Pam Shoemaker Irene Smith Jacki Bebb

1.  Pam ShoemakerIrene SmithJacki Bebb Jacki: Although this is a hands on presentation, I am unable to access the intranet site. So if you could bare with me for a few minutes and take a break from your hands on learning that Pam presented (give your fingers a rest? and I will walk you through the HIM Metric Dashboard. Jacki: Although this is a hands on presentation, I am unable to access the intranet site. So if you could bare with me for a few minutes and take a break from your hands on learning that Pam presented (give your fingers a rest? and I will walk you through the HIM Metric Dashboard.

2. Class Overview Ambulatory Care Reporting Package (hands-on) - Pam Shoemaker Health Information Management Metrics Dashboard – Jacki Bebb Inpatient Reports (hands-on) – Irene Smith

3. AMBULATORY CARE REPORTING PACKAGE (acrp) My name is Pam Shoemaker. I’m the Business Office Program Integrator (Health Administration Service ADPAC) in Lexington, KY. I am a RHIT, been with the VA for 34 years and have a background in Health Information Management. My portion of this presentation will be mostly hands-on. I’ll be covering the Ambulatory Care Reporting Package and the AD HOC report.My name is Pam Shoemaker. I’m the Business Office Program Integrator (Health Administration Service ADPAC) in Lexington, KY. I am a RHIT, been with the VA for 34 years and have a background in Health Information Management. My portion of this presentation will be mostly hands-on. I’ll be covering the Ambulatory Care Reporting Package and the AD HOC report.

4. Objectives Identify Canned ACRP Reports and the Data they provide Navigate through the ACRP AD HOC Reports My objectives are to familiarize you with the canned reports that are available through the Ambulatory Care Reporting Package and to teach you how to pull your own data from the AD HOC repoMy objectives are to familiarize you with the canned reports that are available through the Ambulatory Care Reporting Package and to teach you how to pull your own data from the AD HOC repo

5. ACRP AD HOC Reports You can pull data in a variety of ways Detailed or Summary of Data You control the style of the report You are able to narrow down the data Can compare data for the same date range the previous year Eliminates the need for pulling the data from fileman This portion of the training is hands on. I’m going to show you a variety of ways to pull specific data through the AD HOC Report. I want to you be able to see the variety of reports you can pull without having to be a rocket scientist. So, lets get started. First, select the menu option: ACRP AD HOC Reports.This portion of the training is hands on. I’m going to show you a variety of ways to pull specific data through the AD HOC Report. I want to you be able to see the variety of reports you can pull without having to be a rocket scientist. So, lets get started. First, select the menu option: ACRP AD HOC Reports.

6. SCENARIO 1 You have received a request asking for the number of outpatient visits for the month of January 2010. Select summary, date range, outpatient visits, status, checked out.Select summary, date range, outpatient visits, status, checked out.

7. SCENARIO 2 That isn’t what they really wanted. They want to know the number of outpatient visits by service/specialty for the month of January 2010. Summary, date range, service, status, checked out.Summary, date range, service, status, checked out.

8. SCENARIO 3 Now that you have pulled that data, it would really be nice to see the workload by provider for the patients in Primary Care. Is the workload being distributed equally? Still looking at January 2010. Summary, date range, provider, all providers, clinic, clinic group, 323, status, checked out.Summary, date range, provider, all providers, clinic, clinic group, 323, status, checked out.

9. SCENARIO 4 There is talk of opening a new CBOC. To help decide which patients would best benefit by opening one closer to their home, management needs to know what counties the patients that were seen in January 2010 live. Summary, date range, patient demographics, state, patient demographics, county, status, checked out.Summary, date range, patient demographics, state, patient demographics, county, status, checked out.

10. HEALTH INFORMATION MANAGEMENT METRICS DASHBOARD Jacki: Although this is a hands on presentation, I am unable to access the intranet site. So if you could bare with me for a few minutes and take a break from your hands on learning that Pam presented (give your fingers a rest? and I will walk you through the HIM Metric Dashboard. Jacki: Although this is a hands on presentation, I am unable to access the intranet site. So if you could bare with me for a few minutes and take a break from your hands on learning that Pam presented (give your fingers a rest? and I will walk you through the HIM Metric Dashboard.

11. Definitions of Metrics Date of discharge to date of Patient Treatment File (PTF) transmission Notes completed within 2 days External Peer Review Program (EPRP) Coding Accuracy indicators – Quality indicators Moderate sedation code usage Educode on-line training usage QuadraMed webcast usage Add-on code usage Modifier 25 usage The metrics are as you see here. one of the criteria for choosing a national metric is the availability of the data at the national level. Regarding the metrics above the data of discharge to date of PTF transmission, moderate sedation code usage, Add On code Usage, and Moodier 25 code usage are all extracted from the Corporate Data Warehouse at the national level. The notes completed within 2 days is pulled in from the Office of Quality and Performance website as it is an established supporting indictor. The Educode and QuadraMed usage metrics are fed to our portal via the vendors who provide these services. The metrics have a direct to the demonstration of the quality of coded data, timely completion of the electronic health record, impact to the performance measurement system (i.e. EPRP), HIM operational efficiencies – are your coding cases being completed timely. How are you doing in comparison to other facilities, your visin, the nation? Are you fully utilizing the coding resources given to you to train your coding staff to function at the level that is expected and described in VHA Handbooks. The metrics are as you see here. one of the criteria for choosing a national metric is the availability of the data at the national level. Regarding the metrics above the data of discharge to date of PTF transmission, moderate sedation code usage, Add On code Usage, and Moodier 25 code usage are all extracted from the Corporate Data Warehouse at the national level. The notes completed within 2 days is pulled in from the Office of Quality and Performance website as it is an established supporting indictor. The Educode and QuadraMed usage metrics are fed to our portal via the vendors who provide these services. The metrics have a direct to the demonstration of the quality of coded data, timely completion of the electronic health record, impact to the performance measurement system (i.e. EPRP), HIM operational efficiencies – are your coding cases being completed timely. How are you doing in comparison to other facilities, your visin, the nation? Are you fully utilizing the coding resources given to you to train your coding staff to function at the level that is expected and described in VHA Handbooks.

12. HIMS Metric Report from VSSC Jacki: Here is a screen shot of the dashboard. For a more detailed definition of all of the metrics displayed, click on the data definitions box. Overall the dashboard is organized by VISN – you navigate to your visn by selecting the drop down arrow on the upper left hand side of the page. There are 2 or 3 pages displayed per VISN and you will be able to tell this by seeing what page you are on, for example this page is on page one of 3 in VISN 1, you click the right arrow to advance to the next page. There are two helpful buttons on the right hand side of the page, in blue boxes, the data definitions and the VSSC Help Desk. You may click into these to find out the definitions of the metrics and the date sources or if you are having a problem viewing your data you may send a ticket to the help desk here. The dashboard is organized by subject, facility, current reporting period ( you will notice some are different based on the frequency of their collection , the PTF metric is collected after close out so it will update each month) Target is the established goal or benchmark to reach and the trend column and the target indicator column are directly tied to this field in conjunction with the current period performance number. Actual is the performance for the reporting period, target indicator give you a red or yellow stop light indictor. Prior period to tied to the performance trend. The trend is displayed in a green or red arrow and the performance trend column tell you if higher or lower numbers will effect the trend column. Jacki: Here is a screen shot of the dashboard. For a more detailed definition of all of the metrics displayed, click on the data definitions box. Overall the dashboard is organized by VISN – you navigate to your visn by selecting the drop down arrow on the upper left hand side of the page. There are 2 or 3 pages displayed per VISN and you will be able to tell this by seeing what page you are on, for example this page is on page one of 3 in VISN 1, you click the right arrow to advance to the next page. There are two helpful buttons on the right hand side of the page, in blue boxes, the data definitions and the VSSC Help Desk. You may click into these to find out the definitions of the metrics and the date sources or if you are having a problem viewing your data you may send a ticket to the help desk here. The dashboard is organized by subject, facility, current reporting period ( you will notice some are different based on the frequency of their collection , the PTF metric is collected after close out so it will update each month) Target is the established goal or benchmark to reach and the trend column and the target indicator column are directly tied to this field in conjunction with the current period performance number. Actual is the performance for the reporting period, target indicator give you a red or yellow stop light indictor. Prior period to tied to the performance trend. The trend is displayed in a green or red arrow and the performance trend column tell you if higher or lower numbers will effect the trend column.

13. Metrics Changes for FY10 New: Date of Outpatient Encounter to Date of Transmission Unstable Angina Discontinued FY09 Jacki: I mentioned before that one of the criteria for selecting national metrics is the availability of that data at the national level. Unfortunately we do not have access to the date of outpatient encounter to date of transmission. The date of transmission field in the Austin data base is overwritten each time a transmission is received. After testing this we realized that this information would have to come from the local level. This information is in your quadramed applications. The HIM Field Leadership council it rewriting a proposed set of instructions to extract this data each month at your local site. The CBO as you can imagine is very interested in how long billable op encounter are taking to be coded. In other words this metric will mirror the inpatient PTF metric, but will report TAT of outpatient encounter coding. There will be two data points that will need to be reported and entered into central SharePoint site. Those will be the TAT from the visit date and the TAT from the coder assignment date. More detail and deadlines will be forthcoming. It is the expectation of the CBO that the HIM community provide this national metric by the end of this FY. FY10 Q3 will be the testing period and FY10 Q4 will be the go live date. Jacki: I mentioned before that one of the criteria for selecting national metrics is the availability of that data at the national level. Unfortunately we do not have access to the date of outpatient encounter to date of transmission. The date of transmission field in the Austin data base is overwritten each time a transmission is received. After testing this we realized that this information would have to come from the local level. This information is in your quadramed applications. The HIM Field Leadership council it rewriting a proposed set of instructions to extract this data each month at your local site. The CBO as you can imagine is very interested in how long billable op encounter are taking to be coded. In other words this metric will mirror the inpatient PTF metric, but will report TAT of outpatient encounter coding. There will be two data points that will need to be reported and entered into central SharePoint site. Those will be the TAT from the visit date and the TAT from the coder assignment date. More detail and deadlines will be forthcoming. It is the expectation of the CBO that the HIM community provide this national metric by the end of this FY. FY10 Q3 will be the testing period and FY10 Q4 will be the go live date.

14. External Peer Review Program Coding Quality Indicators Acute Myocardial Infarction Heart Failure Pneumonia Coding Quality Indicators under the Office of Quality and Performance Measurement system. These are reported to you at you facilities EPRP exit each time they complete their review of your facility. Coding Quality Indicators under the Office of Quality and Performance Measurement system. These are reported to you at you facilities EPRP exit each time they complete their review of your facility.

15. Is the Coding Validation a Performance Measurement? No, the coding validation study indicators are quality indicators and are scored for quality improvement purposes only. However they could be chosen as performance measures in the future. But….it’s important to remember that most performance measures are directly impacted by coding, as the pulled cases are identified by the ICD 9 code. Jacki: I pulled some FAQ’s regarding the EPRP process. Remember that the coding abstraction are supporting indicators, not actual performance measures. However, if the coding is incorrect the pulls for the performance measures can be skewed. Jacki: I pulled some FAQ’s regarding the EPRP process. Remember that the coding abstraction are supporting indicators, not actual performance measures. However, if the coding is incorrect the pulls for the performance measures can be skewed.

16. Goal 95 % Coding Accuracy VHA Handbook 1907.03 HIM Clinical Coding Program Procedures All Inpatient Coding Quality Indicators Met FY10 Q1 & Q2 Jacki: The goal of all coding indicators – whether inpatient or outpatient our standard is documented in our coding handbook. The good news is we have met or exceeded all of the inpatient coding measures as of Q1 of this fiscal year. So all of you should stop and take a minute to say “good job” to yourself! Very nice work! Celebrate!Jacki: The goal of all coding indicators – whether inpatient or outpatient our standard is documented in our coding handbook. The good news is we have met or exceeded all of the inpatient coding measures as of Q1 of this fiscal year. So all of you should stop and take a minute to say “good job” to yourself! Very nice work! Celebrate!

17. VHA Comparative Results Jacki: As you can see coding accuracy has improved on all of the inpatient quality indicators since the inception of the indicators. This is a tribute to all of the VHA coders in the VA who have continued to focus on these issues and work to improve their coding practices and also their local documentation practices when needed. In the case study we conducted on AMI and UA, may times the lack of documentation specificity was the root of the coding error.Jacki: As you can see coding accuracy has improved on all of the inpatient quality indicators since the inception of the indicators. This is a tribute to all of the VHA coders in the VA who have continued to focus on these issues and work to improve their coding practices and also their local documentation practices when needed. In the case study we conducted on AMI and UA, may times the lack of documentation specificity was the root of the coding error.

18. Coding Quality Indicator References http://vaww.pdw.med.va.gov/index.asp Performance Cube External Peer Review Program (EPRP) Liaison Handbook Results are found Quarterly on Office of Quality and Performance Executive Briefing Book: http://vaww.oqp.med.va.gov/ Standard Operating Procedure SOP to re-transmit a record: ://vaww.vhaco.va.gov/him/refsresources/419ValidationProcess_Cleveland.doc Reference Material is available on all Coding Indicators: EPRP Coding Validation Study- Frequently Asked Questions Past PowerPoint Presentations All can be found on the reference page of the HIM Website: http://vaww.vhaco.va.gov/him Jacki: here are some specific references regarding the EPRP coding indicators. Jacki: here are some specific references regarding the EPRP coding indicators.

19. Dashboard Access http://vaww.vhaco.va.gov/him/ Jacki: If you haven’t visited the dashboard, I highly encourage you to do so. The dashboard can be accessed via the VACO HIM Website. When you go to the website, choose the HIM Metrics on the left hand side of the page, then click on the VSSC HIM Metrics Dashboard which will launch you to the dashboard. The actual site is listed for you reference eon the slide displayed. There are also other information and references regarding the metrics such as the history, data definitions, VSSC helpdesk, and all previous presentations regarding the metrics. Jacki: If you haven’t visited the dashboard, I highly encourage you to do so. The dashboard can be accessed via the VACO HIM Website. When you go to the website, choose the HIM Metrics on the left hand side of the page, then click on the VSSC HIM Metrics Dashboard which will launch you to the dashboard. The actual site is listed for you reference eon the slide displayed. There are also other information and references regarding the metrics such as the history, data definitions, VSSC helpdesk, and all previous presentations regarding the metrics.

20. INPATIENT, SURGERY PROCEDURE CODING, CONSULT TRACKING MONITOR REPORTS We now want to review a couple of “miscellaneous” reports that are important reports to validate and are also very useful when trying to monitor inpatient activity, Surgery activity passing to the Patient Care Encounter application and consult tracking. I will list several reports that are daily activity reports and can be ran at any time but I want to highlight those that are essential for “someone” at your medical center to be on top of at all times.We now want to review a couple of “miscellaneous” reports that are important reports to validate and are also very useful when trying to monitor inpatient activity, Surgery activity passing to the Patient Care Encounter application and consult tracking. I will list several reports that are daily activity reports and can be ran at any time but I want to highlight those that are essential for “someone” at your medical center to be on top of at all times.

21. Inpatient ReportsCurrent Inpatients  'Inpatient Listing' Option name: DG INPATIENT LIST This option is used to generate a listing of current inpatients. The list can be generated in several formats, i.e., with ward breakout, DRG breakout, etc.   'Inpatient Roster' Option name: DG INPATIENT ROSTER The Inpatient Roster report will provide a listing of patients sorted/selected by either Ward or Provider. The report contains Name, Id, Age, Admission Date, LOS, Ward, Room-Bed, Primary Physician, Attending Physician, Treating Specialty, and Means Test Status. It will also allow you to specify the number of copies to print.   Female Inpatient List (Current)' Option name: DG FEMALE CURRENT INPT LIST This option is used to generate a listing of females who are currently inpatients in the medical center. The reports listed here are daily reports which are ran by many services in the medical center for different reason. The Inpatient Listing will give the user ward breakout along with DRG. The Inpatient Roster will give more demographic information to include Means Test Status. There is also a report that is a subset of the inpatient reports that will only show the Females currently in the hospital. There are also reports that can be ran for a past date for inpatient listing. Please note that the Historical Listing reports should be ran sparingly and preferably in off peak hours. These reports have be used to find where patients were in hospital or a specific room for a date in the past. Maybe a patient returns to the medical center with a communicable disease and you need to know what patients may have come in contact with this patient during his stay. Printing one of the Historical Inpatient reports may help with that search. The reports listed here are daily reports which are ran by many services in the medical center for different reason. The Inpatient Listing will give the user ward breakout along with DRG. The Inpatient Roster will give more demographic information to include Means Test Status. There is also a report that is a subset of the inpatient reports that will only show the Females currently in the hospital. There are also reports that can be ran for a past date for inpatient listing. Please note that the Historical Listing reports should be ran sparingly and preferably in off peak hours. These reports have be used to find where patients were in hospital or a specific room for a date in the past. Maybe a patient returns to the medical center with a communicable disease and you need to know what patients may have come in contact with this patient during his stay. Printing one of the Historical Inpatient reports may help with that search.

22. Inpatient Reports Patient Movement List' Option name: DGPM PATIENT MOVEMENT LIST This option lists the admissions discharges and transfers that have taken place up to T-5 to today. The list displays the patients name, PT ID (SHORT FORM), DATE/TIME OF THE MOVEMENT, the FROM and TO of the movement. This was an old Dietetics routine renamed in the MAS namespace. 'Treating Specialty Print' Option name: DG TREATING PRINT This option is used to generate a listing of treating specialties for your medical center. The Patient Movement List report can help with validating movements in PTF. Note that the Patient Movement List is limited to current day minus 5 days. The Treating Specialty Print will help in determining how treating specialties are set up within your Medical Center. This is a print of all treating specialties within the facility treating specialty file #45.7. It displays all effective dates, their active or inactive status, and the associated national specialty. You may need this report to understand the next report that we are going to do to validate patient treating specialty assignments. The Patient Movement List report can help with validating movements in PTF. Note that the Patient Movement List is limited to current day minus 5 days. The Treating Specialty Print will help in determining how treating specialties are set up within your Medical Center. This is a print of all treating specialties within the facility treating specialty file #45.7. It displays all effective dates, their active or inactive status, and the associated national specialty. You may need this report to understand the next report that we are going to do to validate patient treating specialty assignments.

23. Inpatient ReportsInpatient Information   'Treating Specialty Inpatient Information' Option name: DGPM TS INPATIENT INFORMATION This option is intended to printout lists with Treating Specialty Inpatient Information for a specific date in the past. Three separate and different lists can be generated. Patient Listing by Ward and Patient Listing by Treating Specialty print the individual patient information, as well as, the subcounts and totals. The Patient Count by Treating Specialty does not print the individual patient information, but does print the subcounts and totals for each Facility Treating Specialty by Division. All three provide information on the absences: Pass, AA, UA and ASIH with subcounts and totals for each of them. I would like to highlight the Treating Specialty Inpatient Information report. This has been a very valuable report when trying to validate the G&L, more specifically the Bed Status Report and the Treating Specialty Report. Let’s take a minute and walk thru this report. This report will list all the patients by ward, then another report listing the patients by treating specialty and then total count of patients by division by treating specialty. Great tool for listing the patient names that are represented on the Bed Status Report and Treating Specialty Report. Lets access the ‘Treating Specialty Report’ by fist going to the Inpatient/Lodger Report menu then selection the option. Enter the date of TODAY-1 (T = today so T-1 = yesterday) Answer YES to the next three questions then hit return at the device prompt. This will create 3 reports in ONE The Patient Listing By Ward The numbers here should reflect the numbers on your G&L’s Bed Status Report. This report will put a name with the number. The last report is the stats only report, by division, for treating specialties. I would like to highlight the Treating Specialty Inpatient Information report. This has been a very valuable report when trying to validate the G&L, more specifically the Bed Status Report and the Treating Specialty Report. Let’s take a minute and walk thru this report. This report will list all the patients by ward, then another report listing the patients by treating specialty and then total count of patients by division by treating specialty. Great tool for listing the patient names that are represented on the Bed Status Report and Treating Specialty Report. Lets access the ‘Treating Specialty Report’ by fist going to the Inpatient/Lodger Report menu then selection the option. Enter the date of TODAY-1 (T = today so T-1 = yesterday) Answer YES to the next three questions then hit return at the device prompt. This will create 3 reports in ONE The Patient Listing By Ward The numbers here should reflect the numbers on your G&L’s Bed Status Report. This report will put a name with the number. The last report is the stats only report, by division, for treating specialties.

24. Surgery & PCE (Patient Care Encounter) Monitors The surgery application includes an interface to the Patient Care Encounters (PCE) software that allows ambulatory procedure workload information to be transmitted to the National Patient Care Database (NPCD) at Austin. The Surgery Site Parameters File has a field that used to be modifiable but no longer is: UPDATES TO PCE: ALL CASES Since patch SR*3*119 (released in 2005) no site can select to send only Outpatient data. The Surgery application includes an interface to the Patient Care Encounter, also known as PCE, which collects specific information that is transmitted to the National Patient Care Database (NPCD) that is located in Austin. Most people think of PCE as a collection of Outpatient Information but as of 2005 it is now collecting procedure information, both Operating Room and Non-O.R. proceduresThe Surgery application includes an interface to the Patient Care Encounter, also known as PCE, which collects specific information that is transmitted to the National Patient Care Database (NPCD) that is located in Austin. Most people think of PCE as a collection of Outpatient Information but as of 2005 it is now collecting procedure information, both Operating Room and Non-O.R. procedures

25. Encounter relationships within Surgery Application All surgery cases, O.R. or NON-O.R., need a location to create an encounter. For O.R. Cases - the location that counts for PCE is the ASSOCIATED CLINIC in the LOCAL SURGICAL SPECIALTY File – not the operating room. For NON-O.R. procedures, there are 2 places where the location is determined: If the NON-O.R. LOCATION is a count clinic, PCE will use that clinic and not look at the ASSOCIATED CLINIC. If the NON-O.R. LOCATION is not a count clinic, PCE will look at the ASSOCIATED CLINIC and that must be a count clinic. All surgery cases are to be sent to PCE for workload capture. O.R. related cases are sent via a set up done by the application coordinator responsible for the surgery application. They would probably coordinated this with the Decision Support Service (DSS) department or the Health Administration Service (HAS) application coordinator. For Non-O.R. procedures..an example would be a cardioversion done in an Intensive Care Unit or Life Support (ER), the encounter will be associated with the “clinic” selected at the time the provider creates a note. All surgery cases are to be sent to PCE for workload capture. O.R. related cases are sent via a set up done by the application coordinator responsible for the surgery application. They would probably coordinated this with the Decision Support Service (DSS) department or the Health Administration Service (HAS) application coordinator. For Non-O.R. procedures..an example would be a cardioversion done in an Intensive Care Unit or Life Support (ER), the encounter will be associated with the “clinic” selected at the time the provider creates a note.

26. Surgery Coding Workload Monitor Reports 'PCE Filing Status Report' Option name: SRO PCE STATUS 'Outpatient Encounters Not Transmitted to NPCD' Option name: SRO PCE NOTRANS ‘Update/Verify Procedure/Diagnosis Codes option’ Option Name: SRCODING EDIT In this section we will highlight the first two reports listed as our hands-on work. These two reports will allow the medical center staff to monitor the completed O.R. cases and Non-O.R. procedures for workload credit. The Update/Verify Procedure/Diagnosis Codes option is the option that is used to code the completed O.R. cases and Non-O.R. procedures for workload credit. It is a VITAL part of the workload capture processIn this section we will highlight the first two reports listed as our hands-on work. These two reports will allow the medical center staff to monitor the completed O.R. cases and Non-O.R. procedures for workload credit. The Update/Verify Procedure/Diagnosis Codes option is the option that is used to code the completed O.R. cases and Non-O.R. procedures for workload credit. It is a VITAL part of the workload capture process

27. 'PCE Filing Status Report' Option name: SRO PCE STATUS This option provides a report of the PCE filing status of completed cases performed during the selected date range. The report may be printed for O.R. surgical cases, non-O.R. procedures or both. Also, the report may be printed for all specialties or for a single specialty only. This report is intended to be used as a tool in the review of Surgery case information that is passed to PCE. The report uses 2 status categories: (1) FILED - This status indicates that case information has already been filed with PCE. (2) NOT FILED - This status indicates that the case information has not been filed with PCE. The case may or may not be missing information needed to file with PCE. Two forms of the report are available, the long and the short. The long form uses a 132 column format and prints case information including the surgeon/provider, the attending, the specialty, the principal post-op diagnosis, and the principal procedure. If the PCE filing status is FILED, the CPT codes and ICD diagnosis codes will be printed. If the filing status is NOT FILED, information fields needed for PCE filing that do not contain data will be printed. At the end of the report, the number of cases in each PCE filing status will be printed, plus the number of CPT and ICD codes for cases with a status of FILED. The short form uses an 80 column format and does not include surgeon/provider, attending, principal post-op diagnosis and CPT and ICD code information. The totals printed at the end will show only the total cases for each status.  This option provides a report of the PCE filing status of completed cases performed during the selected date range. The report may be printed for O.R. surgical cases, non-O.R. procedures or both. Also, the report may be printed for all specialties or for a single specialty. This report is intended to be used as a tool in the review of Surgery case information that is passed to PCE. The report uses 2 status categories: (1) FILED - This status indicates that case information has already been filed with PCE. (2) NOT FILED - This status indicates that the case information has not been filed with PCE. The case may or may not be missing information needed to file with PCE. Two forms of the report are available, the long and the short. The long form uses a 132 column format and prints case information including the surgeon/provider, the attending, the specialty, the principal post-op diagnosis, and the principal procedure. If the PCE filing status is FILED, the CPT codes and ICD diagnosis codes will be printed. If the filing status is NOT FILED, information fields needed for PCE filing that do not contain data will be printed. At the end of the report, the number of cases in each PCE filing status will be printed, plus the number of CPT and ICD codes for cases with a status of FILED. The short form uses an 80 column format and does not include surgeon/provider, attending, principal post-op diagnosis and CPT and ICD code information. The totals printed at the end will show only the total cases for each status.  Note - the ones that are listed as NOT FILED need to be coded via the Update/Verify Procedure/Diagnosis Codes option [SRCODING EDIT] You may also see a status of FILED with the SCHED STATUS = Action Required This means that the encounter IS in PCE but still requires the completion of specified data fields This option can be access through Management Reports [SR MANAGE REPORTS] menu and select the PCE Filing Stats Report. OR under the CPT/ICD9 Coding Menu [SRCODING MENU] The Division we will be using is CAMP MASTER You will have only three prompts to enter At the first prompt let’s select # 3 for both O.R. and Non-O.R. procedures and then enter a date range of February 1, 2007 to April 5, 2007. Select the SHORT form And then accept the default of HOME Reviewing this report you will two types of status’ listed on the far right hand side. Filing Status which can be either FILED or NOT FILED Remember this indicates whether the encounter has made it to PCE Right under the Filing Status you see the SCHED (scheduling) Status This will be either INPATIENT, CHECK-OUT, or Action Required, Non-Count Anything with the filing status of NOT FILED or the Scheduling Status of Action Required must be coded using the Update/Verify Procedure/Diagnosis Codes option [SRCODING EDIT] You may even see one that with a status of NOT FILED but with No Missing Data listed in the area that normally shows the information that needs to be entered. For this case the coder should use the Update/Verify Procedure/Diagnosis Codes option and validate that all data has been entered. This option provides a report of the PCE filing status of completed cases performed during the selected date range. The report may be printed for O.R. surgical cases, non-O.R. procedures or both. Also, the report may be printed for all specialties or for a single specialty. This report is intended to be used as a tool in the review of Surgery case information that is passed to PCE. The report uses 2 status categories: (1) FILED - This status indicates that case information has already been filed with PCE. (2) NOT FILED - This status indicates that the case information has not been filed with PCE. The case may or may not be missing information needed to file with PCE. Two forms of the report are available, the long and the short. The long form uses a 132 column format and prints case information including the surgeon/provider, the attending, the specialty, the principal post-op diagnosis, and the principal procedure. If the PCE filing status is FILED, the CPT codes and ICD diagnosis codes will be printed. If the filing status is NOT FILED, information fields needed for PCE filing that do not contain data will be printed. At the end of the report, the number of cases in each PCE filing status will be printed, plus the number of CPT and ICD codes for cases with a status of FILED. The short form uses an 80 column format and does not include surgeon/provider, attending, principal post-op diagnosis and CPT and ICD code information. The totals printed at the end will show only the total cases for each status.  Note - the ones that are listed as NOT FILED need to be coded via the Update/Verify Procedure/Diagnosis Codes option [SRCODING EDIT] You may also see a status of FILED with the SCHED STATUS = Action Required This means that the encounter IS in PCE but still requires the completion of specified data fields This option can be access through Management Reports [SR MANAGE REPORTS] menu and select the PCE Filing Stats Report. OR under the CPT/ICD9 Coding Menu [SRCODING MENU] The Division we will be using is CAMP MASTER You will have only three prompts to enter At the first prompt let’s select # 3 for both O.R. and Non-O.R. procedures and then enter a date range of February 1, 2007 to April 5, 2007. Select the SHORT form And then accept the default of HOME Reviewing this report you will two types of status’ listed on the far right hand side. Filing Status which can be either FILED or NOT FILED Remember this indicates whether the encounter has made it to PCE Right under the Filing Status you see the SCHED (scheduling) Status This will be either INPATIENT, CHECK-OUT, or Action Required, Non-Count Anything with the filing status of NOT FILED or the Scheduling Status of Action Required must be coded using the Update/Verify Procedure/Diagnosis Codes option [SRCODING EDIT] You may even see one that with a status of NOT FILED but with No Missing Data listed in the area that normally shows the information that needs to be entered. For this case the coder should use the Update/Verify Procedure/Diagnosis Codes option and validate that all data has been entered.

28. 'Outpatient Encounters Not Transmitted to NPCD' Option name: SRO PCE NOTRANS Outpatient surgical and non-O.R. procedures that are filed as encounters in the Patient Care Encounters (PCE) package without an active, count clinic identified for each encounter are not transmitted to the National Patient Care Database (NPCD) as workload. This option may be used as a tool for identifying these encounters that represent uncounted workload so that corrective actions may be taken in the Surgery package to insure these procedures are associated with an active, count clinic. After corrections are made, these encounters may be re-filed with PCE to be transmitted to NPCD. This option provides functionality: - To count and/or list surgical cases and non-O.R. procedures that have entries in PCE but have no matching entries in the OUTPATIENT ENCOUNTER file (#409.68) or have matching entries that are non-count encounters or encounters requiring action. - To re-file with PCE the cases identified as having no matching entries in the OUTPATIENT ENCOUNTER file (#409.68) or having matching entries that are non-count encounters or encounters requiring action. Both the report and the re-filing process may be run for O.R. surgical cases, non-O.R. procedures or both. The report and the re-filing process may be run for a specific specialty or for all specialties and may be run for a selected date range. This report is a little different from the PCE Filling Status Report in that it is only looking at the encounters ALREADY IN PCE that will not be transmitted to Austin because of the location assigned. So in the PCE Filling Status Report their status = FILED. The encounter location is set to non-count or is inactive. Please note the statement SCHEDULING STATUS equals Action Required or NON-COUNT. It should also show any encounters associated with a clinic that is inactive. This is a subset of the surgical procedures that should be coded and transmitted to PCE. It does not include the procedures that are NOT FILED and have not gone to PCE…those are reflected in the PCE Filing Status Report. The encounters listed here should be included in the list Let’s run this report with totals only so select number 2 at the first prompt We will run it for both O.R. and Non-O.R. cases. So select number 3 at the next prompt Let’s just get an overall picture so we will NOT sort by specialty so enter NO And out date range will be May 1 through T for Today Hit return at the device prompt The reflects will show you the number of cases that have NO STATUS, the number of encounters associated with a Non-Count clinic and also those encounters that have a SCHED STATUS of Action Required, which means that some required data elements have not been completed. At the Medical Center if the user received numbers in any of these areas they would want to go back and run the report using the Print list of cases function so they could complete or correct the encounter and then use the Re-file cases in PCE function. This report is a little different from the PCE Filling Status Report in that it is only looking at the encounters ALREADY IN PCE that will not be transmitted to Austin because of the location assigned. So in the PCE Filling Status Report their status = FILED. The encounter location is set to non-count or is inactive. Please note the statement SCHEDULING STATUS equals Action Required or NON-COUNT. It should also show any encounters associated with a clinic that is inactive. This is a subset of the surgical procedures that should be coded and transmitted to PCE. It does not include the procedures that are NOT FILED and have not gone to PCE…those are reflected in the PCE Filing Status Report. The encounters listed here should be included in the list Let’s run this report with totals only so select number 2 at the first prompt We will run it for both O.R. and Non-O.R. cases. So select number 3 at the next prompt Let’s just get an overall picture so we will NOT sort by specialty so enter NO And out date range will be May 1 through T for Today Hit return at the device prompt The reflects will show you the number of cases that have NO STATUS, the number of encounters associated with a Non-Count clinic and also those encounters that have a SCHED STATUS of Action Required, which means that some required data elements have not been completed. At the Medical Center if the user received numbers in any of these areas they would want to go back and run the report using the Print list of cases function so they could complete or correct the encounter and then use the Re-file cases in PCE function.

29. ‘Outpatient Encounters Not Transmitted to NPCD Report’ Since we do not transmit to Austin in the test environment – here is a screen shot of this report. This report will show you the number of cases that have NO STATUS, the number of encounters associated with a Non-Count clinic and also those encounters that have a SCHED STATUS of Action Required, which means that some required data elements have not been completed. At the Medical Center if the user received numbers in any of these areas they would want to go back and run the report using the Print list of cases function so they could complete or correct the encounter and then use the Re-file cases in PCE function. Since we do not transmit to Austin in the test environment – here is a screen shot of this report. This report will show you the number of cases that have NO STATUS, the number of encounters associated with a Non-Count clinic and also those encounters that have a SCHED STATUS of Action Required, which means that some required data elements have not been completed. At the Medical Center if the user received numbers in any of these areas they would want to go back and run the report using the Print list of cases function so they could complete or correct the encounter and then use the Re-file cases in PCE function.

30. Consult Tracking Reports Select Consult Tracking Reports Option: ST Completion Time Statistics [GMRC COMPLETION STATISTICS] PC Service Consults Pending Resolution [GMRC RPT PENDING CONSULTS] SH Service Consults Schedule-Management Report [GMRC RPT SD SCH-MGT CONSULTS] CC Service Consults Completed [GMRC RPT COMPLETE CONSULTS] CP Service Consults Completed or Pending Resolution [GMRC RPT COMPLETE/PENDING] IFC IFC Requests [GMRC IFC RPT CONSULTS] (IFC=Inter-Facility Consult) IP IFC Requests By Patient [GMRC IFC RPT CONSULTS BY PT] IR IFC Requests by Remote Ordering Provider [GMRC IFC RPT CONSULTS BY REMPR] LCR Consults Local Completion Rate [GMRC RPT LOCAL COMPLETE RATE] NU Service Consults with Consults Numbers [GMRC RPT NUMBERED CONSULTS] PI Print IFC Requests [GMRC IFC PRINT RPT NUMBERED] PL Print Consults by Provider, Location, or Procedure [GMRC PRINT BY SEARCH] PMR Consult Performance Monitor Report [GMRC RPT PERF MONITOR] PR Print Service Consults by Status [GMRC PRINT RPT NUMBERED] SC Service Consults By Status [GMRC RPT CONSULTS BY STATUS] TS Print Completion Time Statistics Report [GMRC PRINT COMPLETION STAT] Let’s now move to Consult Tracking Reports. According to VHA Directive 2209-070 consults must be scheduled ASAP from the date of request. There are several reports listed that allow the users to selected whether they want to view the report on the screen and maneuver by using List Manager or send the report to a printer. Example is the first report listed – Completion Time Statistics. This report will run to the screen and allow the user to use List Manager as a viewing tool. The last report on the list – Print Completion Time Statistics Report will give the user the device prompt for entering a printer device. Let’s now run the ‘Service Consults By Status’ report. It is located under the ‘Consult Tracking Reports’ menu. Let’s take the default of All Status’s BUT REMEMBER…when we get to the date prompts – DO NOT hit enter for ALL DATES when you are in a production enviroement…for now we will go for the default of ALL DATES. Select the specialty of Pharmacy and enter the start and end dates for the month of MAY. This is a LIST MANAGER type report, if you can not see the List Manager selection list enter ?? We will take a look at the Service Consults by Status report. It too is a List Manager type of report and it’s print version is listed above it – Print Service Consults by Status. Both reports have the same prompts until you get to the device prompt. This report uses LIST MANAGER. Some users prefer this type of report because they can get the “bottom line” stats and then just print that information if needed. Once the user is familiar with the report and where information is located, they can maneuver around and print only the information they need at the time. Let’s go to the last screen of the report to see the OVERALL status for Surgical Service. Enter LSLet’s now move to Consult Tracking Reports. According to VHA Directive 2209-070 consults must be scheduled ASAP from the date of request. There are several reports listed that allow the users to selected whether they want to view the report on the screen and maneuver by using List Manager or send the report to a printer. Example is the first report listed – Completion Time Statistics. This report will run to the screen and allow the user to use List Manager as a viewing tool. The last report on the list – Print Completion Time Statistics Report will give the user the device prompt for entering a printer device. Let’s now run the ‘Service Consults By Status’ report. It is located under the ‘Consult Tracking Reports’ menu. Let’s take the default of All Status’s BUT REMEMBER…when we get to the date prompts – DO NOT hit enter for ALL DATES when you are in a production enviroement…for now we will go for the default of ALL DATES. Select the specialty of Pharmacy and enter the start and end dates for the month of MAY. This is a LIST MANAGER type report, if you can not see the List Manager selection list enter ?? We will take a look at the Service Consults by Status report. It too is a List Manager type of report and it’s print version is listed above it – Print Service Consults by Status. Both reports have the same prompts until you get to the device prompt. This report uses LIST MANAGER. Some users prefer this type of report because they can get the “bottom line” stats and then just print that information if needed. Once the user is familiar with the report and where information is located, they can maneuver around and print only the information they need at the time. Let’s go to the last screen of the report to see the OVERALL status for Surgical Service. Enter LS

31. Conclusion A good report for validating ward and treating specialty assignment, use ’Treating Specialty Inpatient Information' Option name: DGPM TS INPATIENT INFORMATION For monitoring O.R. and Non-O.R. workload capture in PCE , use 'PCE Filing Status Report' Option name: SRO PCE STATUS and 'Outpatient Encounters Not Transmitted to NPCD' Option name: SRO PCE NOTRANS To validate consult tracking compliance, use ‘Service Consults By Status’ Option name: [GMRC RPT CONSULTS BY STATUS] http://www4.va.gov/vdl/ In conclusion - A good report for validating ward and treating specialty assignment, use ’Treating Specialty Inpatient Information' Option name: DGPM TS INPATIENT INFORMATION For monitoring O.R. and Non-O.R. workload capture in PCE , use 'PCE Filing Status Report' Option name: SRO PCE STATUS and 'Outpatient Encounters Not Transmitted to NPCD' Option name: SRO PCE NOTRANS To validate consult tracking compliance, use ‘Service Consults By Status’ Option name: [GMRC RPT CONSULTS BY STATUS] In conclusion - A good report for validating ward and treating specialty assignment, use ’Treating Specialty Inpatient Information' Option name: DGPM TS INPATIENT INFORMATION For monitoring O.R. and Non-O.R. workload capture in PCE , use 'PCE Filing Status Report' Option name: SRO PCE STATUS and 'Outpatient Encounters Not Transmitted to NPCD' Option name: SRO PCE NOTRANS To validate consult tracking compliance, use ‘Service Consults By Status’ Option name: [GMRC RPT CONSULTS BY STATUS]

32. I’m going to open the lines up for questions. I’m going to open the lines up for questions.

33. Point of Contacts Irene B. Smith Irene.Smith@va.gov Jacki Bebb, Jacki.Bebb@va.gov Pam Shoemaker, HAS ADPAC Pam.Shoemaker@va.gov