Patient Administration Systems and Biostatistics Activity Deployed Medical Records Processing Center (DMRPC) Status Update MAJ John M. Miller Acting Director As of 1May 08

Pop Quiz Why am I here? Quick TDY (TAD) to Orlando Information sharing I needed to get out of the office An O-6 told me I had to All of the above

PASBA DMRPC Background Current Status Current Workload The Way Ahead BRIEFING OUTLINE PURPOSE: To provide information on the Deployed Medical Records Processing Center PASBA DMRPC Background Current Status Current Workload The Way Ahead Questions

Mission To provide timely and useful healthcare data to assist the Department of Defense, US Army, US Army Medical Command, and individual customers in providing the best healthcare for our beneficiaries. We accomplish this by providing expert; data analysis, data quality program management, coding and training program guidance, deployed medical records management, and software development of “just in time” applications in support of our customer’s initiatives. With a customer focused, competent staff that makes a conscience effort at being there for the customers and each other, making the customers’ day, and choosing the right attitude daily.

Vision Provide relevant and timely patient information to the DoD, Army and AMEDD leadership by anticipating and proactively addressing data requirements.

DMRPC The Deployed Medical Records Processing Center supports deployed MTFs by processing inpatient medical treatment records. Diagnosis and procedure coding Data entry into the AMEDD central repository Record Scanning Record retirement to the National Personnel Record Center in St Louis.

DMRPC Background Began processing records Spring ’04 in PASBA basement Opened DMRPC in Apr 05 MOA with the Navy (22 Aug 05) and Air Force (19 Aug 05) Steadily increasing volume of records Nov 06 – MEDCOM CoS and TSG redirect priority of processing Feb 07 – Soldiers Awaiting Training (68Gs 5 week rotation) assisted in getting records completed.

DMRPC Current Status Use of Web Interface to Scanned Patient Records (WISPR) in Aug 06 ended the need to transfer hard copy records to JTTR, and others; greater personnel efficiency Started retiring completed and scanned records to NPRC (St. Louis) in Jun 06 for first time since operations began Huge retirement surge in Mar 07 with assistance of Soldiers Awaiting Training (SAT) Intense scrutinizing of business processes during the last year yielded increased efficiency: Closer management Better work effort Working smarter Employee buy in – less absenteeism

DMRPC Current Actions Lean Six Sigma New process implemented Medical Clerk processes record to completion by assembling, abstracting, and entering data Coders use the Web Interface for coding records Intense scrutinizing of business processes during the last year yielded increased efficiency: Closer management Better work effort Working smarter Employee buy in – less absenteeism The US Army MEDCOM has a MOA with the Air Force and Navy to process their level III inpatient records Current contract will be leveraged to concurrently process outpatient documentation

DMRPC Milestones Retired 38,983 records to NPRC (St. Louis) – EOM April 08 Processed all Active Duty and Detainee records Priority processing as they are received Concurrent processing with all others Optimized and streamlined process Exercise good HR and business process management The DPMRC was established to process deployed inpatient records Began processing records Spring ’04 in PASBA basement Opened DMRPC in Apr 05 with 7 contractors We had as many as 33 contractors (incl. night shift) but problems arose Contract ended FY05 (57% manpower reduction) Training, supervisory, infrastructure issues DMRPC had some growing pains: PASBA, JTTR learning the most efficient business practices; The Level III MTFs in the war had to learn the proper procedures (Deployed medical records guidance) Steadily increasing volume of records Mar 06 – Initial funding request for 10 additional personnel was denied Jun 06 – Started retiring completed records to NPRC (ST. Louis) Aug 06 – ISR funds 4 medical clerks, PASBA funds 5 Nov 06 – CoS and TSG redirect priority of processing active duty, detainees then all others. Feb 07 – Soldiers Awaiting Training (SATs) 68Gs 5 week rotation, assisted in copying, verifying and retirement of records. May 07 –SATs MOS immaterial allocated to support mission Jul 07- Feb 08 – Lean Six Sigma Aug 07- PASBA published Deployed Medical Records Guidance Handbook Implemented new medical record process Sep 07 – Record assembling, abstracting, and data entering processing functions performed to completion by a medical clerk Oct 07 – Coders code records using the Web Interface to Scanned Patient Records (WISPR) Contract ended FY05 (57% manpower reduction) Mar 08 – All Medical Clerks under 1 contract (15 Medical Clerks and 1 Lead)

DMRPC Cumulative Workload “Monthly Snapshot” Thousands 28 MAR 08 – 24 APR 08 Received 81,274 (+1010) Completed 70,868 (+2709) Percent complete 87.2% (+2.3%) In Process US Detainee Other Current(<12months) 4,748 (-1225) 249 166 4,333 Backlog(>12months) 5,658 (-474) Total 10,406 (-1699) 9,991

DMRPC Cumulative Workload “Air Force, Navy, and Army Monthly Snapshot” “Air Force Processing Started May 2007” 27 MAR 08 – 24 APR 08 Received 19,468 (+447) Completed 12,576 (+1834) Percent complete 64.6% (+8.1%) In Process US Detainee Other Current(<12months) 3,614 (-1206) Backlog(>12months) 3,278 (-181) Total 6,892 (-1387) “Navy Processing Started August 2007” 27 MAR 08 – 24 APR 08 Received 5,261 (+197) Completed 5,064 (+78) Percent complete 96.3% (-2.2%) In Process US Detainee Other Current(<12months) 197 (+119) Backlog(>12months) (0) Total “Army Processing Started July 2003” 27 MAR 08 – 24 APR 08 Received 56,545 (+366) Completed 53,228 (+797) Percent complete 94.1% (+0.8%) In Process US Detainee Other Current(<12months) 937 (-138) 52 166 719 Backlog(>12months) 2,380 (-293) Total 3,317 (-431) 3,099

The Way Ahead 68G’s (records assembly and retirement) Next 2-3 months Continue priority processing of all Active Duty and Detainee records Prepare to receive outpatient loose documentation CENTCOM FRAGO Refine SOW Procure Scanners Develop information sharing protocols Continue processing all other patient category records > 12 months Continue retiring records Refine coding quality and production Soldiers Awaiting Training (SAT) Utilization 68G’s (records assembly and retirement) MOS immaterial (copying and scanning)

The Way Ahead New contract 1 Mar 08 (1st option yr) Merged two contracts into one Productivity floor requirement (2,700 per month) SOW updated included new processes (update) Projection year out Records pending and incoming projected records (~15,000) Concurrent processing inpatient and outpatient records Data use for War trending up Currently used along with TMDS (incoming units) Data used for studies Expect more requests in future

Questions?