Overview of Information Production Process Details

Reported in the NCQA's Baseline Assessment Tool:

 

         Flowcharts of all parts of the information production process, including the management information systems structure

         Measures of accuracy, completeness and timeliness of information, including audits and reports of deficiencies found, studies and analyses and causes for defects

         Whether practitioners and vendors were contractually obliged to deliver quality information; whether performance standards were in place, whether compensation is tied to submitting quality information, what incentives or penalties were in place for submitting quality information, what activities were undertaken to encourage quality information, and what actions were taken for underperformance

         What processes are being outsourced to vendors; vendor oversight, including oversight activities vendors are subject to, policies and processing standards, frequency of reviews and audits, deficiencies detected and how they were corrected

         Process improvements on both the administration and technical sides

         Whether health plans have had difficulty obtaining quality information from practitioners and vendors

         Systems being used; how data is obtained, entered and verified; how it is integrated and consolidated for reporting; forms used to capture information; use of automated software to verify information

         Any changes in systems used to process information including conversions of information to new systems, and how accuracy and completeness of the data was assured in the new systems

         Processes for producing measures, including production control, job logs, supervisory review, error detection and reruns

         Revisions made to source code to accommodate changes in technical specifications, data processing systems, and measurement processes.

         Processes for producing source code, including development, oversight, review, testing and version control

         Software packages, programming languages and application programs used to prepare measures, including prioducing samples, denominators and numerators

         The process for physical review of medical charts to validate care, including how many charts are reviewed and how they are obtained, and how medical record review is overseen, interrater reliability of review tools, accuracy standards for medical record review, timelines, flowcharts, tools, training materials and quality assurance documentation

         Security procedures, including disaster recovery, how often backups occur, how data access authorization is assigned, whether backups are onsite or off, and physical security such as fire protection and uninterruptible power supply

         Whether data loss occurred, and whether restoration from backups was necessary

         Procedures for monitoring and controlling electronic transmissions, including how the accuracy of electronic transmissions is verified

(Found at: http://www.ncqa.org/programs/HEDIS/2006/Volume5/BAT/main.htm)