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.
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
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.
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
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!!!
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
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%'
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.
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
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
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.
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!
Comments
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
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
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
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
Judi Bates RN, BSN, CCDS
CDI Specialist
856-757-3161
Beeper 66x2906
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
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
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
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
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
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
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
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
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
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
Thanks,
Kerry
********************************************
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
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
Linda Haynes
Legacy Health
Lhaynes@lhs.org