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Navy Medicine DQMC Breakout Session FY11 DQ Guidance and FY12 Preview. Objectives. Overview of the Navy Medicine Data Quality Management Control Program Orientation of the eDQ Discuss FY11 DQMC Guidance Policy and Expectations. Why Have a Program?. Mandated: DoDi 6040.40 Funding
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Navy Medicine DQMC Breakout Session FY11 DQ Guidance and FY12 Preview
Objectives • Overview of the Navy Medicine Data Quality Management Control Program • Orientation of the eDQ • Discuss FY11 DQMC Guidance Policy and Expectations
Why Have a Program? • Mandated: DoDi 6040.40 • Funding • Prospective Payment System (PPS) • Medicare-Eligible Retiree Health Care Fund (MERHCF) • Budgeting • Business Planning • Congressional Inquiries • Business Case Analysis • Special Studies
Significant FY12 Changes • New DQMC Review List Process • Complete Migration to the SharePoint DQ Community Site • Centralized Coding Audit Pull Lists • Changes in MEPRS (EAS) Processing • DQMC Review List Briefing FOR OFFICIAL USE ONLY
Navy Medicine DQMC FY11 DQMC Goals • Improve data transmission metrics to meet deadline 100% for 10 of the 12 reporting months. • Improve DD FM 2569 collection in all three medical record categories. • Achieve 95% in all DQMC Readiness Categories by the March 2011 data month. • Region command DQMC submission will improve to be 100% compliant 10 of the 12 reporting months.
DQMC Program Components • Critical MTF Staff: • Commanding Officer / ESC, Data Quality Manager, Data Quality Assurance Team (DQAT) • DQMC Review List: • Internal tool to identify and correct financial / clinical workload data and processes • Monthly DQMC Commander’s Statement: • Monthly statement forwarded through the MTF Regional Command to BUMED and TMA
The Data Quality Assurance Team • Meets Regularly With DQMC Manager • Acts as Subject Matter Experts • Identifies / Resolves Internal DQMC Issues • Team Membership (minimum): • MEPRS • Coding / PAD / Medical Records • CHCS, AHLTA, and ADM Experts • Physician / Provider Champion • Executive Link • Business Analysts
The Review List Ensure accurate, complete and timely data entry into systems IA, access breach Leadership commitment and DQMC structure Timely and accurate distribution (EAS, WWR, SADR, SIDR, DMHRSi) System administrator ID, IT business processes
Commander’s Statement Overview • 19 Questions, 51 + 2 Individual Elements • Submitted monthly to BUMED via the Regional Commands (and sent to TMA via BUMED) • Signed and reviewed by the Commanding Officer • The month reported on the statement is two months behind the current month (April’s submission is for February data) • When a system-wide issue prevents completing an element of the eDQ, BUMED will provide a standard response for the MTFs to use.
Things to Remember • Accurate Data is essential • Red is not bad, it identifies an issue that requires attention • Need to apply DQ to the DQ Statement • Comments are as important as the metric • Provides the information required to take action • Need to use the correct format • Incorrect submissions will be rejected • Delays reporting to TMA (10th calendar day) • Revised statement will need to be re-signed by CC • DQMC Submissions are reviewed by senior leadership at all levels, including the Region, BUMED & TMA
Coding Timeliness Outpatient = 3 Business Days APV = 15 Calendar Days Inpatient = 30 Calendar Days
MEPRS/EAS & Sub Systems • DQMC Submissions are reviewed by senior leadership at all levels, including the Region, BUMED & TMA
Transmission Timeliness MEPRS = 45 Calendar Days SIDR = 5 Business Days* WWR = 10 Calendar Days* SADR = 1 Calendar Day * Navy Medicine = 4 Calendar Days
DD Form 2569 • DQMC Submissions are reviewed by senior leadership at all levels, including the Region, BUMED & TMA; These metrics are a 2011 BUMED Focus Area
System Workload Comparisons A - D: 103% = 97% E: 103% = 103%
Duplicate Patient Records • Question 11a on the DQ Statement • Only MTFs that are CHCS hosts report this metric • Metric is based upon all duplicate records on the silo, including Army and Air Force Facilities • Starting in 2011, all DMIS IDs included in this metric must be reported in the comments section.
Commander’s Acknowledgement • Question 12a on the DQ Statement • This question is the linchpin in the Data Quality Program; it certifies that the senior leader at the MTF is aware of what is going on and is taking steps to correct deficiencies. DQ Hint: Sometimes, commands forget to select “yes” on the eDQ; if the answer is truly “no”, there must be a reason identified in the comments section.
Operational Personnel Readiness • Questions 1 through 7 (a & b) on the DQ Statement • These are Navy Medicine unique metrics • All Commands must complete this portion of the eDQ • The following systems are gauged for completeness and accuracy: • MRRS • EMPARTS • FLTMPS • DMHRSi • Successful management of these systems are critical for military readiness; Navy Medicine goal is 95% compliance for all questions by the March 2011 data month
Comments and Corrective Actions • All metrics that are non-compliant (less than 95% or 80% for 9e) require a comment • Starting in FY11, comment grouping not allowed • Comments must be in correct format ITEM: 2a, TT# (if applicable), ISSUE: XX% encounters from ER did not meet the 3-day deadline due to staffing issue. CORRECTIVE ACTION: Effective 1 January, temporarily reassign military staff until civilian/contract hiring process can be completed. Correction Date: January DQS. • Commands that report a Metric that is non-compliant for 3 (or more) consecutive months must develop and report the status of a POA&M
Summary • It is important to understand both the current policy as well as the data that is being reported when accomplishing the DQMC CC Statement. • Monthly DQMC submissions are official reports that are reviewed by senior leadership at the Region, BUMED and TMA. • The comments provided within the submission are just as important as the metrics that are reported.
NME NMW NCA NMSC Regional Points of Contact FOR OFFICIAL USE ONLY
Government POC CAI Team BUMED Points of Contact FOR OFFICIAL USE ONLY
Questions FOR OFFICIAL USE ONLY