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Vermont Explor Vermont Explor Data & PlanningData & PlanningVermont Technical CollegeVermont Technical College
March 14March 14thth, 2005, 2005
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IntroductionsIntroductions
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AgendaAgenda
Review of discharge dataReview of discharge data Overview of future changesOverview of future changes
UB-04UB-04 ICD-10ICD-10
Vt. Dept. of Health: Data needsVt. Dept. of Health: Data needs Data Quality: Improving your error rates Data Quality: Improving your error rates
while making life easier!while making life easier! Web-based data reporting toolWeb-based data reporting tool
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Data ReviewData Review
Data submissions: Smoother than ever!Data submissions: Smoother than ever! Issues in 2004:Issues in 2004:
Missing procedures foundMissing procedures found CPT-4 instead of ICD-9 PX codesCPT-4 instead of ICD-9 PX codes Some still include professional feesSome still include professional fees Special rules for Critical Access HospitalsSpecial rules for Critical Access Hospitals County-Town CodesCounty-Town Codes Needs specific to QualityWorksNeeds specific to QualityWorks
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2004 Error Rates2004 Error Rates
Quarter Below 2% 2% - 5% Above 5%
Inpatient Number of Hospitals
1 10 3 2
2 10 2 3
3 8 4 3
4 8 4 3
Outpatient
1 10 2 3
2 8 4 3
3 8 5 2
4 7 5 3
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Submission ReportsSubmission Reports
www.vtexplor.org/status.htmwww.vtexplor.org/status.htm Weekly status report by hospitalWeekly status report by hospital
Including error ratesIncluding error rates
Monthly status of other data collection effortsMonthly status of other data collection efforts
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Change is in the Wind…Change is in the Wind…
UB-04 UB-04 Claim FormClaim Form Medical Record Number moved to FL3Medical Record Number moved to FL3 Reduced RemarksReduced Remarks Distinct: Accident Code, Date & StateDistinct: Accident Code, Date & State 8 more Other Diagnoses8 more Other Diagnoses Why paper at all???Why paper at all???
ICD-10ICD-10 Still stalled, but keep it in back of mindStill stalled, but keep it in back of mind
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Vt Department of HealthVt Department of Health
Race & Ethnicity Race & Ethnicity Click for PresentationClick for Presentation
E CodesE Codes Cause: In 2004, preliminary missing rate = 0.5% !!Cause: In 2004, preliminary missing rate = 0.5% !! PlacePlace PerpetratorPerpetrator
Unique Patient IdentifierUnique Patient Identifier 11 hospitals send us Social Security #11 hospitals send us Social Security # 9 hospitals send us Medical Record # (due 1/1/05)9 hospitals send us Medical Record # (due 1/1/05)
E Codes on follow-ups: Use patient ID to derive?E Codes on follow-ups: Use patient ID to derive? What in the data tells me it’s a follow-up? DX, < x days?What in the data tells me it’s a follow-up? DX, < x days?
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Physician IdentifiersPhysician Identifiers
Primary Care ProviderPrimary Care Provider Referring PhysicianReferring Physician
Hospitals are asking: “Who is referring Hospitals are asking: “Who is referring my patients elsewhere?”my patients elsewhere?”
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Data QualityData Quality
What do we mean by “data quality”?What do we mean by “data quality”? Not just low error ratesNot just low error rates Consistent trends, complete recordsetsConsistent trends, complete recordsets
Why does it matter?Why does it matter? Public health epidemiology (of course)Public health epidemiology (of course) But also, for example:But also, for example:
Act 53: Average charges Act 53: Average charges AHRQ Quality Indicators AHRQ Quality Indicators
Adobe Acrobat Document
Adobe Acrobat Document
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Data QualityData Quality
Ken’s PresentationKen’s Presentation How do you achieve it? How do you achieve it?
1.1. Internal controls before submissionInternal controls before submission1.1. [Insert best practices][Insert best practices]
2.2. HIDInet corrections interfaceHIDInet corrections interface1.1. Any issues here?Any issues here?
3.3. Lauri’s niggling questionsLauri’s niggling questions
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Data QualityData Quality
Validation ReportsValidation Reports Quick overview of submissionQuick overview of submission Top DRGs, DXs, ZIPs, etc.Top DRGs, DXs, ZIPs, etc. Look for changes from month to monthLook for changes from month to month
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Meeting MaterialsMeeting Materials
www.vtexplor.org/events.htmwww.vtexplor.org/events.htm
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Web Reporting ToolWeb Reporting Tool
Launch demonstrationLaunch demonstration
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Planners: IntroductionsPlanners: Introductions
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Dian Kahn, BISHCADian Kahn, BISHCA
Hospital service areas as defined in the Hospital service areas as defined in the 2002 Hospital Monograph Series and 2002 Hospital Monograph Series and referred to in the Act 53 "Community referred to in the Act 53 "Community Needs Assessments“Needs Assessments“ Dian will describe how the areas were Dian will describe how the areas were
defined starting with the 2002 Hospital defined starting with the 2002 Hospital Monograph Series and welcomes your Monograph Series and welcomes your feedback to improve future efforts to define feedback to improve future efforts to define service areas. service areas.
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HIDI Outpatient ReportsHIDI Outpatient Reports
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HIDI Data Download ToolHIDI Data Download Tool
State, ZIP, County, Sex, Admit Type, Admit State, ZIP, County, Sex, Admit Type, Admit Source, Discharge Date, Days Between Admit Source, Discharge Date, Days Between Admit and Discharge, Disposition, Length of Stay, and Discharge, Disposition, Length of Stay, Age, Payor, Other Dx 1, Other Dx 2, Other Dx Age, Payor, Other Dx 1, Other Dx 2, Other Dx 3, Other Dx 4, Other Dx 5, Other Dx 6, Other 3, Other Dx 4, Other Dx 5, Other Dx 6, Other Dx 7, Other Dx 8, Other Dx 9, E-Code, Dx 7, Other Dx 8, Other Dx 9, E-Code, Principal Px, Other Px 1, Other Px 2, Other Px Principal Px, Other Px 1, Other Px 2, Other Px 3, Other Px 4, Other Px 5, Other Px 6, Other 3, Other Px 4, Other Px 5, Other Px 6, Other Px 7, Other Px 8, Other Px 9, Ethnicity, Race, Px 7, Other Px 8, Other Px 9, Ethnicity, Race, DRG, MDC, Patient Type, Observation HoursDRG, MDC, Patient Type, Observation Hours
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Summarizing Data in Summarizing Data in ExcelExcel
Pivot tables (and charts) allow user to:Pivot tables (and charts) allow user to: Drag and drop data elementsDrag and drop data elements Reposition themReposition them Report on a subset of the dataReport on a subset of the data Change the data format ($, %, etc.)Change the data format ($, %, etc.) Show/hide totalsShow/hide totals Easily refresh the report when the underlying Easily refresh the report when the underlying
data changedata changeMicrosoft Excel
Worksheet
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Next StepsNext Steps
Other services that Explor can provideOther services that Explor can provide Educational sessionsEducational sessions Conference calls and/or meetingsConference calls and/or meetings
802-223-3461802-223-3461 Lauri: extension 108Lauri: extension 108 Greg: extension 109Greg: extension 109