Information Bulletin, June 2008


Statement of Deficiencies (SOD) Issued to Eleven Health Care Facilities
New Home Page for SPARCS on the Health Commerce System (HCS), formerly called the Health Provider Network (HPN)
Progress of the Expanded Outpatient Data Collection (EODC) Project
Quality Evaluations of SPARCS Data
Performance Metrics available on the HCS
Reminder for Changes in July 2008

Statement of Deficiencies (SOD) Issued to Eleven Health Care Facilities

All health care facilities required to report data to SPARCS were expected to submit data in the new X12-837 format by July 31, 2007. All health care facilities that had not submitted data in the new X12-837 format by the end of December were issued an SOD by the New York State Department of Health, Division of Primary and Acute Care Services. Eleven health care facilities (hospitals and ambulatory surgery centers) received an SOD between January and March 2008. To date, there are three health care facilities that still have not reported SPARCS data in the new X12-837 format; these facilities are potential candidates for enforcement.

New Home Page for SPARCS on the Health Commerce System (HCS), formerly called the Health Provider Network (HPN)

Available on the password-protected Health Commerce System is a new SPARCS home page, https://commerce.health.state.ny.us/hpn/sparcs/sparcs.html. Located on the left side of the web page is a navigation bar guiding the user to important SPARCS topics and helpful submission tools. Health care facilities should review their contact information to confirm accuracy. This is done by selecting Contact Information on the navigation bar to arrive at the SPARCS - Contact web page. From this web page, there are links for reviewing and updating your contact information.

Progress of the Expanded Outpatient Data Collection (EODC) Project

The Expanded Outpatient Data Collection (EODC) project came into existence when a law was passed in April 2006 amending Article 28 Section 2816 (2) (a) (iv). The purpose of the legislation is to expand the collection of outpatient clinic visit data to include all hospitals and diagnostic and treatment centers in New York State certified under Article 28 of the Public Health Law. The data will be used to develop new methodologies of calculating the Upper Payment limit for Medicaid reimbursement as requested by the federal government. SPARCS is involved in the first phase of this project, establishing facility contacts and assisting facilities in obtaining accounts on the Health Commerce System, the Department's electronic information interface. The regulation that governs SPARCS data collection (10 NYCRR 400.18) is being modified to include provisions for this project.

Quality Evaluations of SPARCS Data

The New York State Department of Health is continuing its efforts to improve the quality of SPARCS data submissions. New data quality reports are available on the Health Commerce System for review by the SPARCS coordinator and quality assurance department for each facility. In addition, information can be requested on your facility's Acute Myocardial Infarction (AMI) reporting.

Data Quality Reports available on the HCS
SPARCS posted data quality analysis reports specific to your facility's Permanent Facility Identifier (PFI). Only designated SPARCS coordinators with active HCS accounts may view their facility's data quality reports. The purpose of these reports is to bring to your attention anomalies identified in the discharge data reported to SPARCS. There are four types of Quality Reports (see Table 1):

  1. Present on Admission (POA) Indicator by Payer (POA_DOH);
  2. POA Indicator Criteria for the Potentially Preventable Complications (PPC) Analysis. (Conducted by 3M Corporation) (POA_PPC_3M);
  3. Race and Ethnicity (Race_Ethnic) Analysis; and
  4. Physician License Numbers verification with the New York State Education Department license file (PhysLic).

Analysis of Acute Myocardial Infarction (AMI) Data Elements
SPARCS continues to analyze the accuracy of the clinical data elements pertaining to Acute Myocardial Infarction (AMI) reporting: heart rate, diastolic blood pressure and systolic blood pressure. A primary diagnoses of 410.0x - 410.9x for inpatient and emergency department visits requires the reporting of the new clinical data elements. During the phase in period of this edit (July 2007 to December 2007) AMI cases were accepted and a warning message was posted on the edit report. Upon request, SPARCS can provide facilities with the records that were missing the clinical data elements during this time period. Those AMI patient discharges/visits with primary diagnoses of 410.0x - 410.9x submitted after December 31, 2007 to SPARCS will be rejected if the clinical data elements; heart rate, diastolic blood pressure and systolic blood pressure, are not correctly reported. In the near future, SPARCS will be comparing the 2008 discharges for AMI to determine if a drop in reporting is occurring due to the addition of clinical data elements.

Table 1: SPARCS Data Quality Reports

Report Name Description Data Used and Update Cycle

POA_DOH_DESC
POA Indicator by Payer
(PDF 17 KB, 1 page)
Inpatient only: by 6 mo. period of Discharge year
(Quarterly update) (DOH)

POA_PPC_3M
POA Indicator Criteria
(PDF 17 KB, 1 page)
Inpatient only: by Discharge year
(Annual update) (3M Corp)
- PPC Descriptions
- PPC List 1
- PPC List 2
- PPC List 3
Race_Ethnic_IP_06
Race_Ethnic_IP_07
Inpatient Race and Ethnicity Analysis
(PDF 16 KB, 1 page)
Inpatient: by Discharge year
(Quarterly update) (DOH)
Race_Ethnic_AS_06
Race_Ethnic_AS_07
Outpatient: Ambulatory Surgery Race and Ethnicity Analysis
(PDF 16 KB, 1 page)
Ambulatory Surgery (AS) by Discharge year (Quarterly update) (DOH)
Race_Ethnic_ED_06
Race_Ethnic_ED_07
Emergency Department Race and Ethnicity Analysis
(PDF 16 KB, 1 page)
Outpatient: Emergency Department (ED) Discharge year
(Quarterly update) (DOH)
Spotlight SPARCS Spotlight Report
(PDF 26 KB, 5 pages)
Inpatient and Outpatient - Monthly, Bi-Annual, Yearly
(Yearly update) (DOH)
PhysLic_IP_06
PhysLic_IP_07
Inpatient Physician License verification with the NYSED Master License File (PDF 17 KB, 1 page) Inpatient Discharge year
(Monthly update) (DOH)
PhysLic_OP_06
PhysLic_OP_07
Outpatient Physician License verification with the NYSED Master License File (PDF 17 KB, 1 page) Outpatient: AS and ED
(Monthly update) (DOH)

Performance Metrics available on the HCS

SPARCS posted Performance Metrics (Table 2) reports specific to your facility's Permanent Facility Identifier (PFI). These reports are available to all individuals within your organization who have an active Health Commerce System (HCS) account. Each health care facility organization (hospitals and diagnostic and treatment centers) can view its own facility reports. These reports are designed to assist your facility with a variety of topics related to facility performance and analysis of health care provided to your patients. The Inpatient ICR/SPARCS Comparison Report compares specific Institutional Cost Report data to SPARCS discharge data. The Inpatient Quality Indicators reports apply the criteria specified by the Agency for Healthcare Research and Quality (AHRQ) under the U.S. Department of Health and Human Services.

Table 2: SPARCS Performance Metrics

Report Name Description
ICR05IP
ICR06IP

Inpatient ICR/SPARCS Comparison Report (PDF 17 KB, 1 page)
IQI_06 AHRQ Inpatient Quality Indicators 2006 (PDF 43 KB, 5 pages)

Reminder for Changes in July 2008

Two changes were announced in the November, 2007 Information Bulletin; these changes are required for submissions sent on and after July 1, 2008.

Required Expected Principal Reimbursement for Emergency Department Discharges:
Details are explained in the November 2007 Information Bulletin. The data element is reported in the 2300 Loop, NTE segment, position 1-2, the same for Inpatient and Ambulatory Surgery. The change for Principal Reimbursement for Emergency Department discharges is associated with the discharge year of 2008; thus any submission after July 1, 2008 that has a 2008 discharge year going forward, will require this change.

Procedure Time moved to NTE segment:
Details are explained in the November 2007 Information Bulletin. Procedure Time is now required in the 2300 Loop, NTE segment, position 17-19. The Procedure Time change is associated with any discharge year; thus, any record submitted after July 1, 2008 with any discharge year must have the procedure time in the correct position on the NTE segment.

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