SOI/ROM

Can some one tell me how to calculate SOI/ROM. Where do you pull the numbers from. I keep seeing it refered to in post and in powerpoints.
Thanks

Comments

  • edited May 2016
    From my facility these are automatically calculated from our 3M encoder.

    Stacy Vaughn, RHIT, CCS
    Data Support Specialist/DRG Assurance
    Aurora Baycare Medical Center
    2845 Greenbrier Rd
    Green Bay, WI 54311
    Phone: (920) 288-8655
    Fax: (920) 288-3052
  • Ok, Thank You. We do not have acess to 3M, I thought it was something the CDS's were calculating and I for the life of me could not figure out the formula. LOL I feel like a goof but not so bad since I couldn't figure it out.
  • edited May 2016
    not a goof. better to ask!!

    Stacy Vaughn, RHIT, CCS
    Data Support Specialist/DRG Assurance
    Aurora Baycare Medical Center
    2845 Greenbrier Rd
    Green Bay, WI 54311
    Phone: (920) 288-8655
    Fax: (920) 288-3052
  • edited May 2016
    There is an interesting article in the Jan 2009 ACDIS Quarterly Journal that suggests a method to look at SOI/ROM (Measure your CDI program using severity-adjusted data Dr Robert Gold http://www.hcpro.com/content/225223.pdf ).

    Worth taking a read.

    Using it in combination with CMS Final Rule table 7 gives you national average data on DRG distribution to compare yourself to. I off hand can't remember if CMS also provides average cost of care or mortality data. I do believe LOS is available in the final rule tables.

    Don
  • The numbers range from 1-4. This is all under APR-DRG, not MS-DRG. Some hospitals have it in place, alot doesn't. Remember 4 is the highest and 1 is the lowest. To understand where you could calculate on sick your patients really are, then go on Google or AHIMA and ask for information on APR-DRG , you will get all the information you need. I believe all hospitals will eventually be under this system eventually.
  • Hi Karen,
    We use 3M and the APRDRG will auto populate the SOI/ROM. I use it when speaking to physicians as it drives the profiling. It is a great tool!
    Hope this helps!
    Patti Fountain, BS RN MBA
    Clinical Documentation Specialist, Manager
    HIM
    St. Vincent Hospital
    123 Summer Street
    Worcester, MA 01608
    Office: 508-363-9453
    Pager: 27207
  • edited May 2016
    Are you using a computer system or writing worksheets? We are still on paper and looking up everything...The encoder would definitely be on my wishlist!!!


    Judi Bates RN, BSN, CCDS
    CDI Specialist
    856-757-3161
    Beeper 66x2906
  • edited May 2016
    We have an encoder for read only. However we use the DRG Expert. Our facility does not use the APRDRG.



    Karen McKaig, BSN, RN, CCM, CPUR, CCDS
    Case Manager
    Clinical Documentation Specialist
    Baxter Regional Medical Center
    Mountain Home, AR 72653
    870-508-1499
    kmckaig@baxterregional.org
  • edited May 2016
    Patti we use the same... Love the SOI/ROM feature to present to the docs!
    Vicki S. Davis, RN CDS
    Clinical Documentation Improvement Manager
    Health Information Management Department
    Alamance Regional Medical Center
    Office (336) 586-3765
    Ascom Mobile (336) 586-4191
    Fax (336) 538-7428
    vdavis2@armc.com

    "The difference between the right word and the almost right word is the difference between lightning and the lightning bug."- Samuel "Mark Twain" Clemens
  • Vicki,
    Thank you for your quick response! I love the SOI/ROM feature as well! It is a great selling point to the physicians!
    Patti Fountain, BS RN MBA
    Clinical Documentation Specialist, Manager
    HIM
    St. Vincent Hospital
    123 Summer Street
    Worcester, MA 01608
    Office: 508-363-9453
    Pager: 27207
  • Hi All,

    To those of you who are using the 3M APR DRG for SOI/ROM for the physicians:

    How are you using the data? Do you track their individual scores? Is there a benchmark that is used for the "average" Hospitalist SOI score?

    Our program would like to begin tracking the SOI/ROM 'average' for individual doctors (they have actually asked for this).

    Thanks,
    Kathy McDiarmid, RN CDIS
  • After 2 years of reviewing every death chart, I say: Not Possible. Good goal but it's not gonna happen. I certainly look closer at charts that are not a 4/4 to ensure we have not missed anything but sometimes it's not going to get there. In fact, we occasionally have patients with a 2 as well. As long as I can clearly define "why", I don’t stress over it. It's usually a situation where the patient arrived with metastatic cancer or something and was quickely n\made comfort care or an unexpected sudden death. Like a elective shoulder repair that ends up unexpectedly coding.
    I do send low SOI/ROM charts to are coding manager as well as our physician liaison as well.

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • I agree with Katy - every death will not be 4/4 and this does not necessarily mean there is an 'opportunity for improvement'. I would ask the consultant to provide a solid, rational reason, preferably citing statistics, supporting the statement all 'should be a 4/4'. This does not sound rational, IMO - similar to the other consultant stated a query rate 'should be 50%'

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.637.9002
    Fax:  415.600.1325
    Ofc:  415.600.3739
    evanspx@sutterhealth.org
  • edited May 2016
    Boy do I agree with every comment so far. Thanks.

    Donna

    Donna Kent, RN, BSN, CCDS
    Manager, Clinical Documentation Integrity Program
    Clinical Quality and Accreditation
    Torrance Memorial Medical Center
    ph.:310 784-6884  fax:310 784-6899
    donna.kent@tmmc.com
  • I sometimes encounter patients with Cancer - they may expire here. I find no acute organ dysfunctions noted or treated or reportable. The physicians tell me they expire with grace and dignity with Comfort Care Measures. These are sometimes a ROM of "2". I see very little opportunity to legitimately optimize them to a "3" ROM.

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.637.9002
    Fax:  415.600.1325
    Ofc:  415.600.3739
    evanspx@sutterhealth.org
  • edited May 2016
    Thank you.

    Donna Kent, RN, BSN, CCDS
    Manager, Clinical Documentation Integrity Program
    Clinical Quality and Accreditation
    Torrance Memorial Medical Center
    ph.:310 784-6884  fax:310 784-6899
    donna.kent@tmmc.com
  • Yes, same phenomenon here as well. It is now more difficult to obtain an ROM or SOI of 3 or 4 with version 30 of the 3M product when compared to version 29 of the 3M product. I did many direct comparisons entering identical scenarios in both versions, and fared 'worse' with version 30.0 when compared to version 29.0.



    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.637.9002
    Fax:  415.600.1325
    Ofc:  415.600.3739
    evanspx@sutterhealth.org
  • edited May 2016
    Wow-just out of curiosity, has 3M provided any feedback as to which version was accurate? We just recently started using 3M CDIS, and I am having a tough time with many of the reports.
    Thanks,
    Kerry
  • Kerry: Both versions were deemed accurate with an explanation that some of the logic had been changed. (See message below).

    ********************************************
    Dear Clients:

    The CPMS and DataVision web applications now use version 30 of the 3M All Patient Refined Diagnostic Related Groups (APR DRG). This version significantly changes the risk-of-mortality (ROM) and severity-of-illness (SOI) ICD-9-CM assignments, as well as the APR DRG routing logic.
    *****************************************
    We were told that this change in the grouper logic should not affect our published Observed/Expected mortality because the change affected all acute sites within our comparative data base of 600 sites. (Logically, this makes 'sense' in a statistical model. However, while I will not cite exact numbers via this forum due to privacy issues, I can state that our O/E ratio was better with the previous version (29.0).

    I have not found an efficient way to deal with the change. V 30.0 went into effect with Discharge on/after Oct 1 2013.


    Paul Evans, RHIA, CCS, CCS-P, CCDS
  • edited May 2016
    Thank you Paul for sharing this information.
  • edited May 2016
    The 30.0 is the most recent version and is automatically loaded on your
    3M system. You might check which version you currently have, but I
    found comparing last year's results to this year is like apples to
    oranges! Very frustrating!

    Linda Hayne
    lhaynes@lhs.org
  • edited May 2016
    Thanks, Paul. I appreciate hearing you are finding this change to be a challenge as well and appreciate the added information below.

    Linda Haynes
    Legacy Health
    Lhaynes@lhs.org
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