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)