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APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical Director
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APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Dec 16, 2018

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Page 1: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

APR DRG Data Discovery

Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant

Henry Johnson MD, MPH Midas+ Vice President and Medical Director

Page 2: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Agenda

• Review:

– 3M APR DRG Methodology

– DataVision: Web and Server Applications

• Data Discovery:

– Resource use and Length of Stay:

• Wren Memorial, Cardiac Services

• Michael Memorial Orthopedic Services

– Mortality

• Vitale Memorial Hospital, Percutaneous Coronary Intervention (PCI)

• Summary and Questions

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 2

Page 3: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Severity Adjustment Systems

• All Patient Diagnostic Related Group (AP DRG) – 1987: New York passed prospective payment for all

non-Medicare patients

• All-Payer Severity-adjusted DRG (APS DRG) – Different methodology, also developed from the DRG

model

• All Patient Refined DRG (APR DRG) – Researched and developed by New York Department

of Health (NYDH) in partnership with 3M™ Health Information Systems (HIS)

• Others: – STS, APACHE, Disease Staging, MedisGroups

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 4: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

3M™ APR DRG

• Expanded the scope of DRGs to add:

– Severity of Illness (SOI)

• The extent of physiologic decompensation or organ system loss of function

– Risk of Mortality (ROM)

• The likelihood of dying

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 5: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Development Process: Clinically Coherent with Sufficient Case Volume

• Start with All Patient DRGs (AP DRGs)

• Consolidate – Combine the “with CC” and “without CC” DRGs

– Each APR DRG has a four-point “CC” scale built in

• Pediatric additions

• Add APR DRGs for mortality – Eliminate any unique DRGs for deaths only

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 6: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Subclass Assignment

• Assign each secondary diagnosis a SOI and ROM level (subclass) from 1 to 4

• In an iterative fashion, assign a subclass number based on dominant secondary diagnoses

• Some modifications for age

– Hypertension in children is considered major as a secondary

• Some modifications for specific APR DRGs

– Chronic Renal Failure as a secondary is Moderate, except if the APR DRG is diabetes, in which case it is Major

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 7: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Testing

• After the clinical model for SOI and ROM is developed for each base APR DRG, it is evaluated with historical data to be sure the subclasses predict resource use (SOI) and mortality rate (ROM).

• Version 20.0 was evaluated with a national database of 8.5 million discharges, all payers, from 1,000 hospitals from 10 states, and 47 children’s hospitals in the U.S.

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 8: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Beginning with APR DRG v.20

• For each APR DRG subclass, a Relative Weight (RW) was calculated to reflect the resources required for a patient in that APR DRG subclass.

• The subclass RW allows calculation of an overall Case Mix Index (CMI) for the hospital or by physician or physician group, which is severity-adjusted.

• Allows for more refined reimbursement

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 9: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

APR DRG v20: Relative Weights

Base Rate RW Payment

4,113.00$ 0.5804 2,387.19$

4,113.00$ 0.793 3,261.61$

4,113.00$ 1.2736 5,238.32$

4,113.00$ 3.0052 12,360.39$

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 10: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Cautions

• APR DRG SOI and ROM subclasses are ranked categories unique to each APR DRG and cannot be averaged across APR DRGs (they are not really numbers).

– For example, congestive heart failure patients in severity subclass 4 are not comparable to patients with a fractured leg in severity subclass 4.

• In version 20.0 or later, you can average the RW.

• Beware choosing a population by MS-DRG or ICD-9 diagnosis and running reports or doing analysis for the whole population by APR DRG SOI or ROM.

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 11: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

DataVision Architecture

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 11

Midas+ Care Management

Midas+ Solutions: Tucson AZ

Standardized Measures:

DataVision

Navigator

National Comparisons:

DataVision

Web Application

Hospital Server

Page 12: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

DataVision APR DRG Reports

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 12

Page 13: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

APR DRG Reports

• APR-DRG Lives/Days Saved Report

– Compares the facility's mortality and average length of stay (ALOS) data observed/expected (O/E) ratio statistics with the Midas+ comparative database (CDB) mean

– Provides site percentile rank in comparison with the CDB

– Predicts the number of lives and days that might be saved if outcomes improved to a different percentile

• Hospital APR-DRG Service Line Profile

– Lists all 3M™ APR DRG–defined service lines for the facility

– Provides mortality, ALOS, and Potentially Preventable Readmission (PPR) O/E ratio or delta statistics based on the CDB mean

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 13

Page 14: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

APR DRG Reports

• Hospital APR-DRG Ranking Profile

– Lists all APR DRGs and provides mortality, ALOS, and Potentially Preventable Readmission (PPR) O/E ratio or delta statistics based on the CDB mean

• APR-DRG Comparative Trend Analysis

– A two-part report that displays the length of stay O/E ratio and the mortality O/E ratio for the selected APR DRG, comparing the facility’s performance with percentiles from the CDB

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 14

Page 15: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

APR DRG Reports

• APR-DRG Subclass Detail

– A three-part report that examines facility

• LOS for the APR DRG, stratified by four severity-of-illness (SOI) levels

• Mortality rates for the APR DRG, stratified by four ROM levels

• Potentially Preventable Readmissions, stratified by four SOI levels

– This report includes percentile comparisons with the comparative database

• Single APR-DRG Comparison Profile

– Lists all providers for a specific APR DRG and provides mortality and ALOS statistics for each provider

– Can be viewed by provider name or code

– Parameter allows report to be viewed by attending or principal procedure provider

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 15

Page 16: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

APR DRG Reports

• APR-DRG Specialty Comparison Report – Compares a single provider to her peers for LOS and mortality, within

the hospital and with the comparative database

– Based on mapping of specialty groups specialties with admitting or attending activity

• Provider APR-DRG Detail Report – Lists all APR DRGs for a selected provider and provides mortality and

LOS statistics for each APR DRG as well as a specialty comparison

• All APR-DRG Provider Summary – Observed and expected mortality and LOS data for each of the facility’s

providers

– This report is useful for identifying high-volume providers

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 16

Page 17: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

• What is in the ToolPack?

– 256 fields . . .

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 17

What Is New on Your Server?

Page 18: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Description # fields

Patient Demographics 14

Encounter description, including LOS 15

Admitting/Attending Physician 8

Discharging Physician 3

Payer, charge, and cost data 6

DRG (CMS) related 10

Principal Diagnosis 3

Principal Procedure 5

Count of Diagnoses, Count of Not Present on Admission 2

Secondary Diagnoses (total 25 possible, including principal) 72

Secondary Procedures (total 20 possible, including principal) 95

Consultants (total 5) 10

Primary Care physician 2

APR DRG-related 10

Birthdate 1

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 18

Page 19: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

New fields in Excel Toolpack Export

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 19

APR DRG 174

APR DRG DESC Percutaneous cardiovascular

procedures w AMI

APR DRG Severity 2

APR DRG Mortality Risk 2

APR DRG MDC 5

CDB APR DRG All Inpatient Expected 2.9

CDB APR DRG All Inpatient Expected

Mortality

0.41%

CDB APR DRG Acute Care Expected 2.9

CDB APR DRG Acute Care Expected

Mortality

0.41%

Page 20: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

20 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Steps to Data Discovery

Page 21: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Resource Use and Length of Stay:

Wren Memorial, Cardiac Services

21 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Question: What determines LOS?

• Discharge planning

• Events that prolong stay

Why is looking at long LOS important?

Page 22: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Basic Steps:

• Start with DataVision web application:

– SmartReport

– APR-DRG Reports

• Next, move to server for patient data

– Report Toolpack

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 22

Page 23: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

23 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 24: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

24 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 25: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

25 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 26: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

26 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 27: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

27 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 28: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

28 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 29: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

29 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 30: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

30 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 31: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

31 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 32: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

32 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 33: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

33 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Total of 1,214.3 days, or 3.3 beds/day if we can go to the mean.

Can we do better?

Page 34: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

34 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 35: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

35 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 36: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

36 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Wren March 2011 to February 2012

APR DRG

CodeDescription

#

Cases

Obs

ALOS

Expec

ted

LOS

Ratio

Perce

ntile

Rank

20th Percentile

Pred ALOSDays saved # hospitals

194 Heart failure 1313 5 4.69 1.07 78th 3.81 1553.51 676

201Cardiac arrhythmia & conduction

disorders615 3.62 3.24 1.12 82nd 2.67 580.16 671

175Percutaneous cardiovascular

procedures w/o AMI384 3.53 2.91 1.21 82nd 2.47 407.00 457

190 Acute myocardial infarction 186 5.23 4.19 1.25 93rd 3.15 386.92 653

174Percutaneous cardiovascular

procedures w AMI312 4.34 3.87 1.12 79th 3.37 303.54 434

If we can perform better than 80% of the hospitals in the comparative database, for these five APR-DRGs in the cardiac service line, we will save 3,231 bed days, or almost 9 extra beds/day – more room for transferring ICU patients and decreasing waits in the Emergency Department.

Page 37: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

37 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 38: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

38 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 39: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

39 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 40: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

To the Server:

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 40

Midas+ Care Management

Midas+ Solutions: Tucson AZ

Standardized Measures:

DataVision

Navigator

National Comparisons:

DataVision

Web Application

Hospital Server

Page 41: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

41 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 42: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

42 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 43: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

43 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 44: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

44 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 45: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

45 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 46: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

46 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Wren

APR DRG 194

Heart Failure

Page 51: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

51 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Steps to Data Discovery

• Web application: reviewed

SmartReport

• Hospital APR-DRG Ranking Profile

• Set parameters to Days Delta

• Take contents to Excel to view and

rank

• Hospital APR-DRG Service Line

Profile

• Drill down to a service line

• Days Saved Report – bring out to

Excel

• Estimate total Days Saved at 20th

percentile

• Check by Attending and Principal

Procedure Provider

• To server: build APR Indicators

• Run Toolpacks

Page 52: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Resource Use and Length of Stay:

Michael Memorial,

Orthopedics

52 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 53: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

53 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 54: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

54 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 55: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

55 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 56: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

56 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 57: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

57 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 58: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

58 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 59: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

59 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 60: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

60 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 61: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

To the Server:

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 61

Midas+ Care Management

Midas+ Solutions: Tucson AZ

Standardized Measures:

DataVision

Navigator

National Comparisons:

DataVision

Web Application

Hospital Server

Page 62: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

62 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 63: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

63 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 65: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

65 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Steps to Data Discovery

• Web application: review

SmartReport

• APR-DRG Service Line Profile

• Set parameters to Days Delta

• Review APR-DRG 313 . . . .

• Choose APR-DRG that is easily

“actionable”

• Look at AP-DRG 301, Total Hips

• To server: build APR Indicators

• Run Toolpack

Page 66: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

Mortality: Vitale Memorial Percutaneous Coronary Intervention

• Consider:

– Does the hospital have a hospice unit?

• Recall that on the DataVision web application

– Acute Care is All Patients, excluding

» Obstetrics

» Rehabilitation

» Behavioral Health

» Hospice

– Does the hospital use code V66.7 Palliative Care?

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 66

Page 67: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

67 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 68: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

68 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 69: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

69 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 70: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

70 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 71: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

71 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 72: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

72 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 73: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

73 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Page 74: APR DRG Data Discovery - midasplus.com · APR DRG Data Discovery Vanessa Dorr RN MSN Midas+ DataVision Clinical Consultant Henry Johnson MD, MPH Midas+ Vice President and Medical

74 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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75 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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76 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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77 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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78 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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79 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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80 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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81 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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82 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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83 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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84 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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85 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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86 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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87 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

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To the Server:

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona 88

Midas+ Care Management

Midas+ Solutions: Tucson AZ

Standardized Measures:

DataVision

Navigator

National Comparisons:

DataVision

Web Application

Hospital Server

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89 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Vitale

APR DRG 174

PCI w AMI

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90 21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona

Steps to Data Discovery

• Review SmartReport, find high

mortality rate

• Run Comparative Trend Analysis

• APR-DRG Ranking Profile

• Facility/Mortality Data

• Hospice present

• Review SmartReport

• Facility/Mortality Data: No hospice

• Lives/Days Saved Report: APR 174

• Remove V66.7 coded patients

• View CTA and subclass detail

• Profile by Doctor

• To server: build Indicator, run

ToolPack

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Questions:

21st Annual Midas+ User Symposium • May 20–23, 2012 • Tucson, Arizona