Data Validation
Data Submission
Your facility will typically submit data to Premier in monthly or quarterly increments. However, even if you choose to submit data to Premier quarterly, you can publish that data to QualityAdvisor by the month. For example, if you submit data for the first quarter of 2015 to Premier, and January’s data has met all the data validation requirements for Facility publish but February and March have not, you can choose to publish only January’s data to QualityAdvisor.
Data Publish Schedule
Premier processes scheduled data publish jobs for QualityAdvisor twice per week. In general, you can expect to see new data appear in QualityAdvisor four to seven days after you schedule it for Facility or Comparative publish.
Data Publish Frequency
Facilities decide when Facility Data is ready to be published and there is no restriction on the number of times Facility publish can be scheduled while waiting to complete the Comparative validation process.
Premier works with facilities to prepare their data for Comparative publish. This chapter provides an overview of that process. As facilities publish Comparative Data for a time period, they obtain access to the Peer database for that period. The Peer database is updated as facilities publish Comparative data.
QualityAdvisor Data Validation
The validation report also lists data that is missing or invalid for data publish to QualityAdvisor. As additions and corrections are made to your data, patient records reach a state of completion and validity that qualifies them for publish to QualityAdvisor. There are two levels of validation available for QualityAdvisor data:
- Facility Data validation prepares your data for use in QualityAdvisor Facility analyses only. This gives you the opportunity to analyze certain aspects of your data, such as Complications or Outcomes, while you are waiting for the more comprehensive Comparative validation process to be complete.
This process can take anywhere from five to ten business days from the date of submission, depending on how much time your facility requires to correct the data.
Note: Publishing Facility Data is optional. Your facility may decide to publish only Comparative Data. - Comparative Data validation continues beyond Facility Data validation and includes complete mapping of resources to standard code languages, financial reconciliation and clinical quality assurance by Premier staff. When your data reaches this level of validation, you can use it for resource and cost analyses, as well as accurate comparison to peer data.
This process can take approximately 45 business days from the date of submission due to the additional validations for Comparative Data, such as financial reconciliation and clinical quality assurance, which includes Standard Product List (SPL) mapping of resource data.
Facility and Comparative data validation can happen simultaneously, which means that the validation level of Facility Data can actually fall anywhere between the minimum Facility Data validation standards and the completed Comparative Data validation process.
Data Validation Process
While the data validation process is slightly different for former Quality Manager and ClinicalAdvisor facilities, it generally accomplishes the following tasks:
- Your facility’s data technician reviews the validation report. Each validation report includes data for a specified time frame, which is usually a month.
- Errors that keep a patient from being published to QualityAdvisor, such as missing or invalid data elements, are corrected.
- Warnings, which are missing or invalid data elements that do not keep a patient from being published, may be corrected.
-
When the validation process is complete, your data technician schedules the data to be published to QualityAdvisor for reporting.
Facility data validation catches data Errors that would impede patient risk adjustment. Correcting the Errors ensures that the data is suitable for Facility analyses. Facility data Warnings are generally escalated to Comparative data Errors. These must be corrected to ensure consistency throughout all customer data for Peer analyses. For example, a patient whose Admitting Practitioner is not mapped to a Practitioner Specialty would pass Facility Data validation with a Warning but fail Comparative Data validation as an Error.
Validating Facility Data
Facility Data is subject to many of the same validation rules as Comparative Data, but is generally available to publish sooner.
When a new month of Facility data is published to QualityAdvisor, the Facility analyses date range on the Facilities prompt is updated to include it.
Validating Comparative Data
Comparative Data validation is a continuation of Facility Data validation. The process requires that additional missing and invalid data elements be corrected by your data technician, and Premier also performs the following tasks.
- Maps all new Facility charge master codes to standard language codes.
- Reconciles financial data totals with facility-provided financial information.
- Checks data for clinical discrepancies, such as C-section charges for vaginal births.
All Premier facilities go through the same validation process for Comparative Publish, which enables accurate and consistent Peer reporting.
When a new month of Comparative data is published to QualityAdvisor, the Peer analyses date range on the Facilities prompt is updated to include it.
Financial Reconciliation
Premier works with your facility to reconcile submitted data with facility summary information before and after the validation process. The purpose of reconciliation is to detect excessive variances in patient counts, costs and charges between submitted data and facility summary information. While variance can sometimes be a normal reflection of resource consumption and patient discharge occurring in different periods, it can also indicate missing or invalid data.
Financial reconciliation occurs to .5% for cases, 2% for charges, and 2% for costs.
Clinical Quality Assurance
Clinical Quality Assurance occurs during Comparative Data validation to validate the accuracy of resource mapping. Premier generates an aggregated report of charges for patients grouped into various diagnoses for the specified time period (e.g., one month of data), then verifies that the charges are reasonable for the care the patient received. For example, there should not be a charge for hip hardware on a patient who received a knee replacement.
Data Validation Rules
There are a number of business rules that determine whether a patient record can be published to QualityAdvisor as Facility or Comparative data.
If a rule displays W (for Warning) in the Facility column, the patient record can be published as Facility Data without correcting that problem. We are simply letting you know there is a warning on this record that you should be aware of.
If a rule displays E (for Error) in either column, the data must be corrected before the patient record can be published as the indicated type of data, Facility or Comparative.
“Required” means that the data element must be submitted to Premier. “Valid” means that the data must meet one or more of the following criteria:
- Is in the correct data format; e.g. date or numeric.
- Is an allowable value; e.g., all submitted Practitioners must also be included in the Practitioner master table.
- Is mapped to a Premier standard value; e.g., all Facility-defined Practitioner Specialties must be mapped to Premier Standard Practitioner Specialties.
The following table is a sample listing of data validations for Facility and Comparative publish:
|
Category |
Message Description |
Facility |
Comparative |
|---|---|---|---|
|
Patient |
Date of Birth is required and must be valid; age must be valid |
E |
E |
|
Patient |
Birth weight cannot be less than zero |
E |
E |
|
Patient |
Race and Sex codes are required and must be valid |
E |
E |
|
Patient |
Medical Record Number, Marital Status, Smoker, Zip and State Codes are required and must be valid |
W |
E |
|
Patient |
Patient Type must be valid for the Patient Class |
W |
E |
|
Encounter |
Admission and Discharge Dates are required and must be valid |
E |
E |
|
Encounter |
Admission Type and Source of Admission are required and must be valid |
E |
E |
|
Encounter |
Present on Admission flag is required and must be valid. Procedure Date cannot be after Discharge Date |
E |
E |
|
Encounter |
Procedure Type code is required and must be valid |
E |
E |
|
Encounter |
Patient Class is required and must be valid (I/O) |
E |
E |
|
Encounter |
Discharge Status is required and must be valid |
E |
E |
|
Encounter |
Procedure Date is required and must be valid |
W |
E |
|
ICD |
Principal Diagnosis code is required and must be valid |
E |
E |
|
ICD |
Admitting Diagnosis code is required and must be valid |
W |
E |
|
Payer |
Payer Code and Class are required and must be valid |
E |
E |
|
Practitioner |
Practitioner codes may be required and must be valid |
W |
E |
|
Billing |
Billing Data is required and must be valid |
W |
E |
|
Cost |
Billing total charges and Discharge total charges must be greater than $0, equal, and have a variance less than the permitted % |
W |
E |
|
Cost |
Billing total cost and Discharge total cost must be equal and have a variance less than the permitted % |
W |
E |
|
Cost |
Ratio of Cost to Charge (RCC) data is required and must be valid (RCC Facilities only) |
W |
E |