2014 Morrisey Technology and Educational Conference 1

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1 Conference Data Standardization: the Source of Truth Jan Brown, RN, MN Executive Director UPMC Credentials Verification Office UPMC Facts and Figures UPMC is an integrated global healthcare delivery system headquartered in Pittsburgh, Pennsylvania and affiliated with the University of Pittsburgh Schools of the Health Sciences. 60,000+ employees 20 academic, community and specialty hospitals in western Pennsylvania with licensed beds 400 clinical care sites in 29 western Pennsylvania counties 17 retirement and long term care facilities 70 hospital and outpatient rehabilitation facilities UPMC Cancer Centers in 40 locations 2 UPMC Facts and Figures (con t) ISMETT (Institute for Transplantation and Advanced Specialized Therapies Palermo, Italy) International sites Italy, Ireland, Japan, China, Kazakhstan and Singapore Train 1800 medical residents 1000 nurses in training UPMC Health Plan (a health insurance plan - commercial, Medicare and Medicaid products) with 2.2 million members Total of 7500 credentialed practitioners with 5300 physicians 4900 employed physicians and extenders 21 facilities in MSO 14 credentialing entities 33 organizations in Apogee 1 credentialing entity 3 Conference 1

2 Standardization Begins with Policies and Procedures The CVO policies and procedures Developed with the implementation of the CVO Staff new hires none with credentialing experience! Provided direction and instruction for what to do Ongoing policy initiation and revision New policies are developed or policies are revised with operational changes - major additions and revisions with installation of MSOW Policies and Procedures important for Staff orientation User/Client orientation Basis for file reviews for the CVO Quality Improvement Program 4 Importance of Standardization Users/ Clients facilitates practitioner file review easier to find information and answers to questions if data entry, scanning and verification are standard Staff absence short term or long term easier for the staff member providing coverage to review for follow up and respond to inquiries 5 Maintenance of the Database Policy One of the major responsibilities of the CVO is the maintenance of the database Yes we have a policy for that! 6 Conference 2

3 Additional Policies MSOW Data Entry Practitioner level data (Staff screen) data entry only by the CVO staff 7 CVO MSO Data Entry Standards Specify data entry for every screen and every field 8 Document Scanning Standards Specify scanning documentation and document names 9 Conference 3

4 CVO Process Initiation and Documentation Standards Specify what process is initiated, when it is initiated, who is responsible to initiate, who it is initiated for and who is responsible to close it Specify the management of tasks Specify the format and content of the documentation 10 Verification Standards Specify what is to be verified Specify how it is to be verified Specify how it is to be documented 11 The Process of Data Standardization Development of Business Rules for Standardization Easy to create a few revisions to the data entry policy Sample Followed the Morrisey work/project plan Weekly calls with Morrisey to keep the project on task Mapping tools Many hours of work, but necessary and worthwhile Basically a process of merging and cleaning up all the data in the database (just like the merge offices functionality only bigger!) Sequencing scripts 12 Conference 4

5 Keeping the Data Clean on an Ongoing Basis A challenge! Standards must be followed for data entry Deviations from the standards cannot be tolerated Reports run against the database every 2 weeks feedback to the staff and concurrent correction Monitoring for compliance via the CVO Quality Improvement Program assessment of staff performance detection of issues and trends identification of needs for education or retraining Mergers (offices/hospitals/universities) on an ongoing basis Sequencing scripts run periodically Monitor! Monitor! Monitor! 13 Conference 5