1. AHLTA Data Quality Management Course August 2008 DHIMS Sustainment

2. Known Issues • Current elephant in the closet • Duplicate Patients • ADM Writeback Errors

3. Why Duplicate Patients • Human unintended error • Typographic errors • Critical errors (EDI_PN, SSN, Last_Name) • Less critical errors (MIDDLE_Name, Gender, SPONSOR_SSN, etc.) • Inaccurate information from source • Human Intentional error • Time pressure • Multiple eligibilities • Pseudo-SSN • Automated errors • PIT calls, etc.

4. Attention to detail at the MTF • Errors have been classified result • Ongoing assessment of error generation mechanism • Manual process developed to correct errors • Exploration of automated error correction • Experience and training • Air Mobility Command experience • Pre-study error rate: 25% • Post-training error rate: 15% Air Force assessment all CHCS hosts except Wilford-Hall and Wright-Patterson

5. AHLTA and Patient Merge… • How are patient merge issues resolved today • TMCI (Tier 3) Triage group receives and manages all MHS trouble tickets • After investigation and verification that it is truly a merge issue the information is sent to DISA • DISA then combines the different records into one “KEPT” record. • Automated identification and resolution • Today resolve as identified by patients – 18000/year • 1.3 million in CDR – automated system will clean up • Automated system with find and resolve realtime

6. 102 Exceptions ADM Processing Error - Failed WAM Validation • Invalid or Out-of-Sync ICD9 codes and CPT codes • 99371 is not a valid value for EM code (99372,99373,99361,99362) • There has been a significant increase in 102 failures is due to obsolete E&M codes being removed from the table without the replacement E&M codes being available for selection in AHLTA. • Can be manually coded in CHCSI by the site but will still show on the AHTLA ADM exception report. We can have the site run an adhoc in CHCS to confirm which failures were coded manually and change the status in the CDR so it will no longer be reflected as a 102 exception. • Day forward remedied when all sites upgraded to 838.23. Historical fix is ongoing through NG Tier III

7. 103 Exceptions ADM Processing Error - Undefined CHCS Error Disposition is required Invalid Modifier MOD1 for EM code Injury Cause Code is missing M/Objects errors 3 Current Major Issues: Error due to codes not available for use. Fix is requeue done centrally by NG The significant increase in 103 failures is attributed to TCONs failing with the "Disposition is required" error due to the ADMp1p2 requirement, which was implemented with M/Objects 97.2. The problem is that prior to the setting of the ADMp1p2 variable, CHCS/ADM was accepting the TCONS without dispositions. This will be remedied when the sites upgrade to 3.3.3.1 or there is a modification to M/Objects to turn the variable off. There is also a TCON error where there is no IEN. This is fixed in 3.3.3.1 or in an M/Objects fix. M/Objects fix for both “Disposition is required” and IEN = 0 is aprox 30 days away.

8. Questions???