date TBD
  • Includes step-by-step guidance to correct errors
  • Recommendations for provider file management
  • Includes helpful resources
dq performance metrics
DQ Performance Metrics

https://vc.afms.mil/AFMOA/Matrix/default.aspx

dq performance metrics1
DQ Performance Metrics

https://vc.afms.mil/AFMOA/SGA/SGAR/SGARDQ/Documents/Forms/AllItems.aspx

http://www.tricare.mil/ocfo/mcfs/dqmcp/metrics_reports.cfm

workload guidelines sample
Workload Guidelines Sample
  • Supplements AF Coding Guidelines
  • - Published by AF Coding Experts
  • MHS Coding Guidelines, inpatient and outpatient, dated 1 January 2011
  • http://www.tricare.mil/ocfo/bea/ubu/coding_guidelines.cfm
slide46

Support Provided

  • Correct CHCS patient registration errors for all Air Force MTFs
    • Primary Care Manager Information Transfer (PIT) Errors
    • Correct Patient Registration Errors (FY11-558K Patients)
    • Merge CHCS Duplicate Patients
    • Identify AHLTA Multiples and Log MHS tickets
    • Subject Matter Expertise Support
    • Partner with DoD to develop policies and processes to reduce patient registration errors
    • Identify and correct systemic issues, which contribute to the duplication of clinical records and put patient safety at risk
    • AFMS Record Reconciliation Initiative

46

support provided
Support Provided
  • Training
    • Conduct Pt Reg, PIT Error, Duplicate Patient training at MTFs, Conferences, DCO Connect, etc.
    • Phone consultations as needed
  • Enterprise Health Data Optimization System (eHDOS) Reports
    • Summary Reports by MAJCOM and MTFs on Vector Check
      • Users with Registration Capability
      • Number of New Patients Added to CHCS with Critical Errors
      • Number of Potential CHCS Duplicate Patients
      • Number of Patients with Patient Category Mismatches
      • Number of PIT Errors
      • Managed Care File/Table Concerns Affecting PIT Errors
afmoa data quality vector check
AFMOA Data Quality Vector Check
  • MTF Reports are posted to the AFMOA Data Quality Vector Check monthly
  • Menu path: Vector Check-AFMOA-SGA-SGAR-Data Quality-Documents-Patient Registration MAJCOM_MTF Reports
slide51
TUG
  • Primary AF-specific DQ guidance
  • Clarifies questions on the DQMC Review List
    • Includes formulas, background information, and how to get the data
  • Available on Vector Check
  • Share with the DQAT
  • Discuss at your DQ meeting to ensure it is read and understood by those answering DQ statement and review list question
    • Organization mirrors the review list
  • Updated during the year as needed
tug six linked worksheets
TUG: Six Linked Worksheets

Click the options box and select "enable this content"

Tab 1: Forward

Tab 2: TUG Contents Filtered & Linked

Tab 3: TUG

Tab 4: TUG Appendix

Tab 5: DQ Review List

Tab 6: DQ Statement

tug contents
TUG Contents

The following is provided for each review list and statement question:

Performance threshold

Calculation (if applicable)

Details (may include “step-by-step” guidance)

Process

Additional Information

dq review list statement reminders
DQ Review List/StatementReminders
  • Refining/expanding beyond DQ statement…TUG
  • Internal tool to assist in identifying & correcting financial & clinical workload data problems
  • DQMC Review List requires all supporting summary documentation kept on file for 5 years
  • Monthly Requirement
  • All variances on the REVIEW LIST should be briefed with DQ Team and Executive Committee
  • MTFs need back up plans for Data Quality and all other areas that support completing the Review List
  • eDQ is based on the Review List
dq statement due date
DQ Statement Due Date

Aggressive follow up if late:

  • Day One – Notify RMO
  • Day Two – Notify MDSS/CC
  • Day Three – Notify MDG/CC

DUE THE LAST DUTY DAY OF THE MONTH

25th

dq review list comments
DQ Review List Comments
  • Evaluate all comments non-compliant
  • Review comments to ensure complete and concise
  • Problem, corrective action plan, ECD required
  • Do not use “I”, “AFMOA”, “John Doe”, etc…
  • Do use functional area, ie. DQ Manager, Coding Auditor, AFMOA Coding…
  • If stating contractor, system or AFMOA has impacted a metric negatively, require back up documentation
    • These comments will be validated before approved
  • Review comments with Contracting Officer Representative (COR) (if comment provided by contractor) for comments requiring further clarification
  • Comments included on your MTF Statement are posted word for word on TMA and vector check websites
dq review list dq assurance team meeting
DQ Review List DQ Assurance Team Meeting

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question A.3: The DQ Assurance Team or other designated structure met during the month to complete the DQ Management Control Review List (recommend attaching meeting minutes)

Date Completed: __________

Data Month: ______________

dq review list dq assurance team meeting1
DQ Review List DQ Assurance Team Meeting

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question A.4: The DQ Manager briefed last month’s Data Quality Management Control Review List, and Financial and Workload Data Reconciliation and Validation results to the MTF Executive Committee
dq review list tma dq course
DQ Review List TMA DQ Course
  • Recommend using the A.7 a-c to highlight training needs to your MTFs leadership

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question A.7a: TMA Data Quality Course (DQ Manager in the last three years)?
dq review list negative findings
DQ Review List Negative Findings

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question A.8: Was there evidence in meeting minutes or other sources of corrective plans, of appropriate resourcing and actions to follow-up on the previous month's negative findings? 
dq review list rejected data
DQ Review List Rejected Data
  • a) ADM - ADM SADR CAPER Error Report
  • b) AHLTA - AHLTA ADM Exceptions Report
  • c) CCE - ADM SADR/TPOCS Extract Status Display & CCE Interface Error Report
  • d) CHCS - PIT Errors
  • e) DMHRSi - 100% Timecards approved?
  • g) MEPRS (EAS) - Error Correction Unit
  • h) TPOCS – File Upload Status Report

Yes

No

(comment required)

N/A

  • (Only use when no rejected data needed to be corrected or retransmitted)
  • Question B.4: Were all rejected data corrected and retransmitted?  (As applicable.)
dq review list statement end of day
DQ Review List/StatementEnd of Day

Number of closed CHCS appointments

Total CHCS appointments for the month

≥ 97%

≥ 80% but < 97%

(comment required)

< 80%

  • (comment required)
  • Question B.5.a. (DQ Statement question 1a): In the reporting month (include only B*** and FBN* accounts): a) What percentage of appointments were closed in meeting your “End of Day” processing requirements, “Every appointment – Every day?”

Source: BDQAS

bdqas
BDQAS
  • Biometric Data Quality Assurance Service (BDQAS) is a source for many DQ statement questions (https://bdqas.afms.mil/)
  • Updated on the 10th or 11th for non-EAS data
  • EAS data on BDQAS is updated between the 16th and 20th
  • If EAS transmission did not occur on-time, questions that are applicable to EAS must be manually calculated and annotated on the review list
bdqas1
BDQAS

Metrics you can drill down to clinic level and get AFMS rankings

DQ Review List / Statement Report data is found here:

https://bdqas.afms.mil/data_metrics/data_metrics.htm

dq review list monthly statistical report
DQ Review List Monthly Statistical Report
  • MINI_CAPER_DQ adhoc– Use frequently throughout the month to encourage correcting workload in a timely manner

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question B.5.c: Were all workload discrepancies on the CHCS Monthly Statistical Report corrected prior to processing the WWR and WAM files?
mini caper dq report
MINI CAPER DQ REPORT
  • Designed to help Medical Treatment Facilities (MTFs) identify and correct patient appointment workload discrepancies prior to running the MSR
  • Some examples on how to utilize report:
    • Appts Closed at EOD (B.5.a)
    • Workload Count By Provider Type (B.5.c)
    • Ensuring Providers Sign T-cons and Encounters on Time (B.6.a)
    • Determining whether the “ADMIN” status is properly utilized (B.5.d)
  • Report generates a significant amount of appointment data, it can also be used for statistical analysis.
dq review list admin closed
DQ Review List ADMIN Closed
  • # of admin closed appointments: ______

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question B.5.d: Do you have a process or policy in place to ensure the appropriate use of using "admin" when closing encounters in CHCS?
  • NOTE: Administratively closing an appointment is as if the appointment never existed. "Admin" should be used for one of the following reasons:
  • Training and Testing purposes
  • Duplicate encounters
  • Appointment created in error
dq review list statement outpatient timeliness
DQ Review List/StatementOutpatient Timeliness
  • Nurses and Techs with “count” encounters will negatively impact metric; FY12 data has 32K encounters with incorrect workload

Sum of Non-APV CAPER Encounters Coded W/in 3 Business Days

Sum of Non-APV Daily Outpatient Workload Reports (DOWR)

≥ 95%

≥ 80% but < 95%

(comment required)

< 80%

  • (comment required)
  • Question B.6.a (DQ Statement question 2a): What percentage of Outpatient Encounters, other than APVs, has been coded within 3 business days of the encounter?

Source: BDQAS

dq review list statement apv timeliness
DQ Review List/StatementAPV Timeliness

Sum of APV CAPERs Coded W/in 15 Calendar Days

Sum of APV DOWR

≥ 95%

≥ 80% but < 95%

(comment required)

< 80%

  • (comment required)
  • Question B.6.b (DQ Statement question 2b): What percentage of APVs have been coded within 15 days of the encounter?

Source: BDQAS

  • If non-compliant, a time study is required each month until compliant
  • Where are your delays?

Transcription

Records

Provider

Coder

dq review list statement inpatient timeliness
DQ Review List/StatementInpatient Timeliness
  • If the MTF lacks a coder, the numerator will be “0” and the denominator will be taken from the WWR Total Dispositions

Total # of Records Coded

WWR Total Dispositions

≥ 95%

≥ 80% but < 95%

(comment required)

< 80%

  • (comment required)
  • Question B.6.c (DQ Statement question 2c): What percentage of Inpatient records have been coded within 30 days after discharge?

Source: Run “Inpatient Timeliness” ad hoc found on BDQAS

dq review list cce
DQ Review ListCCE

Denominator

  • This question measures CCE utilization. Due to the AF coding model, AF MTFs will have a low percentage for this question.

Numerator

≥ 95%

≥ 80% but < 95%

(comment required)

< 80%

  • (comment required)
  • B.7.a: What percentage of encounters had an encounter coding status of “Completed” for the data month?

Source: CCE

dq review list statement reconciliation
DQ Review List/StatementReconciliation

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question C.1.a (DQ Statement question 3a): Was the monthly MEPRS (EAS) financial reconciliation process completed, validated and approved by the MTF Resource Manager (i.e., AF Budget Officer or Analyst prior to MEPRS monthly transmission?

Source: MEPRS Manager and RMO Office

  • EAS Transmission does not impact this question.
dq review list statement reconciliation1
DQ Review List/StatementReconciliation
  • WGC process is an 11 step process

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question C.1.b: Has the MTF used the Workload Generation Controller (WGC) in CHCS to generate their WWR and WAM files?

Source: MEPRS Manager

dq review list statement mewacs
DQ Review List/StatementMEWACS

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • C.1.d. (DQ Statement question 3b): Were the data load status, outlier/variance, WWR-EAS IV, and allocations tabs in the current MEWACS document reviewed and explanations provided for flagged data anomalies?

Source: MEPRS Manager

  • C.1.d.1 through C.1.d.4 must be answered
  • If you reviewed tabs on MEWACS, C.1.d.1 - C.1.d.4, regardless of anomalies, ANSWER YES
slide77

MEWACS:

http://www.meprs.info

Will be required to register to access

slide78

Select:

Data Load Status

Summary Outliers

WWR/EAS IV Outliers

Allocation Test

afmoa meprs dashboard
AFMOA MEPRS Dashboard
  • Launched MEPRS Dashboard Oct 2009
  • Objectives:
    • Identify variance
    • Evaluate processes
    • Provide training
  • Measures:
    • 20 Key data points with supporting detailed reports
  • Controls:
    • 1 or 2 standard deviations
    • Upper-Lower controls
  • Visibility: Resides on Vector Check – Enterprise-Wide Access https://vc.afms.mil/AFMOA/SGA/SGAR/SGAR_MEPRS/default.aspx

79

afmoa meprs dashboard nellis afb nov 2009
AFMOA MEPRS Dashboard Nellis AFB, Nov 2009

Validated

Error

Error

Error

Research

Error

Error

Errors

80

afmoa meprs dashboard nellis afb apr 2010
AFMOA MEPRS Dashboard Nellis AFB, Apr 2010

Corrected

Corrected

Validated

Corrected

Research

Research

Corrected

Corrected

Corrections Pending

81

dq review list statement timecards
DQ Review List/StatementTimecards
  • Number of Timecards Submitted On-time
  • Total Number of Timecards for an MTF
  • C.1.g (DQ Statement question 3d): For DMHRSi, what is the percentage of approved timecards by the suspense date?
  • Number of Timecards Approved On-time
  • Total Number of Timecards for an MTF
  • Source is MEPRS Manager

=100%

< 100%

(comment required)

  • C.1.f. (DQ Statement question 3c): For DMHRSi, what is the percentage of submitted timecards by the suspense date?
dq review list statement timecards1
DQ Review List/StatementTimecards

C.1.f. (DQ Statement question 3c) For DMHRSi, what is the percentage of submitted timecards by the suspense date? Source is MEPRS Manager?

C.1.g. (DQ Statement question 3d) For DMHRSi, what is the percentage of approved timecards by the suspense date? Source is MEPRS Manager

Number of Timecards Approved On-time

310

320

Total Number of Timecards for an MTF

Cannot be greater than C.1.e.

Remove the following statuses

NULL

NOT SUBMITTED

REJECTED

WORKING

SUBMITTED

Remove all personnel who did not work during pay period

Remember, comments are required if under 100%

Number of Timecards Submitted On-time

315

320

Total Number of Timecards for an MTF

  • Denominators (bottom numbers) should be the same
  • Remove the following statuses
    • NULL
    • NOT SUBMITTED
    • REJECTED
    • WORKING
  • Remove all personnel who did not work during pay period
dq review list statement timecards2
DQ Review List/StatementTimecards

Timecard compliance and EAS transmission

DQ Statements due to AFMOA

Pay period ends

Member PCS’d

Timeliness Timecard submission

Timeliness Timecard approval

Rejected timecards corrected

dq review list statement timecards3
DQ Review List/StatementTimecards

Timecard compliance and EAS transmission

Pay period ends

Timeliness Timecard submission

Timeliness Timecard approval

Rejected timecards corrected

DQ Statements due to AFMOA

dq review list statement chcs duplicate patients
DQ Review List/StatementCHCS Duplicate Patients
  • Run the CHCS standard report – “Potential Duplicate Patient Search”

Report Ran

Report Not Ran

(comment required)

If you are not a host site, LEAVE BLANK

  • Question C.2. a. (DQ Statement question 10) Use CHCS during the data month to identify duplicate patient registration. For CHCS or AHLTA hosts only, what was the number of potential duplicate patient registrationin the data month for all MTFs under the host? (NOTE: Only Host sites report up.)

Source is Internal Process

slide87

DQ Review List/StatementCHCS Duplicate Patients

  • Run Time Statistical Report
    • Validate the accuracy of the potential duplicate patients being reported
    • Provide Summary Documentation (5 year requirement)
    • Detailed Results w/out Protected Health Information (PHI)
    • Identifies if Potential Duplicate’s are resolved
  • The sum of these 4 columns is the potential duplicate number reported on the DQ Statement

87

dq review list statement chcs duplicate patients1
DQ Review List/StatementCHCS Duplicate Patients
  • Must add up to the total listed above
  • Pre-populated with DMIS ID(s) and MTF(s) associated with host site

Total # of potential duplicate patients

slide89

DQ Review List/StatementCHCS Duplicate Patients

  • Potential Duplicate Report
  • Run Time Statistical Report
  • Run the Registration report
  • Run for the entire data month
  • Run this report no earlier than the first day after the data month
  • Identify, Exclude, and/or Merge potential duplicates
  • Provide DQ Manager the potential duplicate number(s) by unresolved, identified, excluded, and merged
  • Use this report as summary documentation
  • Provides results of the Potential Duplicate Report
  • Run this report for the first day after the data month to present
  • This report captures WHEN the potential duplicate report was ran and the results
  • The numbers in the unresolved, identified, excluded, and merged columns are all to be reported on the DQMC Review List & Statement
patient duplicate reporting
Patient Duplicate Reporting
  • DISCLAIMER: We know this is not catching all duplicate patients. Do not use this to gauge the health of your patient file on your CHCS platform. Would recommend on occasion running the “ALL” report and Registration report. However, for DQ reporting purposes, the Registration report number is what should be on the Statement.
  • Just because DQ is asking for the Potential Duplicate Patient Report, does not exclude a facility from running the required monthly PIT Error Discrepancy Report and working them separately. Two different requirements and two different problems.
    • Might see some crossover that the same patient’s are on both reports, but this is normal
dq review list statement eas transmission
DQ Review List/StatementEAS Transmission

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question C.3.a (DQ Statement question 4a): MEPRS/EAS (45 days)
  • Source: MEPRS Manager
  • EAS transmission should not occur until 100% timecard compliance is achieved, per AF/SG policy letter
meprs transmission c 3 a
MEPRS Transmission (C.3.a)
  • Request summary documentation of timely submission
    • Email is generated when MEPRS Transmission occurred
    • Ensure transmission occurred on or before the 45th calendar day after the data month
  • When reviewing BDQAS data, if the numerator for C.9.c is not available, MEPRS Transmission was not timely
dq review list adm sadr caper errors
DQ Review List ADM SADR/CAPER Errors
  • Question C.4.b: Correct the errors listed on the report?

Yes

No

(comment required)

N/A

(not appropriate for this question)

  • Question C.4.a: Check the ADM SADR/CAPER Error Report?
dq review list statement coding accuracy calculation

*Note[p1] : The denominator for all categories should include codes identified by the auditor.

[p1]#134, 135, 136

DQ Review List/Statement Coding Accuracy Calculation

The Service Headquarters will determine the specific random sample to be audited.

*Note: The denominator for all categories should include codes identified by the auditor.

*Note: If your MTF doe not have a coder; the numerator will be 0 and the denominator will be 30

inpatient coding rounds
Inpatient Coding/Rounds
  • MS-DRG and E&M denominators must
  • Expect ICD-9 codes to be higher
  • No good indicator for CPT

Must audit a minimum of 30 records

availability outpt apv
Availability (Outpt/APV)
  • Availability and E&M denominators should match or be close
  • Expect ICD-9 codes to be higher than E&M
  • No good indicator for CPT

If the documentation is available; however, the patient’s outpatient health record is not available, the “record of the encounter” is available for audit

Calculated from the records audited by coding auditor

dq review list statement dd form 2569 availability
DQ Review List/Statement DD Form 2569 Availability
  • If you do not have a coding auditor, an alternate method is provided in the TUG

≥ 95%

≥ 80% but < 95%

(comment required)

< 80%

  • (comment required)
  • Question C.8. (DQ Statement questions 8a (Inpatient), 8c (Outpatient), 8e (APVs)): What percentage of completed and current (signed within the past 12 months) DD Form 2569s (TPC Insurance Info) are available for audit?

Source: UBO Manager

Number of Complete and Current DD Form 2569s Available

Number of Non-Active Duty Records available from Audit

roles and responsibilities 2569 pull list audit
Roles and Responsibilities2569 Pull List/Audit
  • Coding Auditor - COPY and PASTE the encounters from CARS then paste in a word document in a landscape format
  • UBO Manager - Exclude all the active duty member’s and audit ALL non-active duty members
    • Do not alter list
    • Auditing only 30 is not acceptable
  • DQ Manager - Provide a listing of non-active duty members to UBO Manager using alternate method only when there is not a coding auditor
2569 dq review list statement questions
2569 DQ Review List/Statement Questions

C.8.c. What percentage of completed and current (signed within the past 12 months) DD Form 2569s (TPC Insurance Info) is available for audit (non-active duty encounters only)?

C.8.d. What percentage of available, current and complete DD Form 2569s is verified to be correct in the Patient Insurance Information (PII) module in CHCS?

Number of DD Form 2569s Correct in PII Module in CHCS

93

95

Number of Available, Current and Complete Non Active Duty DD Form 2569s available from the Outpatient – Non APV 2569 Audit

The numerator in C.8.c. becomes your denominator in question C.8.d.

Number of complete and Current DD Form 2569s Available

95

100

Number of Non-Active Duty Non-APV Records Available from Audit

  • Searching for a patients 2569 information in Mini Registration is incorrect and should not be used to conduct the audit
dq review list statement workload
DQ Review List/Statement Workload
  • Source: BDQAS
  • If EAS was not transmitted on-time, manually calculate numerator

≥ 95%

≥ 80% but≤ 95% or

≥ 105%

(comment required)

< 80%

  • (comment required)
  • C.9.c. (DQ Statement question 9c): Comparison of reported workload data.

Number of MEPRS visits

Number of Kept Appts (count only)

dq review list statement rounds
DQ Review List/Statement Rounds
  • Number of “A***” CAPERS completed by attending provider or service (FCC=A***)
  • Number of Sum WWR
  • (Bed Days + Bassinet Days + Dispositions)

Questions C.5.f-h

≥ 95%

≥ 80% but < 95%

< 80%

Question C.9.e

≥ 80%

≥ 110%

< 80%

  • Question C.5.f-h (DQ Statement questions 5b-d): Coding Accuracy of Rounds
  • Question C.9.e (DQ Statement question 9e): Comparison of reported workload data
  • Source: M2 and WWR
rounding
Rounding
  • Per AF DQ TUG: Percentages must be reported to one decimal point. Rounding of actual performance calculations beyond one decimal point is prohibited.
    • This means if percentage is 94.9% for the questions where compliance is 95%, a comment will be required and question is non-compliant
edq documents
eDQ Documents

Vector Check URL: https://vc.afms.mil

comments space limitations
Comments & Space Limitations

Limited to 1,000 Characters

Limited to 1,000 Characters

Limited to 1,000 Characters

take aways
Take Aways

END OF DAY

CODING

  • Data must be:

APPT STANDARDIZATION

  • Front-end processes are CRITICAL to back-end success

ASD RECONCILIATION

DMHRSi

BUSINESS PLANS

PROVIDER FILE

CAPERS

ENGAGED DQ TEAM

2569 COLLECTION

ANALYSIS OF DATA

ADM

AND MUCH, MUCH MORE!

Data Quality is much more than the DQ Statement

afmoa dq point of contacts
AFMOA DQ Point of Contacts

Group Email Box: afmoa.dq@us.af.mil

summary
Summary

Organization

Why Data Quality?

MTF Engagement

Guidance

DQ Assurance Team

CHCS Provider File

Metrics

Other DQ Efforts

DQ Review List/Statement Guidance & Completion

eDQ