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Tracking San Francisco Based Referrals

Tracking San Francisco Based Referrals. DWH User Group January 28, 2010. Historic Ability to Track. Historically we have had difficulty tracking the source of our referrals.

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Tracking San Francisco Based Referrals

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  1. Tracking San Francisco Based Referrals DWH User Group January 28, 2010

  2. Historic Ability to Track • Historically we have had difficulty tracking the source of our referrals. • Once a patient sees more that one provider in our system, we lose the ability to retain the original referring provider.

  3. We have been able track our patient population by referral county, but we have had almost no ability to adequately describe the largest subset of our catchment area, the San Francisco population.

  4. What’s Changed… • Two years ago Medicare replaced the Universal Physician Identification Number (UPIN) with the National Physician Identifier (NPI). Part of the requirement was that we track the NPI of all of our referring physicians. • This change has allowed us to group our referring physicians in more meaningful ways.

  5. Referral Groups • UCSF (internal referrals) • CPMC • Hill Physician – San Francisco • One Medical Group • Others The local San Francisco referring providers have been grouped into the following categories:

  6. What Questions Can We Now Answer? • Who are the referring physicians, by department? • What are the volumes? • Who specifically are they referring to? • What is the payer mix of the patients they are referring?

  7. Referring Groups Charges “Blank” Visits that do not require a referral. “No Referral” Listed as “Unknown” or “Self Referral”. “Other” Valid, but does not belong to other groups.

  8. CPMC Top 10 Referring Providers The top referring provider from CPMC is a dermatologist. Six of the top ten providers are adult primary care providers. There are also several oncologists highly placed in the ranking, including Dr. Tuan at number six. Two of the top 10 referring providers are not physicians at all. Mark Illeman is a Nurse Practitioner who specializes in HIV patients and Michael Karls is a Physician’s Assistant for Dermatology Center of SF.

  9. Referrals By UCSF Provider The referrals can be broken out by providers receiving these patients at UCSF.

  10. Referrals by Payer Type The referrals can also be broken out by payer type. This can be extended to break out referrals to UCSF individual providers by payer type.

  11. Referral_tracking_utilization The Referring Providers are a new dimension. The provider groups are updated via the credentialling process.

  12. Cancer Center Flag • A new flag has been added to the referral_tracking_utilization and referral_tracking_transaction cubes for isolating Cancer Center billing areas. • To use the flag, filter on the Cancer Center “Y” flag and suppress all zero rows.

  13. Referral_tracking_utilization The Cancer Center Flag is also a new dimension. To use it filter from either the dimension pane or the dimension bar.

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