1. electronic Submission of Medical Documentation (esMD) electronic Determination of Coverage (eDoC) PMD Discrete Data Definition October 30, 2013

2. What we are doing –Facilitate the review process for the F2F evaluation, LCMP evaluation, and DME supplier documentation –Move from unstructured data (PDF) to structured data –Move from text to discrete data elements –Move to standards based clinical vocabularies –Determine where we can use discrete data sets and where they will not work What we are not doing –Designing forms with check boxes –Designating a single method for evaluation and/or documentation –Requiring that discrete data sets and coded medical data must be used –Code all medical data –Define all possible reasons that a PMD is necessary and appropriate Goals 2

3. Moving from unstructured documents to structured documents Using the Consolidated CDA as the basis for the record Able to accommodate both coded and un-coded (textual) information Provides a “home” for the various components of the documentation –Reference: mapping work for the eDoC general use case –Reference: current work on Additional Administrative Templates Provides entry templates that allow for highly coded information Can accommodate specific assessment tools (e.g. OASIS) that use highly coded data Structured Documentation 3

4. Take the most easily coded information first –Supplier information –Home evaluation –Patient willingness to use –Ability to ambulate –Diagnoses --separate into appropriate groups (discuss) Simple single cause (e.g. spinal injury) Complex single cause (e.g. progressive COPD) Multiple causes (co-morbidities that contribute) –COPD –CHF –Obesity –Validate degree of specificity for the various code sets (e.g. ICD- 10) Approach 4

5. Summary Create discrete data definitions for key components of the PMD eClinical template Use the C-CDA as the standard for communication the structured data Follow the process of coding simple information first and then more complex data sets Identify exemplary assessment tools, relevant to PMD, that currently or with some effort can produce highly coded discrete data sets. Avoid trying to “solve” coding all problems

6. Questions?