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Auditing Techniques for Ensuring Quality Data in a Registry
Alisa Johnson Hennepin County Community Health
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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
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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
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Auditing Techniques Formal Audit Uploading Processes
Ongoing Maintenance
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Formal Audit Purposes Verify that export file process includes all immunization codes Check for accuracy and completeness Ensure quality data in registry
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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
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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
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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Not pulling all codes Out of date CPT codes Incomplete billing ticket Billing ticket not current Shots charted, not billed Practice Issues
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Formal Audit -- Results
If Pass Schedule training Determine ongoing file submission schedule. If Fail Discuss improvement needs, next steps Schedule re-audit.
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Formal Audit -- Outcomes
Clinic finds lost revenue Improved vaccine administration Improved documentation/charting Registry receives accurate information Patients do not receive unnecessary shots!
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Auditing Techniques Formal Audit Uploading Processes
Ongoing Maintenance
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Uploading Immunization Deduplication Process Batch file entry
Client Verification Report “Rules” and “Review” Use +/- 5 day window Antigen Families
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Uploading Deduplication Antigen “Family” example Antigen Family: Polio
DTP/IPV IPV OPV Polio
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Uploading Deduplication “Rules” based on: History versus History
History versus Actual Actual versus History Actual versus Actual
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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
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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’
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Auditing Techniques Formal Audit Uploading Processes
Ongoing Maintenance
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Ongoing Maintenance Maintain ‘Rules’ Maintain ‘Review’
Check for missing vaccinations Participant Relationships Reports - Client Verification Report (CVR) Periodic queries
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Ongoing Maintenance Reports Examples Duplicate shots Duplicate clients
Client status Clients seen at other sites
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Ongoing Maintenance Periodic Queries Examples: OPV/IPV PCV7
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ImmuLink Website http://www.co.hennepin.mn.us/commhlth/immulink/
immulinkhomepage.htm
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Senior Planning Analyst 612-348-4125 alisa.johnson@co.hennepin.mn.us
For More Information: Alisa Johnson Senior Planning Analyst Technical Information:
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