1. Vermont Explor Data & Planning Vermont Technical College March 14 th, 2005

2. Introductions

3. Agenda  Review of discharge data  Overview of future changes  UB-04  ICD-10  Vt. Dept. of Health: Data needs  Data Quality: Improving your error rates while making life easier!  Web-based data reporting tool

4. Data Review  Data submissions: Smoother than ever!  Issues in 2004:  Missing procedures found  CPT-4 instead of ICD-9 PX codes  Some still include professional fees  Special rules for Critical Access Hospitals  County-Town Codes  Needs specific to QualityWorks

5. 2004 Error Rates QuarterBelow 2%2% - 5%Above 5% InpatientNumber of Hospitals 11032 2 23 3843 4843 Outpatient 11023 2843 3852 4753

6. Submission Reports  www.vtexplor.org/status.htm www.vtexplor.org/status.htm  Weekly status report by hospital  Including error rates  Monthly status of other data collection efforts

7. Change is in the Wind…  UB-04 Claim Form Claim FormClaim Form  Medical Record Number moved to FL3  Reduced Remarks  Distinct: Accident Code, Date & State  8 more Other Diagnoses  Why paper at all???  ICD-10  Still stalled, but keep it in back of mind

8. Vt Department of Health  Race & Ethnicity Click for Presentation Click for PresentationClick for Presentation  E Codes  Cause: In 2004, preliminary missing rate = 0.5% !!  Place  Perpetrator  Unique Patient Identifier  11 hospitals send us Social Security #  9 hospitals send us Medical Record # (due 1/1/05)  E Codes on follow-ups: Use patient ID to derive?  What in the data tells me it’s a follow-up? DX, < x days?

9. Physician Identifiers  Primary Care Provider  Referring Physician  Hospitals are asking: “Who is referring my patients elsewhere?”

10. Data Quality  What do we mean by “data quality”?  Not just low error rates  Consistent trends, complete recordsets  Why does it matter?  Public health epidemiology (of course)  But also, for example:  Act 53: Average charges  AHRQ Quality Indicators

11. Data Quality  Ken’s Presentation Ken’s Presentation Ken’s Presentation  How do you achieve it? 1.Internal controls before submission 1.[Insert best practices] 2.HIDInet corrections interface 1.Any issues here? 3.Lauri’s niggling questions

12. Data Quality  Validation Reports  Quick overview of submission  Top DRGs, DXs, ZIPs, etc.  Look for changes from month to month

13. Meeting Materials  www.vtexplor.org/events.htm

14. Web Reporting Tool  Launch demonstration Launch demonstration Launch demonstration

15. Planners: Introductions

16. Dian Kahn, BISHCA  Hospital service areas as defined in the 2002 Hospital Monograph Series and referred to in the Act 53 "Community Needs Assessments“  Dian will describe how the areas were defined starting with the 2002 Hospital Monograph Series and welcomes your feedback to improve future efforts to define service areas.

17. HIDI Outpatient Reports

18. HIDI Data Download Tool  State, ZIP, County, Sex, Admit Type, Admit Source, Discharge Date, Days Between Admit and Discharge, Disposition, Length of Stay, Age, Payor, Other Dx 1, Other Dx 2, Other Dx 3, Other Dx 4, Other Dx 5, Other Dx 6, Other Dx 7, Other Dx 8, Other Dx 9, E-Code, Principal Px, Other Px 1, Other Px 2, Other Px 3, Other Px 4, Other Px 5, Other Px 6, Other Px 7, Other Px 8, Other Px 9, Ethnicity, Race, DRG, MDC, Patient Type, Observation Hours

19. Summarizing Data in Excel  Pivot tables (and charts) allow user to:  Drag and drop data elements  Reposition them  Report on a subset of the data  Change the data format ($, %, etc.)  Show/hide totals  Easily refresh the report when the underlying data change

20. Next Steps  Other services that Explor can provide  Educational sessions  Conference calls and/or meetings  802-223-3461  Lauri: extension 108  Greg: extension 109