Data Quality Management Program

FY 06 Changes

Outline

• Introduction

• DQ Review List & Commander’s

Statements

• DQ Data Submission Schedule

Overview FY 06 DQMC Changes

• DQMC Review List– C 1 (a)– C 5 (f)– C 6 (f) & 7 (f)– C 9 formula

• Commander Statement– C 5 (b)– C 6 (f) & 7 (f)– C 8

• Navy-Specific DQMC Changes– End of Day

C.1.  In accordance with TMA policy, "Implementation of EAS/MEPRS Data Validation and Reconciliation," dated 21 Dec 99 and "MEPRS Early Warning and Control System," dated 28 May 02 along with the most current Service-Level Guidance: (Question 3 of Commander's Statement.)

New Question: Was the monthly MEPRS/EAS financial reconciliation completed, validated, and approved by the MTF Resource Manager (i.e., Navy/Army Comptroller or Air Force Medical Budget Officer) prior to MEPRS monthly transmission?

FY 06 Changes DQMC Review Lists

FY 06 Changes DQMC Review Lists

C.5.  In a random review of CHCS dispositions from the reporting month, the medical records staff determined the following percentages from a minimum sample of 30 records and/or sampling size as set by Service-Level Guidance, whichever is more, the degree to which: (See applicable DoDD/DoDI on Medical Records Retention and Coding and Service specific guidance)

New question: 5 (f) Percentage of IBWA Rounds encounters audited and deemed correct? (Question 5b of the Commander’s Statement).

FY 06 Changes DQMC Review Lists

C.6.  In a random review of CHCS outpatient encounters from the reporting month, the medical records staff determined the following percentage from a minimum sample of 30 records and/or the sampling size as set by Service-Level guidance, whichever is greater: (Question 6(a,b,c,d,e,f) of Commander's Statement.) (See applicable DoDD/DoDI on Medical Records Retention and Coding and Service specific guidance)

New question: f) What percentage of the completed and current DD form 2569s in the medical records were verified to be correct in the Patient Insurance file in CHCS

FY 06 Changes DQMC Review Lists

C.7.  In a random review of CHCS Ambulatory Procedure Visits (APV) appointments from the reporting month, the medical records staff determined the following percentages from a minimum sample size of 30 "on-hand" records (extended/abbreviated) or maximum available if fewer than 30, (documentation of visit is included in record) and/or the sampling size as set by Service-Level guidance, whichever is greater:  Question 7(a, b, c, d, e, f) of Commander's Statement.) (See applicable DoDD/DoDI on Medical Records Retention and Coding and Service specific guidance)

New question: f) What percentage of the completed and current DD form 2569s in the medical records were verified to be correct in the Patient Insurance file in CHCS

FY 06 Changes DQMC Review Lists

C.9.  Comparison of reported workload data.  (Question 8 of Commander's Statement)

New note: * For IBWA SADR completion insure WWR calculation includes lives births (section 01) and Bassinet Days (section 00)

FY 06 Changes Commander Statements

5.  Outcome of monthly inpatient coding audit:  (C.5.c,f) New question: (b) IBWA Rounds encounters audited and deemed correct

6.  Outpatient RecordsNew question: (f) What percentage of the completed and current DD form 2569s in the medical records were verified to be correct in the Patient Insurance file in CHCS?

7. Ambulatory Procedure Visits (APV)

New question: (f) What percentage of the completed and current DD form 2569s in the medical records were verified to be correct in the Patient Insurance file in CHCS?

8.  Comparison of reported workload data.  (C.9.)

e) # of IBWA Rounds SADR encounters (FCC=A***) / # SUM WWR (Total Bed days + Total Dispositions)

New footnote: FY06 Goal 80%

FY 06 Changes Commander Statements

End of Day

• Processing Requirements for Emergency Departments– Navy recommended that 24 hr emergency rooms

have the flexibility to perform EOD by 0600 the following day.

– The EOD Community website calculations for MEPRS Code BIA* (Emergency Medicine) will be changed to meet this new FY06 reporting requirement.

– The DQ Manual will be updated to include this change.

– SADRs are still required to be coded within 3 days.

FY 06 DQ Data Submission Schedule

Data Extracted from Clinical/Financial Systems(SADR/SIDR/EAS IV, etc)

Oct-05 Thursday, 15 December 05 Tuesday, 27 December 06 Tuesday, 3 January 06Nov-05 Wednesday, 18 January 06 Wednesday, 25 January 06 Wednesday, 1 February 06Dec-05 Wednesday, 15 February 06 Friday, 24 February 06 Wednesday, 1 March 06Jan-06 Wednesday, 15 March 06 Friday, 24 March 06 Friday, 31 March 06Feb-06 Friday, 14 April 06 Monday, 24 April 06 Tuesday, 2 May 06Mar-06 Tuesday, 16 May 06 Thursday, 25 May 06 Thursday, 1 June 06Apr-06 Thursday, 15 June 06 Tuesday, 27 June 06 Friday, 31 July 06May-06 Friday, 14 July 06 Tuesday, 25 July 06 Tuesday, 1 August 06Jun-06 Tuesday, 15 August 06 Friday, 25 August 06 Friday, 1 September 06Jul-06 Friday, 15 September 06 Tuesday, 26 September 06 Tuesday, 3 October 06Aug-06 Tuesday, 17 October 06 Wednesday, 25 October 06 Wednesday, 1 November 06Sep-06 Wednesday, 15 November 06 Tuesday, 28 November 06 Friday, 1 December 06

Month Data Reporting

Signed Commander’s Statement faxed to Navy Medicine DQ

Manager

Navy Medicine DQ Manager’s Submission faxed to BUMED