Auditing Techniques for Ensuring Quality Data in a Registry Alisa Johnson Hennepin County Community Health
ImmuLink -- Overview Developed in 1994 All ages registry Populated with birth certificate data Web-based application Consolidates billing & school data Batch data supplied electronically Option to directly enter into database
ImmuLink -- Overview As of April 26, 2002 Maintains 530,000 records and 3.6 million immunizations 95 participating sites Covers four metro counties Approximately 800 users
Auditing Techniques Formal Audit Uploading Processes Ongoing Maintenance
Formal Audit Purposes Verify that export file process includes all immunization codes Check for accuracy and completeness Ensure quality data in registry
Formal Audit Accuracy - immunization data in export file matches data on medical chart Clinics must meet 90% accuracy Completeness -all immunization information in chart is in the export file Clinics must meet 80% completeness
Formal Audit Process Generate random sample of 200 + 20% Clinic pulls charts for scheduled audit date Audit at site Calculate results Prepare audit report: numerical results and summary Present results at audit meeting
Formal Audit -- Results Not pulling all codes Out of date CPT codes Incomplete billing ticket Billing ticket not current Shots charted, not billed Practice Issues
Formal Audit -- Results If Pass Schedule training Determine ongoing file submission schedule. If Fail Discuss improvement needs, next steps Schedule re-audit.
Formal Audit -- Outcomes Clinic finds lost revenue Improved vaccine administration Improved documentation/charting Registry receives accurate information Patients do not receive unnecessary shots!
Auditing Techniques Formal Audit Uploading Processes Ongoing Maintenance
Uploading Immunization Deduplication Process Batch file entry Client Verification Report “Rules” and “Review” Use +/- 5 day window Antigen Families
Uploading Deduplication Antigen “Family” example Antigen Family: Polio DTP/IPV IPV OPV Polio
Uploading Deduplication “Rules” based on: History versus History History versus Actual Actual versus History Actual versus Actual
Uploading Deduplication Rules, example Actual vs History 1/1/1990 DTP ‘Clinic A’ vs 1/2/1990 DTaP HIST History vs History 2/15/1990 DTP HIST vs 2/17/1990 DTaP/Hib3 HIST
Uploading Deduplication Rules, Examples History vs. Actual 2/15/1990 DTP HIST vs 2/16/1990 DTaP/Hib3 ‘Clinic B’ Actual vs Actual 1/1/1990 DTP/Hib ‘Clinic A’ vs 1/2/1990 DtaP ‘Clinic B’
Auditing Techniques Formal Audit Uploading Processes Ongoing Maintenance
Ongoing Maintenance Maintain ‘Rules’ Maintain ‘Review’ Check for missing vaccinations Participant Relationships Reports - Client Verification Report (CVR) Periodic queries
Ongoing Maintenance Reports Examples Duplicate shots Duplicate clients Client status Clients seen at other sites
Ongoing Maintenance Periodic Queries Examples: OPV/IPV PCV7
ImmuLink Website http://www.co.hennepin.mn.us/commhlth/immulink/ immulinkhomepage.htm
Senior Planning Analyst 612-348-4125 alisa.johnson@co.hennepin.mn.us For More Information: Alisa Johnson Senior Planning Analyst 612-348-4125 alisa.johnson@co.hennepin.mn.us Technical Information: shelly.labarre@co.hennepin.mn.us