Introduction to SDPS for New Users Iowa Foundation for Medical Care Marilyn Schulte, Manager SDPS Health Informatics

Putting the Puzzle Together

Objectives Understand what is SDPS Understand types of SDPS users Understand SDPS products/systems Understand commonly used acronyms

What is SDPS? The Standard Data Processing System (SDPS) supports the Office and Division of Clinical Standards and Quality (central and regional offices), the Clinical Data Abstraction Center, and the Quality Improvement Organizations (QIO) data system for communications It is also the standard platform for data, and for accessing data. Components of SDPS include, but are not limited to: File servers and database servers Workstations Commercial off the shelf (COTS) products such as nCoder and Care Enhance Review Manager (CERM) Custom written software such as PRS, PARTner, and CRIS Video conferencing capabilities

What is SDPS? QIOs are required to use the same software, hardware, and procedures to conform to the SDPS standard QIOs are required to use all components of SDPS and SDPS developed applications to manage and report work done under the current Statement of Work (SoW) Equipment, software, and associated data remain the property of CMS Data collected by QIOs, providers, and vendors is stored in SDPS data warehouses Reports developed by SDPS are used to measure how QIOs and providers are doing on improving quality measures Some health care data collected via SDPS is publicly reported for consumers to review

User Communities Internal External QIOs (Quality Improvement Organization) CDAC (Clinical Data Abstraction Center) CMS (The Centers for Medicare &Medicaid Services External Hospitals Nursing Homes (NH) Home Health Agencies (HHA) Physician Offices Vendors

QIO Users QIOs have access to: CART (CMS Abstraction and Reporting Tool) CATS (CDAC Abstraction Tracking System) CRIS (Case Review Information System) PARTner (Program Activity Reporting Tool) QIO PRS (QIO Program Resource System) Provider PRS (Provider Program Resource System) Remedy QIOnet (Internal SDPS site)

QIO Users QIOs have access to: QualityNet (public) QualityNet Exchange (secure) QualityNet Exchange Reports MedQIC Program Progress Reports Dashboard Reports

CDAC Users CDAC users have access to: CART (CMS Abstraction and Reporting Tool) CATS (CDAC Abstraction Tracking System) OAT (Online Adjudication Tool) QIOnet (Internal SDPS site) QualityNet (public) QualityNet Exchange (secure) MedQIC

Hospital Users Hospital users have access to: Hospital users can: CART HCAHPS Online Tool Provider PRS QualityNet (public) QualityNet Exchange (secure) QualityNet Exchange Reports MedQIC Hospital users can: Upload abstracted data to Inpatient Clinical Warehouse Upload survey data to HCAHPS warehouse

Nursing Home Users Nursing Home users can: Nursing Home users have access to: NHIFT Tool QualityNet (public) QualityNet Exchange (secure) QualityNet Exchange Reports MedQIC Nursing Home users can: Upload data to the NHIFT Clinical Warehouse

Home Health Users Home Health users have access to: POA Tool QualityNet (public) MedQIC

Physician Office Users Physician Office users have access to: QualityNet (public) MedQIC Physician Office users can: Upload data to Outpatient Clinical Warehouse (DOQ-IT Doctors’ Office Quality Information Technology)

Vendor Users Vendors have access to: Vendor users can: CART MedQIC NHIFT Provider PRS QualityNet (public) QualityNet Exchange (secure) QualityNet Exchange Reports Vendor users can: Upload abstracted data to Inpatient Clinical Warehouse Upload survey data to HCAHPS warehouse

SDPS - Clinical Data Warehouses CMS Data Inpatient Claims Administrative EDB (Enrollment Database) Outpatient Claims Administrative (Part B data) Prescription Drug (Part D data)

SDPS - Clinical Data Warehouses Provider Data Inpatient Clinical Warehouse HCAHPS Warehouse (survey data) Outpatient Clinical Warehouse (DOQ-IT) Nursing Home Clinical Warehouse

Information Management QNet Quest (Q & A Management) Multiple topics available Specified staff are researchers and publishers ListServe Discussion Lists Notify Lists SDPS Memos Official CMS communication Require CMS approval prior to release Posted on QIOnet

CMS Abstraction & Reporting Tool Acronym – CART Designed to allow hospitals, QIOs, and other organizations to abstract, edit, export, and report on the quality measures. CART may be used across data collection programs and is available for downloading at no charge from the QualityNet Website.

Clinical Abstraction Tracking System Acronym – CATS Allows the Clinical Data Abstraction Centers (CDAC) to track abstraction and medical record event information Integrates with the Case Review Information System for the hospital payment monitoring program Will go end of life in the future

Case Review Information System Acronym – CRIS Allows QIOs to perform on-line real time case review Allows QIOs to track Medicare beneficiary help line activities and Beneficiary complaints CMS case review selections are added to CRIS monthly

Doctors’ Office Quality - Information Technology Acronym - DOQ-IT Designed to improve quality of care, patient safety, and efficiency of services provided to all patients (not just Medicare beneficiaries) Promotes the adoption of electronic health record (EHR) systems and information technology (IT) in small-to-medium sized physician offices Promotes greater availability of high quality affordable health information technology and provides assistance to physician offices in adopting and using technology

CAHPS Hospital Survey Acronym - HCAHPS Survey of patients’ perspectives of the quality of hospital care Provides a standardized survey instrument and data collection methodology Results of the HCAHPS survey will be publicly reported on Hospital Compare

Nursing Home Improvement Feedback Tool Acronym - NHIFT Free, computer-based, process-of-care data collection tool Assists nursing homes in collecting data and viewing process measure scores for four clinical topics

Online Access Request System Acronym – OARS OARS is utilized by the community to create and manage user accounts for access to the various SDPS applications Accessed through QualityNet Exchange, QIOnet and the SDPS applications

Plan of Action Tool Acronym – POA Benefits HHA staff that apply Outcome Based Quality Improvement (OBQI) at their agency Focuses on improving patient outcomes by analyzing the care provided to those patients Home health care providers develop a Plan of Action (POA) to improve care for each target outcome identified They can submit their POA to the QIO electronically via the tool

Program Activity Reporting Tool Acronym – PARTner Allows QIOs to track: Identified Participants Health care quality improvement activities Progress Measures Payment monitoring activities Narrative deliverables Allows QIOs to upload documents to CMS. Allows CMS to download documents from QIOs. Allows Project Officers to approve documents.

Provider Program Resource System Acronym – PPRS Also known as Program Management Allows provider and/or their vendors to manage and identify the measures they will be submitting to the QIO Clinical Warehouse Allows providers and/or their vendors to identify their ICD populations and sampling numbers Online appeals will be added in the future

QIO Program Resource System Acronym – QIO PRS Used by the QIOs Centralized database that stores information used by many SDPS applications. Includes provider, physician, Medicare Advantage Data is replicated to other SDPS applications as needed Ensures data integrity

Remedy Acronym – None COTS Product – Customized to meet SDPS needs Allows for tracking of business processes Provides tracking for: Help Desk Tickets Referrals ERBs (Engineering Review Board requests) Inventory Customized reports run from Remedy

QualityNet Help Desk Acronym – QNet Help Desk QualityNet Help Desk provides QIOs, CMS, ESRDs, and providers with assistance for problems encountered using a SDPS developed application or system. QIO designated users can enter issues directly into Remedy. Each QIO has designated users to enter or forward issues to the QualityNet Help Desk. QualityNet Help Desk Email address: qnetsupport@ifmc.sdps.org QualityNet Help Desk telephone numbers of 866-288-8912 (toll free) 7 a.m. to 7 p.m. CT Monday through Friday.

QualityNet and QualityNet Exchange Acronym - QNet QualityNet provides the public pages and portal to QualityNet Exchange Acronym – QNE QualityNet Exchange is the only CMS-approved website for secure communications and healthcare quality data exchange between: quality improvement organizations (QIOs), hospitals, physician offices, nursing homes, end stage renal disease (ESRD) networks and facilities, and data vendors Provides access to the secured applications

National Claims and EDB Warehouse Repository that has enterprise-wide use and impact Data is utilized to support multiple initiatives Includes: Beneficiary enrollment database Beneficiary claims Physician/Provider information Medicare Advantage information Data from CMS is loaded monthly Case review selections done after the monthly CMS claims data merge

QIO Clinical Warehouse Acronym – QCW Data repository with enterprise-wide use and impact Quality data is used to support multiple initiatives Centralization of data maintains data integrity, streamlines processes, increases productivity, and forms a basis for improving the quality of care

SDPS – Reports Dashboard Program Progress Reports Summary Reports, updated monthly or quarterly Accessed from QIOnet Program Progress Reports Acronym - PPR Over 227 reports User ID and password required

SDPS – Reports QualityNet Reports Must register for QualityNet Exchange prior to obtain user ID and Login Accessed from QualityNet Exchange Submission and Feedback reports for different user types OLAP (Online Analytical Processing) Reports Hospital Payment Monitoring Program Long Term Acute Hospital Ad Hoc Reports Special one time reports CMS approval required

Other QualityNet Web Sites Medicare Quality Improvement Community Acronym MedQIC Public and secure site Provides resource center to QIO community and healthcare providers on quality improvement ideas QIOnet Internal, used by SDPS users only Provides information on QIO business and CMS policy Provides sign up for ListServe Provides access to all SDPS memos Provides access to Program Progress Reports and Dashboard reports

Commonly Used Acronyms SDPS - Standard Data Processing System CMS - Centers for Medicare and Medicaid Services BCSSI – Buccaneer Computer System and Services Incorporated BDS - Buccaneer Data System (CDAC) QIO – Quality Improvement Organization QIOSC – Quality Improvement Organization Support Contractor CDAC – Clinical Data Abstraction Center

Finishing the Puzzle