Vermont Explor Vermont Explor Data & PlanningData & PlanningVermont Technical CollegeVermont Technical College

March 14March 14thth, 2005, 2005

IntroductionsIntroductions

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

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

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

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

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

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?

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?”

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

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

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

Meeting MaterialsMeeting Materials

www.vtexplor.org/events.htmwww.vtexplor.org/events.htm

Web Reporting ToolWeb Reporting Tool

Launch demonstrationLaunch demonstration

Planners: IntroductionsPlanners: Introductions

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.

HIDI Outpatient ReportsHIDI Outpatient Reports

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

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

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