FINAL-DRAFT
11-12 February 2004 MMIG Meeting Minutes
Opening Remarks
Mr. Wesley opened by acknowledging and welcoming the change in staff and subject matter experts within the Services since the last MMIG meeting September 16, 2003. This was followed by a brief introduction of the new MMIG members.
Mr. Wesley provided comments regarding the 2004 Tricare Conference and the opportunity that was given to brief the audience from a MMIG perspective regarding the connection of MMIG activities and those across the MHS. He specifically mentioned the T-Nex Program’s Prospective Payment initiative and its inclusion of MEPRS data as the primary system for the budgeting and cost accounting information.
He stated that the comments were well received at the conference and the MMIG was congratulated on the great work being done and they were grateful to have visibility of MMIG activities through the web portal and other avenues.
Mr. Wesley presented the September 16, 2003 MMIG minutes which were approved as written.
Old Business
ADM EAS IV Extract Testing
Mr. Turner provided the status of the ADM EASIV Extract and Beta Test. The three beta sites (NH Great Lakes, Ft. Carson, and Keesler, AFB) have submitted the sign- off documents to EAS PO to indicate a successful completion of beta testing. EAS PO will be coordinating a wrap-up conference call with the Services to include lessons learned, Cost per CPT Report review, and review of the Repository updates for acceptance of new data elements coming from the EAS ADM file.
The Unfunded Requirement (UFR) for the $57K ADM Reconciliation Report is still pending and being coordinated through the CITPO office. Mr. Wesley requested that Ms. Linda Sauer, the Information Management (IM) representative follow-up on the UFR and provide the status.
Actions Item(s): 283
CHCS Task Order
Mr. Smith informed the MMIG that the CIO’s approved the WAM/HIPAA software deployment schedule. The distribution of the software enhancements will take place beginning February 6 - March 5 2004. He continued with an update of the WAM APV Module FST beginning February 12 - March 5, 2004.
The CITPO office will fund guest testers for the FST. The Services have submitted names of testers to TMA, who will continue the coordination with CITPO to complete the travel orders for the report date of February 18, 2004 at SAIC in La Jolla, CA.
The AF CIO approved Wright-Patterson AFB as the site for Alpha testing of the APV Module. The end-to-end testing of the APV Module is being coordinated with SAIC and EAS PO, with NH Portsmouth providing the database for testing. The APV project schedule is still within the period of performance ending March 30, 2004.
The Air Force requested clarity of SAIC's process for requesting a site to support Alpha in order to inform their leadership through the proper channels. The support staff will query SAIC and validate the process for requesting site approval for software testing.
Finally, Mr. Smith stated that SAIC was coordinating system changes with program managers working CHCS II to ensure there are no impacts related to sites which have implemented CHCS II functionality.
Action Item(s): 284
DMHRSi
Mr. Smith provided a brief update on the status of testing of the DMHRSi (LCA) module. He mentioned that RITPO had briefed the Human Resources Steering Committee on the schedule to return to Malcolm Grow for Phase III of the SQT on March 1, 2004. The Army is preparing to return to Winn Army Medical Center in mid-March. The testing with the TMCI testing group has been placed on hold by RITPO until the MMIG resolved the issue regarding identification of borrowed labor. A meeting was scheduled February, 12, 2004 for the Services to discuss resolution of this issue.
Mr. Scott Schuler provided a brief discussion on activities occurring during the Phase III SQT setup at Jacksonville. The site was working on completing the organization and tasks set-up within the module to support operational testing.
Mr. Smith stated he had included a listing of issues identified by the TMCI testing group related to the labor cost assignment functionality of DMHRSi in the MMIG binder, along with an updated DMHRSi Project Timeline.
Review of Open Issue Papers and SCRs
Mr. Jerry Baker provided background on the issue paper and SCR process. He noted three goals with respect to issue papers and SCRs: 1) eliminate the backlog, 2) manage the process more effectively, and 3) make the process more user friendly.
With respect to eliminating the backlog, he noted there had been a lot of activity in the last couple months, with six issue papers and SCRs being either approved or withdrawn. He stated TMA’s intent to continue to pursue this goal aggressively with discussion planned for today’s MMIG as well as the week of February 23, 2004.
Mr. Baker reviewed the correct process for submitting issue papers as currently described in the DoD 6010.13-M. This process has evolved to the following which is reflected in the current draft of the DoD 6010.13-M:
§ Issues papers are either initiated by Service MEPRS Coordinators or submitted by site personnel to Service MEPRS Coordinators.
§ Service MEPRS Coordinators submit the issues to TMA.
§ TMA assigns a tracking number and enters into a database for tracking and follow-up.
§ TMA assigns the issue to a member of the MEPRS Program Office contractor team who gathers additional information then coordinates with the Services’ MEPRS Coordinators and prepares the issue for presentation to the MMIG for approval.
Mr. Baker briefly discussed the potential for web-enabling the issue paper and SCR process as well as the potential for providing the capability of viewing the status of open issue papers and SCRs on the MEPRS portal (www.MEPRS.info).
Vaccine Healthcare Center # 041003
Ms. Bacon and COL Engler summarized the DOD VHC Network for the group. This is a congressionally directed initiative in which the Army was identified as the Executive Agent. Walter Reed Army Medical Center was identified as the initial start up site. Since the initial start-up, the network has expanded to Portsmouth, Ft. Bragg and Wilford Hall Medical Center.
The Army decided the host MTF would identify the appropriate clinical “B” outpatient codes to capture workload performed in the MTF clinic. Non-clinical personnel time in support of education and case management would be captured under FCC “FAZ”.
The Army is requesting standardization of the “F” FCC for non-patient care activities across the three Services. Overall goals are to develop educational information and case management related to vaccine safety and acceptability. COL Engler also explained the initial funding for this program was through the Center for Disease Control. However in 2002, CDC turned over the dollars to a DoD Appropriation with Army as lead agent. HA asked the Army to lead implementation of this program.
There was some confusion based on the recommendation within the issue paper to capture non-clinical workload. The Navy did not feel the issue paper provided enough information for staffing within the Service. The Army agreed to review and update the issue paper to include specific workflows for clarification of how to track funds, workload, and FTEs in MEPRS. COL Engler verified they are only looking to capture FTEs in the “F” account associated with the VHC Network in performing mission research, education and training. TMA agreed to arrange a follow-up meeting February 19, 2004 in order to finalize this issue.
Navy requested the issue paper be updated to reflect the information as briefed by COL Engler and Ms. Bacon to provide further clarification. COL Engler stated that she required MEPRS information for the Command review to show the breakdown of what was being done in the “F” code. MSgt Dorrian asked if there was a separate Program Element Code (PEC) for the VHC program. If so, the Services will have to add the PEC to their financial systems to support tracking this program across Services. The Army will verify if there is a separate PEC (AMSCO) for the VHC program.
Action Item(s): 285, 286
Family Practice Issue # 031013
Ms. Snoddy gave a brief summary on the consolidation of FCC codes for Family Practice Inpatient (FP IP). In the last meeting, the AF and Army did not concur with the Navy’s request for elimination of all FP IP codes except AGA. The Army briefed they continue to not concur with the consolidation of MEPRS codes for FP IP. Per Ms Bacon, the Army’s FP IP Specialty Advisor, COL Kugler is opposed to consolidation of FP IP codes due to the extensive data/cost analysis performed within the FP IP area. The Air Force also stated opposition to the consolidation of the FP IP codes and wants to keep the codes for FP/OB and Nursery.
MSgt Dorrian stated the AF is concerned about not having a sufficient amount of OB providers to cover staff shortages in regular OB. He also suggested submitting a CHCS change request to admit Newborn Nursery to AGAA as opposed to AGHA, if they did eventually decide to consolidate these codes.
Navy suggested other sources to pull clinical statistical reports, recommending use of the M2. Capt. Deneen suggested tracking the work by occupation code; however the issue was raised that the occupation codes in CHCS do not match the occupation codes in the personnel system.
Capt. Deneen provided a brief summary of data depicting the potential workload and costs being captured inaccurately in MEPRS for inpatient work centers. He requested the Services review this information with their respective FP consultants. In conclusion, Navy indicated there is not a mandate in the DoD 6010.13-M to use all of the FP IP (AG) MEPRS codes; the Services have flexibility to use the codes. The Services agreed to meet with their specialty advisors to allow them to discuss some of the data presented by Capt. Deneen and have a follow-up meeting in March 2004.
Action Item(s): 289
Surgical Research’s Burn Clinic Issue # 031008
Ms. Snoddy gave a brief overview of the Institute of Surgical Research’s Burn Clinic issue. This issue was submitted by the Army to establish a third-level FCC for Burn Clinic at Brooke Army Medical Center. DoD had previously approved an FCC to identify Inpatient Burn patients but not an FCC for the Outpatient Burn Clinic.
Army is requesting a permanent FCC “BBN” for capture of workload performed in the outpatient Burn Clinic. The Air Force and Navy concurred with the establishment of the code. The code will be for Army use only. The DoD 6010.13-M will reflect Army specifications. Navy requested review of the functional description prior to finalizing the update for the MEPRS Manual. The FCC approval is pending the review of the Burn Clinic description within the issue paper.
Action Item(s): 290
Updated Ambulatory Procedure Visits (APV)
Ms. Cunningham provided a summary of updates to the APV issue paper. This paper contains definitions for APV and APU which require approval by the Services. She discussed that in reviewing the definitions, clear guidance is needed on the period of time which allows for counting of workload as an APV. She stressed the need to ensure UBU coordination of these definitions.
Ms. Cunningham outlined some current deficiencies in identification and capture of the APV workload which is also limited based on the systems available to support capture of activities associated with the APV for cost determination. Navy is looking for an accurate accounting of how resources are used.
Mr. Smith reviewed the updated issues:
1) Item 7 addresses concerns with FCC’s DGA and DGE and a review of definitions for possible consolidation.
2) Item 8 addresses concerns with capture of minutes of service associated with surgical suite, anesthesia, and post anesthesia care provided. It was stated that TMA was able to update and include some requirements to enhance capture of MOS within the existing requirements capability during POM 06-11.
3) Item 9 will be brought up for further discussion within the MMIG. It was presented as a result of comments during development of the APV enhancements that providers would like to see their time spent in support of surgeries captured differently.
Ms. Cunningham stated there was no established listing of APV’s to assist the MTF’s in what should be captured. She stated she could forward a listing of what the Navy has developed for the Services to review.
Mr. Wesley stated the listings were not always clear due to differences in interpretations. For example, some procedures performed on older patients are considered APV due to the level of nursing support required.
TMA will summarize outstanding issues contained within the paper and setup follow-up meetings to discuss. The Navy agreed to update the definitions of APV and APU and provide to the MMIG for consideration as we work towards final approval of outstanding issues.
Action Item(s): 287, 288
SCRs 014003 and 014013
Mr. Baker facilitated a discussion of SCRs 014003 – Change EAS IV Archival Process, and 014013 – Modify Current Army EOR to SEEC Mapping Table.
SCR 014003
Mr. Baker noted that there are (at least) two important questions to be answered with respect to archiving:
1. What is the basis for retaining current plus two previous years of financial records in EAS IV?
2. Is it worth the effort to change the number of years of financial records that are accessible in EAS IV in order that all three Services are processing uniformly?