Information Bulletin, October 1996


Data Quality Issues
Documentation Updates
SPARCS Update Process
SPARCS Submission History Report
National Issues of Note

Data Quality Issues

We recognize and appreciate the tremendous efforts that have been made in the past to report complete and accurate data to SPARCS. We remain confident that ongoing efforts by New York State hospitals and clinics will continue to improve the quality of SPARCS data to better serve the health care industry in our state.

With the signing of the New York Health Care Reform Act of 1996 (NYHCRA), effective January 1,1997, we firmly believe that more than ever it is important to confront SPARCS data quality issues. Under this new legislation requiring negotiated rates for an increasing number of services, we see a greater need for complete and accurate SPARCS data as a tool for New York State hospitals and clinics to assist in rate negotiations, quality assessment, and market analysis for their facility.

Within the next month, facilities around the state will receive a letter from SPARCS detailing reporting problems with the Payer Identification data element. In the NYHCRA environment this is a critical data element which needs to be reported accurately so that facilities and the Department will be able to analyze the types of services provided by each payer.

Among other data anomalies we are investigating, we see an apparent inconsistency in the reporting of the Other Diagnosis Emergent Indicator. Some facilities appear to be hard coding entries that pass SPARCS edits but do not reflect the actual situation.

We will continue to report data anomalies in the Bulletin.

Documentation Updates

By the end of this month a complete replacement of the SPARCS Documentation will be distributed on diskette. The source documents for this mailing are created in WordPerfect 5.2. Any facility wishing to have a hard copy sent may request one from the SPARCS administrative staff. The updated Universal Data Set for Institutional Providers (UDS/IP) Specifications are also included in this mailing. The SPARCS changes for 1997 were also distributed statewide in a mailing dated July 17, 1996. The summary document enclosed with the documentation diskette again highlights the 1997 changes to the SPARCS system.

SPARCS Update Process

As announced in our August 1996 Bulletin we are implementing a new update process for our inpatient and outpatient master files this fall. The effective date will be November 1, 1996, which is sooner than previously announced. This new process was designed to make our current tape-based system appear to be more like a real-time transaction system. Based on feedback and extensive testing, this new system will make it easier and more logical for facilities to maintain their SPARCS data. Corrections and/or deletions to the SPARCS data base can now be submitted as dictated by hospital processing needs rather than being contingent on the SPARCS update schedule.

SPARCS Submission History Report

We get many inquires from data submitters wanting to know; "Where do I stand?" or "Where did all of my submitted data go?" To answer these questions a new report has been created that lists key data for each record submitted and indicates the history, that is whether it failed the edits, passed the edits yet is not on the cumulative master file, or passed the edits and resides on the master file. This report can be generated for inpatient or outpatient data for a given PFI and discharge year. Optionally, a range of discharge months can be specified.

National Issues of Note

Recently President Clinton signed into law the Health Insurance Portability and Accountability Act of 1996. A subsection of this law mandates administrative simplification. Under this subsection, the Secretary of Health and Human Services is required to select data standards for a variety of health care transactions, including the health claim. It is expected that ANSI (American National Standards Institute) ASC (Accredited Standards Committee) X12N (Insurance Subcommittee) standards will be chosen. If that is the case, efforts made in New York State over the past 2 years to convert to the national UB-92 billing form using the UDS electronic format will put NYS in an excellent strategic position.

In anticipation of the events that will occur over the next 2 to 3 years, an EDI Migration Survey was distributed to all hospitals in the state. We encourage all facilities to allocate the time to complete this survey. It is important for us to identify any obstacles that currently exist for ANSI ASC X12 EDI compliant transactions to be implemented. Once any impediments are identified, a coordinated and cooperative statewide strategy can be established.

The surveys were sent to hospital CEO's in cooperation with the Greater New York Hospital Association and the Healthcare Association of New York State. The response to date has been excellent. If you have any questions or need additional copies of the survey, please contact the SPARCS administrative staff.