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Navy Data Quality Management Control Program

Navy Data Quality Management Control Program. DQMCP Conference Feburary, 2008. Objectives. Understand DQMCP Components Comprehend DQ Statement parameters and metrics Recognize Navy Tier Roles and Responsibilities Identify DQ process flow and deadlines. Why DQ ?.

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Navy Data Quality Management Control Program

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  1. Navy Data Quality Management Control Program DQMCP Conference Feburary, 2008

  2. Objectives • Understand DQMCP Components • Comprehend DQ Statement parameters and metrics • Recognize Navy Tier Roles and Responsibilities • Identify DQ process flow and deadlines DQMCP Conference, February, 2008

  3. Why DQ ? • 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, February, 2008

  4. DQ 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 • Commander’s Monthly Data Quality Statement: Monthly statement forwarded through Regions to BUMED and TMA. DQMCP Conference, February, 2008

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

  6. Review List DQMCP Conference, February, 2008

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

  8. End of Day (EOD) • 24/7 clinics/ER EOD by 0600 following day • Automated through NMIMC DQ Website • Uses SADR and patient appointment files DQMCP Conference, February, 2008

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

  10. 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?” • DQ review month data is not the requirement here DQMCP Conference, February, 2008

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

  12. Professional Services Encounters • Element revised in FY-07 • Requires coding quality checks on IPS (inpatient professional services) encounters DQMCP Conference, February, 2008

  13. Outpatient Records • Random audit DQMCP Conference, February, 2008

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

  15. 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 • If EAS not processed, use WAM data to complete metrics in this section DQMCP Conference, February, 2008

  16. AHLTA / SADR Encounters • “B” accounts only • Excludes APV data • Excludes BIA (Emergency Room) DQMCP Conference, February, 2008

  17. Roles/Responsibilities DQMCP Conference, February, 2008

  18. Navy DQ Issue Process Issue resolved At MTF ? N MTF issue identified Investigate MTF issue impact File DQ trouble ticket Issue logged at NMIMC 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, February, 2008

  19. FY-08 Improvement Goals • Improve NMIMC 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, February, 2008

  20. FY-08 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, February, 2008

  21. Challenges • Trouble ticket status and resolution • Training • DQ Manual updates • New DQ Manager training • System/table upgrade coordination DQMCP Conference, February, 2008

  22. Points of Contact DQMCP Conference, February, 2008

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