2012 TMA DQ Course

1. 2012 TMA DQ Course AFMOA/SGAR Current as of 10 May 2012

2. Air Force TMA DQ Course Break-Out Session Overview Organization Why Data Quality? MTF Engagement Guidance DQ Assurance Team CHCS Provider File Metrics Other DQ Efforts DQ Review List/Statement Guidance & Completion eDQ

3. ORGANIZATION

4. Organization AFMOA (Execution) HAF/SG8Y (Policy)

5. Organization • SGA • SGAI • Info Services • MEPRS • SGAT • Health Benefits • SGAX** • Readiness • SGAR • Resource Mgt • SGAL • Med Logistics • DQ • SGAP • Manpower • UBO

6. AFMOA Strategic Alignment Experience of Care Population Health Readiness Per Capita Cost

7. Our Mission AFMOA Data Quality MAJCOMS Air Force MTFs • Standardize methodology • Evaluate processes • Reduce variance DRUs • Provide Comprehensive DQ Program Management to all AF MTFs • Provide reach-back support to MAJCOMs and DRUs

8. Data Quality (DQ) Roles and Responsibilities • DQ Program Manager • DQ Program Analyst DQ DBA/SME • DQ SME • Focal point for MTF’s DQ Mgmt • Control Program/DQ Statement • Teams to provide policy/MTF’s • business practice improvements • Biometric data consultant • Measures MTF/AFMS DQ • performance & influences change • - Trains MTF DQ Managers • Provide CHCS Database Admin SME support • -- ID & assist MTFs correct: (Provider File errors, Hospital Location Files, site definable MEPRS tables, etc.) • Create CHCS restrictions/business rules to promote standardization • Develop CHCS training guides to promote MTF DQ • Provide Ad Hoc report assistance to support MTF’s • Perform MTF site visits to provide on-site technical assistance • Manage performance metrics to validate improvement efforts • Mission: • Provide Comprehensive DQ - Program Management to all MTFs • Provide reachback support to MAJCOMs and DRUs • Key Objectives: • Standardize Methodology • Evaluate Processes • Reduce Variance • Future Initiatives: • Consolidation • Shape MHS/AFMS DQ efforts

9. Why Data Quality?

10. Data Quality Integrated Approach • MEPRS • Personnel • Workload • Financial Data Quality Completeness • Patient • & • Provider • Coding • SIDR/SADR • MSDRG/RWP • RVU/CPT • UBO • Other Health Insurance • Eligibility • Demographics Timeliness Accuracy

11. Why is Data Quality Important? For these reasons, it is vital your data accurately reflect work performed in your MTF! Monitor efficiency of the healthcare system Prospective Payment System (PPS) Base Realignment And Closure (BRAC) Medicare Eligible Retiree Health Care Fund (MERHCF) MTF Business Plans Provider/Clinic Workload Productivity Reimbursements (TPC, Coast Guard, NOAA…etc) Enable the Leadership to make informed decisions

12. What could go wrong? Interface Errors Clinical Data Mart Air Force TRICARE Ops Center CCQAS Worldwide Workload Report Service Repository (BDQAS) WWR (Count Visits) DoD/VA FHIE/BHIE SHARE MHS Data Repository MDR Coding Compliance Editor SADR CAPER (Encounters) CCE PDTS Standard Ambulatory Data Record Pop Health Portal Pharmacy Data Transaction System ADM SADR 1/SADR 2 EAS IV Extract MHS Mart M2 Essentris EAS Repository TPOCS Billable Encounters WAM Count Visits & Raw Services EAS IV “Eligible” Encounters CPT Codes Units of Service

13. Mtf engagement

14. MTF DQ Engagement • One-on-One Support • Telephone and E-mail: afmoa.dq@us.af.mil • Defense Connect Online (DCO) & optimize use of Vector Check • MTF-AMFOA DQ Teleconferences Every Other Month • PACAF, CONUS, USAFE (schedule on Vector Check) • DCO used to conduct meetings and take attendance • Business and training conducted at each meeting • Site Visits • AF portion of the TMA DQ Course • Other Conferences/Forums

15. Defense Connect Online • Link to meeting will be sent via email/calendar request • Share screen capability to maximize training • Chat capabilities to ask questions to all or individuals • To become a registered user visit: https://www.dco.dod.mil

16. Vector CheckYour DQ Toolkit Announcements Calendar Contacts FAQs Documents Electronic Data Quality Application (eDQ) Subscribe to Alerts!

17. Vector CheckGaining Access • Your Vector Check account is linked to your Knowledge Exchange (Kx) account • If you don’t have a Kx account, create one at https://kx.afms.milClick: • If you have a Kx account, verify your e-mail address is correct (then WAIT 24 Hrs prior to signing into Vector Check). Click:

18. Vector CheckGaining Access • After you have been granted a Kx account (this may take up to 24 hours), navigate to Vector Check at: https://vc.afms.mil • The first time you visit the Vector Check site, you will be redirected to a registration page. The form will be pre-populated. Verify and submit the information.

19. Vector CheckUpdating the RM Master Roster • Update your POC information on the RM Master Roster at: https://vc.afms.mil/AFMOA/SGA/SGAR/Lists/Resource%20Management%20Master%20Roster%20Updates/Summary%20View.aspx • Select “New” to add a new POC, or select “Actions / Edit in Datasheet” to edit POCs. The contact information for these positions must always be kept current: • MDG CC • MDG Deputy CC • MDSS Commander • Administrator • RMO • RMO NCOIC • DQ Manager • DQ Alternate

20. Vector Check DocumentsTraining Material on VC • Review training materials posted on Vector Check • “Alerts, Timeliness and Accuracy, and TUG” • Pathway: Vector Check > AFMOA > SGA > SGAR > SGAR – Data Quality > Documents > Training > Administrative • All DQ Review List and Statement Training Slides • Pathway: Vector Check > AFMOA > SGA > SGAR > SGAR – Data Quality > Documents > Training > DQ Review List and Statement Training Slides • Review the latest DQ Teleconference Notes • Pathway: Vector Check > AFMOA > SGA > SGAR > SGAR – Data Quality > Documents > Data Quality Meeting Minutes-Notes

21. Guidance

22. Overview • DoDI 6040.40 • DQ Mgmt Control (DQMC) Procedures • DQMC Review List • Data Quality Statement • Annual Updates – TMA Led • Recommends Data Quality Assurance Team (DQAT) Composition

23. Health Services Inspection (HSI) • 2012 HSI Checklist, OM.3.2.2 • The Data Quality Assurance Team (DQAT) met monthly: • Completed DQMC Review List • Briefed Executive Committee on all Review List performance that was not compliant • There was evidence corrective action plans were created, monitored and progressing to address non-compliant or underperforming DQMC items

24. Health Services Inspection (HSI) • 2012 HSI Checklist, OM.3.2.2 • Documents Required for Review: • Current and past year’s • DQM reports • DQAT meeting minutes

25. DQ assurance Team

26. DQ Assurance Team • DoDI 6040.40 Recommended Team Composition: • DQ Manager • Directors of Clinical Activities • MEPRS/EAS Coordinator • Budget/Accounting • Medical CIO • Health Information Manager • CHCS Administrator • Group Practice Managers • Patient Administration • Additional team members recommended in Data Quality Team User’s Guide: • Coder/coding auditor • AHLTA Trainer • Ancillary services representative • Defense Medical Human Resources System – internet (DMHRSi) personnel (i.e., DMHRSi Manager, contract liaison, civilian liaison, volunteer liaison, and Command Support Staff (CSS) personnel) • UBO Manager • Clinic support staff representative • Resource Management Flight CC Red indicates required members when AFI 41-120 is published • The Data Quality Assurance Team (DQAT) or other designated structure met during the reporting month to complete the DQMC Review List.

27. DQ Assurance Team

28. DQ Assurance TeamInitiatives - Interest Items (cont)

29. Chcs Provider file

30. CHCS Provider File Report Cards

31. Primary Effects of CHCS Provider File Errors Revenue Patient Safety Data Integrity Workload

32. CHCS Provider FileContinuity Guide • Comprehensive reference for issues related to CHCS provider file maintenance • Nearing completion – release date TBD • Includes step-by-step guidance to correct errors • Recommendations for provider file management • Includes helpful resources

33. Provider File Report Card

34. Provider Details Report

35. Outside Provider Entry Checklist

36. METRICS

37. DQ Performance Metrics https://vc.afms.mil/AFMOA/Matrix/default.aspx

38. DQ Performance Metrics https://vc.afms.mil/AFMOA/SGA/SGAR/SGARDQ/Documents/Forms/AllItems.aspx http://www.tricare.mil/ocfo/mcfs/dqmcp/metrics_reports.cfm

39. AF DQResults

42. DQ Statement Signed by?

43. Provider File Progress Metrics

44. Workload Guidelines Sample • Supplements AF Coding Guidelines • - Published by AF Coding Experts • MHS Coding Guidelines, inpatient and outpatient, dated 1 January 2011 • http://www.tricare.mil/ocfo/bea/ubu/coding_guidelines.cfm

45. Other DQ Efforts

46. Support Provided • Correct CHCS patient registration errors for all Air Force MTFs • Primary Care Manager Information Transfer (PIT) Errors • Correct Patient Registration Errors (FY11-558K Patients) • Merge CHCS Duplicate Patients • Identify AHLTA Multiples and Log MHS tickets • Subject Matter Expertise Support • Partner with DoD to develop policies and processes to reduce patient registration errors • Identify and correct systemic issues, which contribute to the duplication of clinical records and put patient safety at risk • AFMS Record Reconciliation Initiative 46

47. Support Provided • Training • Conduct Pt Reg, PIT Error, Duplicate Patient training at MTFs, Conferences, DCO Connect, etc. • Phone consultations as needed • Enterprise Health Data Optimization System (eHDOS) Reports • Summary Reports by MAJCOM and MTFs on Vector Check • Users with Registration Capability • Number of New Patients Added to CHCS with Critical Errors • Number of Potential CHCS Duplicate Patients • Number of Patients with Patient Category Mismatches • Number of PIT Errors • Managed Care File/Table Concerns Affecting PIT Errors

48. AFMOA Data Quality Vector Check • MTF Reports are posted to the AFMOA Data Quality Vector Check monthly • Menu path: Vector Check-AFMOA-SGA-SGAR-Data Quality-Documents-Patient Registration MAJCOM_MTF Reports

49. AFMOA Vector Check-The MATRIX

50. DQ Review List/Statement guidance & completion