Using APR-DRG DataVision Reports for Hospital Ranking and Physician Review Amy Schoenherr Project Manager Clinical Decision Support Services ACS MIDAS+
What Are 3M APR-DRGs? All Patient Refined Diagnosis Related Groups 3M s proprietary system (grouper) APR-DRG code Severity of Illness subclass (used in LOS) Risk of Mortality subclass (used in Mortality) Subclass categories are numbered 1 4 1 = minor (mild) 3 = major 2 = moderate 4 = extreme 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
What Data Does 3M APR-DRG Use to Determine Subclass Age Principal diagnosis Secondary diagnoses Procedures (especially Non-OR ) Does not currently use diagnosis status (Present/Absent on Admission) 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
Using DataVision APR-DRG Reports My Patients are Sicker MIDAS+ DataVision Web Application Using comparative data Expected Mortality Expected ALOS Viewed by Hospital or by Provider Parameters to customize date range, acute care only, age groups, comparison category, minimum number of cases MIDAS+ DataVision Server Application Research encounter detail on your MIDAS+ server, including Severity of Illness and Risk of Mortality categories 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
DataVision Web Application APR-DRG Reports Hospital APR-DRG Ranking Profile APR-DRG Subclass Detail Single APR-DRG Comparison Profile APR-DRG ALOS Detail Report APR-DRG Mortality Detail Report Provider APR-DRG Detail Report All APR-DRG Provider Summary 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
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Hospital APR-DRG Ranking Profile Lists all clinical populations treated at a facility by APR-DRG ranked high to low by case volume Can sort by clicking on headers (codes ascending, values descending order) Export or Print 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
Hospital APR-DRG Ranking Profile Parameter choices Date range Minimum cases Include all inpatients or acute care only Show variation as ratio or delta values Remove palliative care population Age filter; all, >64, < 18 Comparison categories; all, bed size, Acute care CMI, Nursery level, Region, Teaching Yes/No, Corporate Group 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
Parameter choices show in Report Header and in All or Acute row
Hospital APR-DRG Ranking Profile Things to consider: Use the parameter option for Acute Care only (eliminates moms & babies, rehab, hospice, skilled nursing, psych) to limit the report to cases where tracking mortality and LOS is more urgent Avoid the trap of small numbers: use the parameter option for minimum cases to ensure your focus is on statistically significant variances 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
APR-DRG Subclass Detail All APR-DRG codes available (of which approximately 60 APR-DRGs are linked to specific Clinical Topics) Table includes distribution and ALOS and Mortality by subclass Two tables on one report (ALOS by Severity and Mortality Rate by Mortality Risk) 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
Single APR-DRG Comparison Profile Allows view of a single clinical population by all attributed providers Attribution should be carefully assessed for validity given your organization s recording of attending, admitting, and principal procedure provider Principal procedure may or may not be reflected in the APR-DRG assignment 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
Single APR-DRG Comparison Profile allows access to APR-DRG ALOS Detail Report APR-DRG Mortality Report
APR-DRG ALOS & Mortality Detail Reports Breakdown by severity by provider in two formats Table Graph 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
Provider APR-DRG Detail Report Allows view of a single provider for all APR- DRGs; a provider s entire line of business Includes the provider s specialty ratio for that same APR-DRG Carefully consider validity of provider attribution for admitting, attending, or principal procedure provider Batch option for Export/Print 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
All APR-DRG Provider Summary Lists all providers attributed for treating patients at a facility ranked high to low by case volume Identifies the provider s specialty Carefully consider validity of provider attribution for admitting, attending, or principal procedure provider 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
DataVision Server Application For Researching Details DataVision Navigator > Physician Profiles > Quality Profile (two indicators) DataVision Report Toolpack Report Data Transfer 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
Physician Profile APR-DRG Indicators Mortality Overall Mortality Rate Expected (APR DRG adjusted) LOS Overall Arithmetic LOS Expected (APR DRG adjusted) 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
DataVision Report Toolpack ALOS by Attending
DataVision Report Toolpack Mortality by Attending
DataVision Report Toolpack ALOS & Mortality by Attending Excel pivot table based on selected population Can double-click the values to get a sheet with the detail data Can use pivot selector arrow to limit the APR- DRGs or the providers 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
DataVision Report Toolpack Limit to Single Attending
DataVision Report Toolpack Limit to Single Attending
Researching Details on Your MIDAS+ Server 3M APR-DRG values on your MIDAS+ server requires a 3M license Options for getting your APR-DRG data into your MIDAS+ server (a) Interface the values into your MIDAS+ server from your installation of 3M APR-DRG grouper (b) Retroactively receive data from ACS MIDAS+ on a quarterly basis, approximately 5 months after end of quarter 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
What s Coming in the Future? Provider comparison by mapped specialties Comparison using APR-DRG Relative Weights 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona
Resources Support email to midas.datavision@acs-inc.com Web Application Help (click on?) DataVision User Manual (6.x, 7.0, and 7.1) 17 th Annual MIDAS+ User Symposium GO FOR THE GOLD June 9-11, 2008 Tucson, Arizona