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Navy Medical Data Quality Management Control Program

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

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  1. Navy Medical Data Quality Management Control Program DQMCP Conference February, 2007

  2. 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

  3. 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

  4. 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

  5. Review List DQMCP Conference, February, 2007

  6. 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

  7. End of Day (EOD) • 24/7 clinics/ER EOD by 0600 following day • Automated through NMIMC DQ Website DQMCP Conference, February, 2007

  8. Coding Timeliness • SADR = Three BUSINESS days • APV = 15 calendar days • Inpatient = 30 calendar days DQMCP Conference, February, 2007

  9. 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

  10. Timely Data Submission • MEPRS – EOM + 30 days (Navy) • SIDR – EOM + 5 working days • SADR – Daily • WWR – EOM + 10 DQMCP Conference, February, 2007

  11. Professional Services Encounters • New for FY-07 • Requires coding quality checks on IBWA (inpatient professional services) encounters DQMCP Conference, February, 2007

  12. Outpatient Records • Random audit DQMCP Conference, February, 2007

  13. Ambulatory Procedure Visits • Change for FY-07 in 7 (b). E&M codes no longer required for APVs DQMCP Conference, February, 2007

  14. 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

  15. AHLTA / SADR Encounters • “B” accounts only • Excludes APV data • Excludes BIA (Emergency Room) DQMCP Conference, February, 2007

  16. Roles/Responsibilities DQMCP Conference, February, 2007

  17. 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

  18. 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

  19. 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

  20. Points of Contact DQMCP Conference, February, 2007

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