Advanced SmarTrack Worklist Rules

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1 Advanced SmarTrack Worklist Rules Tawnya Manning Training Specialist Jennifer Basch Solutions Specialist

2 Objectives 1. Indicator-based Rules 2. Elapsed Time Rules 3. Complex AND/OR Conditions 4. Next and Previous Encounter Conditions 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 2

3 Previous Encounter or Next Encounter Qualifying Conditions Available for any Encounter Type Admit Source Admitting Physician Admitting Service Admitting Specialty APR DRG Attending Physician Discharge Physician Discharge Disposition DRG (Federal) Elapsed Time (Hours) Encounter Type Facility Location LOS Principal Diagnosis Principal Payer Principal Procedure Principal Procedure Physician Referral Source State DRG 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 3

4 Previous Encounter Conditions 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 4

5 Emergency to Inpatient Readmission March 1 Inpatient (I) March 12 Short Stay (S) April 7 Emergency (E) April 9 Outpatient (O) April 10 Inpatient (I) Admit Source Admitting Physician APR DRG Attending Physician Discharge Disposition Discharge Physician DRG (Federal) Elapsed Time (Hours) Encounter Type Facility LOS Location Principal Diagnosis Principal Payer Principal Procedure Phys Principal Procedure Referral Source Admitting Service Admitting Specialty State DRG 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 5

6 Emergency to Inpatient Readmission Worklist Conditions Previous Encounter Anchor Encounter 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 6

7 Tools: Other Background Conditions ENCOUNTER:Type:Type (Days Since Last) ENCOUNTER:Days Since Last Encounter ENCOUNTER:Active? ENCOUNTER:Age at Encounter (Days) ENCOUNTER:Age at Encounter (Years) ENCOUNTER:DRG:Code Range ENCOUNTER:Procedure:Code Range ENCOUNTER:Principal Procedure:Code Is Like ENCOUNTER:Principal Procedure:Section/Body System ENCOUNTER:Principal Procedure:Code Range ENCOUNTER:Principal Diagnosis:Code Is Like ENCOUNTER:Principal Diagnosis:Code Range 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 7

8 Emergency to Inpatient Readmission Worklist Previous Encounter Anchor Encounter ENCOUNTER: Type: Type (Days Since Last) - Has Value: Emergency ENCOUNTER:Encounter Type: Type - Has Value: Inpatient ENCOUNTER:Previous ER Encounter:Disposition - Does not have value of: AMA, Transfer Acute Care Reference Date: Encounter: Start Date ENCOUNTER:ENCOUNTER TYPES:Days Since Last Encounter - Has Value:<4 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 8

9 CHF Readmission March 1, 2012 Inpatient (I) DX: initial subendocardial infarction March 12, 2012 Outpatient (S) DX: atrial fib & medication induction March 29, 2012 Inpatient (I) DX: CHF NOS April 7, 2012 Emergency (E) AD DX: Chest Pain NEC April 10, 2012 Inpatient (I) AD DX: SOB, r/o CHF exac 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 9

10 CHF Readmission Worklist Previous Encounter Anchor Encounter Encounter:Type:Type (Days Since Last) Has Value: I ENCOUNTER:Previous Inpatient Encounter: Principal Diagnosis Has Value: ENCOUNTER:Encounter Type: Type Has Value: I or S ENCOUNTER:ENCOUNTER TYPES:Days Since Last Encounter Has Value:<31 Reference Date: Encounter: Start Date 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 10

11 Surgical Procedure Readmission with Post-op Infection August 12, 2010 Principal DX : Abdominal Pain July 21, 2011 Procedures Risk Group: Colon Surgery Procedure: Colostomy November 21, 2011 Principal DX: Convulsions April 7, 2012 Principal DX: Postoperative Infection April 29, 2012 Principal DX: Acute bronchitis Admit Source Admitting Physician APR DRG Attending Physician Discharge Disposition Discharge Physician DRG (Federal) Elapsed Time (Hours) Encounter Type Facility LOS Location Principal Diagnosis Principal Payer Principal Procedure Phys Principal Procedure Referral Source Admitting Service Admitting Specialty State DRG 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 11

12 Surgical Procedure Readmission with Post-op Infection Worklist Anchor Encounter Next Encounter ENCOUNTER:Procedure: Risk Group Has Value: Abdominal Hysterectomy CABG, Chest and Donor Site CABG, Chest Only Colon Surgery Hip Prosthesis Knee Prosthesis ENCOUNTER:Next Encounter:Principal Diagnosis Has Value: Postoperative infection Infected postoperative seroma Other postoperative infection Postop wound disruption Reference Date: Encounter: End Date 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 12

13 Thank you for attending. Questions, anyone? Tawnya Manning Training Specialist Jennifer Basch Solutions Specialist

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