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1 PointRight Data Integrity Audit (DIA) SelfGuided Tutorial

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Page 1: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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PointRightData Integrity Audit 

(DIA)

Self‐Guided Tutorial

Page 2: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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Tutorial Objectives

Table of Contents

• Data Integrity Audit (DIA) Report Overview

• Submit MDS Data to PointRight

• Review Real‐time Feedback

Page 3: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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Tutorial Objectives

After completing this tutorial, you will be able to:

• Identify the purpose of the Data Integrity Audit (DIA) Report

• Submit MDS Data to PointRight• Review and utilize DIA Real‐time Feedback

– This tutorial will take about 20 minutes to complete.

Page 4: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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Overview: What is DIA?

• The Data Integrity Audit (DIA) ensures accurate MDS coding and completion by:

• Real Time: Assessing the clinical and logical consistency of individual MDS assessments

• Summary Reports: Analyzing the facility’s MDS assessments to uncover systematic assessment errors, conflicting coding patterns, and biases

Page 5: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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Overview: Data Integrity Issues

• A data integrity issue is an alert to a combination of MDS item responses that is unlikely to occur in a resident– For example a resident coded as comatose would not also be coded for G0300: Balance During Transitions and Walking  

– Most issues are the result of subtle combinations ofMDS items

• A data integrity issue is not necessarily a data integrity problem!

Page 6: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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Overview: Data Integrity Issues (cont.)

• The DIA process provides an opportunity to identify MDS Data Integrity inconsistencies

• The Facility Interdisciplinary Team decides if a data integrity issue is a data integrity problem– Assessments with data integrity issues are not necessarily 

“wrong”

• If the MDS was correct, review the medical record to ensure that all “strange or unusual relationships” are explained

• In a large, valid MDS data set, about 10%‐20% of assessments will have data integrity issues

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Overview: DIA feedback

Real‐Time DIA feedback provides:

• Immediate feedback on your MDS assessment

• Assistance for eliminating potential errors in MDS data 

• Comparisons based on a collection of over 300 individual tests of logical and clinical consistency

• Feedback that is accessible 24 hours a day 7 daysa week

Page 8: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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Overview: DIA feedback (cont.) Use DIA feedback to:

• Minimize regulatory risk associated with inaccurate assessment and care planning

• Increase accurate representation in clinical outcomes and spend less time responding to false positives and negatives

• Focus interdisciplinary team on real outcomes identified with accurate assessment

• Improve effectiveness of current quality improvement programs

Page 9: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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Overview: DIA feedback (cont.)Use DIA feedback to:

• Improve MDS data quality and documentation to ensure accurate reimbursement 

• Increase RUG accuracy ‐ Accurate RUGs translate into accurate reimbursement

• Reduce likelihood of retrospective denials

• Spend less time and resources responding to outcomes of inaccurate assessment

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Data Integrity Audit (DIA)

Submit MDS Data to PointRight

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Submit MDS Data to PointRight

• View your DIA Real‐Time feedback by generating an MDS test batch file and sending it PointRight. 

• The following slides will guide you through the steps for managing and using DIA Real‐Time feedback:– Step One: Login to PointRight– Step Two: Send the MDS file electronically to PointRight

– Step Three: Manage the Real‐Time DIA Real‐Time feedback

– Step Four: Review feedback details

Page 12: PointRight Data Integrity Audit (DIA)...Overview: DIA feedback Real‐Time DIA feedback provides: • Immediate feedback on your MDS assessment • Assistance for eliminating potential

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Step One: Login to PointRight

                                          1.  Go to: 

www.pointright.com                                                     2.  Click Client Login

Note:   If your facility uses an MDS submission interface, you will submit directly from your MDS software and you will not need to follow these login steps.

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Step One: Login to PointRight (cont.)                                     3.  Click the MDS Submissions & Reports link                                                    

Note:   If your facility uses an MDS submission interface, you will submit directly from your MDS software and you will not need to follow these login steps.

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4.  Enter your Log In information

User Name Password

The password is case sensitive!

5. Click Log In.

Step One: Login to PointRight (cont.)

Note:   If your facility uses an MDS submission interface, you will submit directly from your MDS software and you will not need to follow these login steps.

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Step Two: Send the MDS file to PointRight

1.  Roll the mouse icon over the Products tab. The Products drop‐down menu appears.

2.  In the Products drop‐down menu, roll over File Submissionand click Submit MDS.  The Submit MDS & Review screen appears.

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Step Two: Send the MDS file to PointRight (cont.)

3.  Click the Browse button to select an MDS file to submit to PointRight.

Note:   If your facility uses an MDS submission interface, you will submit directly from your MDS software and you will not need to follow these submission steps.

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Your DIA Feedback appears automaticallyThe DIA Feedback list opens in the “expanded” view to display the resident name and MDS details. 

Click the Collapse Resident List link to view the MDS submissions as a list.  

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Step Three: Manage Real‐Time Feedback Use the Filter drop‐down feature to display all assessments in a submission including those with no DIA issues.

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Step Three: Manage Real‐Time Feedback (cont.)

View your Real‐Time DIA Feedback.

Tip: Click to Ask a Question.

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Step Four: Review Feedback DetailsThe DIA Feedback is divided into sections to make it easy to read.

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DIA Feedback Details

• Issue: Explains the Data Integrity issue that triggered•Why This Is an Issue: Explains why the issue was triggered.  • This is the rationale of the Data Integrity issue

• Resolving the Issue: Displays considerations to help you resolve the issue.  • Includes references to the MDS 3.0 Manual, current standards of practice in long term care, or survey implications.

• Clinical Considerations: Provides additional information as it relates to care planning and risk management.

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Step Four: Review Feedback Details (cont.)

If your facility uses DIA with Exception Reporting, you can choose from a selection of Planned Resolutions.

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Planned Resolution Options(for DIA With Exception Reporting)• Undecided: All Data integrity issues start as undecided.• Reviewed, No Action:  If you have reviewed the issue and decided 

not to change the MDS or select an explanation.  – The DIA issue will remain unresolved on your monthly DIA Summary 

report. • Change the MDS: If you plan to make a correction to the MDS.  You 

will need to go back into your MDS software to correct the MDS.  – Once you re‐submit the corrected MDS to PointRight, the issue will be 

resolved.• Provide Explanation: To select an explanation for why the MDS is 

coded accurately for that resident.  When you select an explanation, a Documentation Complete box will appear.  – The issue will remain unresolved until you check this box.  – After you have verified the documentation in the medical record, click 

Documentation Complete to resolve the issue.

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Step Four: Review Feedback DetailsIssue Status Table  (With Exception Reporting)

The Issue Status Table displays the number of DIA issues in each Planned Resolution category.

Select Submission date or ARD range.

Click to view DIA feedbackin each category.

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Step Four: Review Feedback DetailsIssue Status Table  (Non‐Exception Reporting)The Issue Status Table displays the number of DIA issues that are Unresolved and Resolved.

Select Submission date or ARD range.

Click to view DIA feedbackin each category.

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Tip for New Clients

PointRight will load historical MDS data when your facility begins services• Historical MDS submissions may appear on your Issue Status table.

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Tip for New Clients (cont.)

Change the Date Settings to ARD and shorten the Time Period to display only the new MDSs that you are currently submitting for real time analysis

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Print Your DIA Feedback1. Roll the mouse icon over the Print tab

2. Select Print Report from this Page

3. A printable version of the report will be generated in a new window.

4. Click the Print button in the report window to print.

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Print Your DIA Feedback (cont.) 

Tip: Select specific pages to print if you do not want to print the entire report.

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Tips for Success

• Submit small batches each day– Keeps the workflow manageable

• Take your DIA feedback to your morning stand‐up meetings– Makes IDT communication easier

• Always send your final production batch to PointRight as well as to CMS– Ensures that we receive all MDS corrections, andall Tracking Records

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Contact Us!

PointRight Inc.420 Bedford Street, Suite 210

Lexington, MA 02420www.PointRight.com

(781) 457‐5900 (phone)(781) 674‐2254 (fax)

To speak with Client Services select ‘Option 1’, then ‘Option 2’ ‐or‐

email: [email protected]