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Navy Data Quality Management Control (DQMC) Program

Navy Data Quality Management Control (DQMC) Program. DQMCP Conference February 2009. Objectives. Understand DQMC Program Components Comprehend DQMC Commander’s Statement parameters and metrics Recognize Navy Tier Roles and Responsibilities Identify DQMC process flow and deadlines.

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Navy Data Quality Management Control (DQMC) Program

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  1. Navy Data Quality Management Control (DQMC) Program DQMCP Conference February 2009

  2. Objectives • Understand DQMC Program Components • Comprehend DQMC Commander’s Statement parameters and metrics • Recognize Navy Tier Roles and Responsibilities • Identify DQMC process flow and deadlines DQMCP Conference, May, 2008

  3. Why the DQMC Program? • Lack of standard business rules and policies • Inconsistent coding patterns, weights and algorithms • Lack of training/education • Failure to set/enforce performance expectations DQMCP Conference, May, 2008

  4. FY 09 DATA QUALITY MANAGEMENT CONTROL PROGRAM

  5. DQMC Components • Critical MTF Staff: Commanding Officer/ESC, Data Quality Manager, Data Quality Assurance Team • 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. DQMCP Conference, May, 2008

  6. DQMC Program Team • Meets regularly with DQMC Manager • Acts as Subject Matter Experts • Identifies/resolves internal DQMC issues • Team Membership (minimum): • MEPRS • Coding/PAD/Medical Records • IM (CHCS, AHLTA, ADM experts) • Physician/Provider Champion • Executive “link” • Business analysts DQMCP Conference, May, 2008

  7. Review List DQMCP Conference, May, 2008

  8. MTF DQMC Program’s Commander’s Statement • 10 Categories, 33 Elements • Submitted monthly to BUMED via the MTF Regional Command and NMSC • Signed by Commanding Officer • Reporting month evaluates data 2 months prior • Example: February reporting month evaluates December data DQMCP Conference, May, 2008

  9. End of Day (EOD) • 24/7 clinics/ER EOD by 0600 following day • Automated through NAVMISSA DQ Website • Uses SADR and patient appointment files • May 2008, CHCS Ad Hoc reports provided for MTF data compilation DQMCP Conference, May, 2008

  10. Coding Timeliness • SADR = Three BUSINESS days • APV = 15 calendar days • Inpatient = 30 calendar days DQMCP Conference, May, 2008

  11. Required Actions • MEWACS (MEPRS Early Warning and Control System) review: “Has the MTF DQ or MEPRS Manager reviewed information presented in the CURRENT version MEWACS report?” • DQMC review month data is not the requirement here DQMCP Conference, May, 2008

  12. Timely Data Submission • MEPRS – EOM + 30 days (Navy) • SIDR – EOM + 5 working days • WWR – EOM + 10 (calendar days) • SADR – Daily DQMCP Conference, May, 2008

  13. Professional Services Encounters • Element revised in FY-07 • Requires coding quality checks on IPS (inpatient professional services) encounters • IPS audit process released April, 2008 DQMCP Conference, May, 2008

  14. Outpatient Records • Random audit DQMCP Conference, May, 2008

  15. Ambulatory Procedure Visits • Change for FY-08: Originally 7 (b) reviewed E&M codes linked with APVs. No longer required. DQMCP Conference, May, 2008

  16. Workload Comparison • FY-08 Changes: 8 (a) identifies count and non-count SADR totals. Percentage is still total SADR divided by WWR. • SADR should be greater than or equal to WWR DQMCP Conference, May, 2008

  17. AHLTA / SADR Encounters • “B” and “FBN” accounts only DQMCP Conference, May, 2008

  18. Commanding Officer Signature • CO signs statement verifying that data is correct and that corrective mechanisms/actions have been incorporated. DQMCP Conference, May, 2008

  19. Roles/Responsibilities DQMCP Conference, May, 2008

  20. Navy DQMC Issue Process Issue resolved At MTF ? N MTF issue identified Investigate MTF issue impact File DQ trouble ticket Issue logged at NAVMISSA Y Region notified Issue forwarded To SME Issue resolved Resolution requires MHS tier support? N Submitter notified Issue resolved Issue solution proposed SME reviews issue Y MHS trouble ticket filed` Issue solution proposed DQMCP Conference, May, 2008

  21. FY-09 Improvement Goals • Improve NAVMISSA website and corresponding data. Identify MTF variances and standardize report formats • Electronic Data Quality Statement (EDQ) upgrade with review/analysis processes • Identify trouble ticket issues. Communicate and expedite resolution • Improve coding quality • Identify top three issues • Conduct a program assessment • Develop POA&M DQMCP Conference, May, 2008

  22. FY-09 Goals: Coding Improvement • Improved accuracy of codes assigned for services. • Improvement assignment of codes in DoD reporting systems. • Inpatient Institutional Services • Ambulatory Procedure Visits • Inpatient and outpatient professional services DQMCP Conference, May, 2008

  23. Challenges • Trouble ticket status and resolution • Training • DQ Manual updates - underway • New DQMC Manager training, as approved by BUMED. • The Training Concept of Operations (COO) is provided on the following slide. • System/table upgrade coordination DQMCP Conference, May, 2008

  24. DQMCP Conference, May, 2008

  25. Points of Contact DQMCP Conference, May, 2008

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