1. Vermont Explor Annual Meeting April 29, 2003 Randolph, VT

2. Welcome & Introductions

3. Agenda  Highlights & “Issues” in 2002  Data Quality in 2003  Presentations by BISHCA & VDH  Error Thresholds (Steve Reynolds)  Personal Identifiers (Ken Kuebler)  HIDI web tool for corrections  E Codes  Outpatient Procedure Coding

4. Data Quality in 2002  Highlights – Error Rates  Southwestern (<0.33%)  Porter Medical Center (<0.75%)  Fletcher Allen (<3.0%)  Northeastern (Some 0% months)

5. Data Quality in 2002  Not so Highlights  HCPCS (Missing)  Operating Physician (Missing)  Revenue Code (Duplicate)

6. Data Quality in 2003  New error thresholds (0% and 5%)  Validation reports are important!  Improvements needed?  Correct errors before next submission!  New web-based correction tool

7. BISHCA & Vermont Dept of Health  Dian Kahn, BISHCA  Charles Bennett, Epidemiological Surveillance Chief  Richard H. McCoy, Public Health Statistics Chief  Peggy Brozicevic, Public Health Statistics  Pat Worcester, Caroline Dawson, Laurel Decher, Annette Rexroad

8. Data Corrections  How much is enough?  Hospital work load vs. data quality  Statistical significance

9. Personal Identifiers Ken Kuebler, Executive VP, Hospital Industry Data Institute, Missouri Hospital Association

10. Personal Identifiers  Why collect a personal identifier?  What identifiers are normally used?  How are identifiers kept secure and HIPAA compliant?

11. Personal identifiers can be used to:  eliminate the need for re-admit flag  reduce E-code messages for accident patient follow-up visits  allow tracking of patients across hospitals and services for research and analysis

12. Types of Identifiers  The best identifier is one that a person uses consistently for identification purposes (e.g., Social Security number, driver’s license number).  An identifier built from a combination of existing data (e.g., date of birth, parts of name, ZIP code, sex).  An identifier built from a unique identifier (e.g., encrypted or sequential number). This translation would have to be performed in one office.

13. Keeping Identifiers Secure and HIPAA Compliant  Obtain confidentiality agreements from all users of the data.  Encrypt original I.D. and then destroy original. Keep encryption key at one location only.  Allow a minimum number of persons access to personal identifiers.

14. Breaks Are Good Take 5!

15. HIDI Web Tool Ken Kuebler, Executive VP, Hospital Industry Data Institute, Missouri Hospital Association

16. E Codes  Correct coding  Issues with “error” messages  Value to epidemiology & surveillance

17. Outpatient Procedure Codes  ICD-9 vs. CPT-4  Coverage of the two code sets  Variation across settings  Precision  Grouping  Future trends

18. Conclusions & Lunch  2002 was a much better year than 2001  Timeliness has improved  Most of the important areas have few errors (dx, px, demographics)  Future focus: logical consistency from quarter to quarter