Online pre-course session.

1. Medical Executive Data Overview
Dr. Raymond “Tres” Crawford
Assistant Professor, Health Services
Administration
Uniformed Services University of the
Health Sciences
rcrawford@usuhs.mil

2. Objectives
• Introduce common measures of workload used in the Military
Healthcare System (MHS)
• To identify MHS systems where data is available to allow for
data driven decisions
• Introduce MHS productivity and production related terms and
measures

3. Workload Measures
Raw Workload Measures
Weighted Workload Measures

4. Simple Raw Workload Measures
• Admission – acceptance of a patient by a facility as an inpatient
for treatment
• Disposition – the removal of a patient from a hospital's census
by reason of discharge, transfer, death, or other termination of
inpatient care
• Encounter – serves as a focal point linking clinical,
administrative and financial information. Encounters occur in
many different settings – ambulatory care, inpatient care,
emergency-care, home health care, field and virtual
(telemedicine)

5. Calculated Raw Workload Measures
• Occupied Bed Day – a day in which a patient occupies a bed at
the census-taking hour (usually midnight). Under certain
circumstances, an OBD is also credited when a patient is
admitted and discharged on the same day– e.g. same day
surgery
• Average Daily Patient Load – the average number of inpatients
over a defined period of time
• Length of Stay – refers to the number of days that comprise an
inpatient's hospital stay

6. Case Mix Measures
• Case Mix Complexity – with respect to workload measurement,
the resource intensity of treating a particular group of patients
• Major Diagnostic Category (MDC) – a broad classification of
diagnoses and procedures typically grouped by body system
or etiology
• Diagnosis Related Groups (DRG) – an inpatient
classification system that relates demographic, diagnostic
and therapeutic characteristics of patients to LOS and
amount of resources consumed
• Case Mix Index – the average relative weighted product (RWP)
per disposition

7. Weighted Workload Measures
• Relative Weighted Product (RWP)
• a measure of workload credit derived from biometrics
dispositions weighted by DRG weights
• the number of RWPs is a measure of the relative resource
consumption of a patient’s hospitalization as compared to
that of other patients
• RWP calculation example
• Relative Value Units (RVU)
• a weight assigned to an encounter based on CPT coding

8. Direct Care Outpatient
Workload Documentation
SADR
Standard Ambulatory Data Record
Documentation of an encounter
Detailed information on direct care outpatient workload
Coding needing to show workload
RVU
Relative Value Unit
Similar to CMS RVUs—some differences do exist though
Based on CPT codes from SADR encounters
Used in MHS performance metrics
Used in Prospective Payments System

9. Direct Care Inpatient
Workload Documentation
SIDR
Standard Inpatient Data Record
Documentation of an inpatient episode of care
Detailed information on direct care inpatient workload
Coding needing to show workload
RWP
Relative Weighted Product
Based on DRG rates from SIDR
Used in MHS performance metrics (including PMPM calculations)
Used in Prospective Payments System

10. Where Can You Get Data?
MDR
Raw Data
Difficult to Access
M2
EAS
Processed Data
Analyst Needed
TOC
PEPR
Tri-Service Business Planning Tool
Population Health Portal
Web-based
Balanced Scorecard
DHP or Service Metrics
Provided
Data Driven Decisions

11. MDR
MHS Data Repository
What
MDR
Why
Location of MHS Data Files
Other data sets are often a reflection of the MDR
Legal and financial mechanisms track to the MDR
Extremely limited direct access

12. Data Flow to the M2
Source
“MDR” Big
MDR
File
M2
File

13. M2
MHS Mart
A snapshot/subset of the MDR
What
M2
Why
One-stop shop for many used/needed data elements
Allows MTFs to look beyond the “four walls”
Learn about your MTF, other MTFs, and network
M2 analyst required

14. M2
Direct Care Purchased
Data U Care = M2
Eligibility Non-Institutional MHS Mart:
A very powerful ad-hoc business
Enrollment Institutional objects based query tool for
trained analysts.
Outpatient MCSC Pharmacy
Inpatient TMOP
Pharmacy Enrollee Network Care
EAS MCFAS
WWR ETC
ETC

15. EAS
Expense Assignment System
What
EAS
Why
MEPRS data
FTE data (including skill types)
EAS data is also in the M2

16. Other Tools
If you do not have an M2 analyst
TOC Tri-Service Business Population
Planning Tool Health
Web-based

17. Sample Metrics
• RVUs per provider FTE per day
• Total number of RVUs
• Total number of RWPs
• Enrollee medical cost per member per month