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Choose initial set of reports #739

Closed cecilia-donnelly closed 6 years ago

cecilia-donnelly commented 6 years ago

States need reports about screening.

psm-AD-1.3 The PSM shall provide reports that allow users to drill down from summarized data to detailed data. psm-AD-3.4 The PSM shall support simple queries and pre-formatted reports that are easy to access, follow a user-friendly protocol, and produce responses immediately. psm-AD-3.5 The PSM shall provide ad hoc reporting capability that presents summarized information on key factors to executive staff upon request. psm-FR-6.5 The PSM shall, to extent permitted by law, make screening data available for analytics and other reporting purposes.

These requirements don't tell us exactly which reports states will need. @chj124, @WyomingSarah, can you chime in on this?

A first list:

What are some others?

child of #762

WyomingSarah commented 6 years ago

Quickly brainstorming, I could come up with the list below (I'm sure there's more). It would also be nice to be able to dig down to the detail level in each reporting scenario, so not just the number, but exactly what specific provider is being reported on.

Hope that helps! Sarah

On Thu, Mar 29, 2018 at 11:02 AM, Cecilia Donnelly <notifications@github.com

wrote:

States need reports about screening.

psm-AD-1.3 The PSM shall provide reports that allow users to drill down from summarized data to detailed data. psm-AD-3.4 The PSM shall support simple queries and pre-formatted reports that are easy to access, follow a user-friendly protocol, and produce responses immediately. psm-AD-3.5 The PSM shall provide ad hoc reporting capability that presents summarized information on key factors to executive staff upon request. psm-FR-6.1 The PSM shall download all monitoring risk scores for each month as a CSV psm-FR-6.5 The PSM shall, to extent permitted by law, make screening data available for analytics and other reporting purposes.

These requirements don't tell us exactly which reports states will need. @chj124 https://github.com/chj124, @WyomingSarah https://github.com/WyomingSarah, can you chime in on this?

A first list:

  • Number of applications received by month
  • Percent of applications rejected/approved by month
  • Mean and median time from submission to review by month

What are some others?

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Sarah Hoffdahl

Sarah Hoffdahl Lead MMIS Special Project Business Analyst Division of Healthcare Financing Wyoming Department of Health

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cecilia-donnelly commented 6 years ago

@WyomingSarah this is a great list. Thank you for the quick response!

I'm going to split these into a few groups:

Could be done now:

  • Timestamped information regarding who/what specific user is approving/pending/denying applications...
  • Number of system documents uploaded (such as licenses) that were reviewed,
  • Number of applications that were started but not finished by a provider, remaining in pending status
  • Reporting based on provider types/taxonomies (how many dentists are enrolled) - able to break out provider types/taxonomies by say month (how many dentists enrolled in August of 2017)
  • Reporting based on CMS' provider risk levels (limited, moderate, high...)

Belong in a future phase:

We haven't set up an area for site visits in the PSM yet and won't be able to report on them until we do so. Similarly, we don't have full system logs yet for auditing, but we do know that they're necessary and have them in the roadmap. Providers can't yet renew/re-enroll, but we'll add this report when they can.

  • Site visits conducted, outcome
  • Site visits pending
  • Site visits out of state
  • Site visits in state
  • Really, we would want system timestamps and log of all system activity
  • be able to report on it. These system logs should be static (unable for anyone to have authorization to change them).
  • Reporting based on re-enrollments (such as how many - including drill down into detail of the actual provider name) per month (for example)

Need more explanation:

  • How many providers need to provide updated license information (current, upcoming)

How far in advance would you want to know that a provider needs to update their license? The extreme end would be to have a list of all providers, with the expiration date of their licenses (from soonest to farthest out), but probably there's a version that would be more useful to you.

  • Outcome assigned to reviewed system documents (approved, pending additional information, rejected)

I'm not sure what "system documents" means here. Can you expand?

  • Reporting based on Providers enrolled, facilities enrolled, Owners enrolled...

Can you be more specific about this? It's probably worth having a longer conversation about how you define "facilities," but what kind of information would you want to report about providers and owners?

  • You would also want to be able to report or search a provider based on demographic information.

So far we don't track demographic information outside of age. That is, we don't ask any questions about provider gender and race. Are those what you're thinking of? Does Wyoming ask providers those questions when they apply?

chj124 commented 6 years ago

That is a great list!!!

Is there a way to determine if an approved provider is eligible to be used as a Primary Care Provider?

If so, we would want to see a list of providers that can be assigned as a Primary. I would also expect this to be accessible via an api

WyomingSarah commented 6 years ago

I've included my responses in blue - thank-you!

Need more explanation:

  • How many providers need to provide updated license information (current, upcoming)

I believe that your system captures the effective dates for provider licenses. For this report, I was thinking that the system would be able to pull a report that shows what providers now who are in a pending or inactive status until they provide their updated license, and be able to look out for maybe 30 days and see what provider licenses are set to expire. It would be helpful to have in order to send out a reminder to upload the new license and update their profile so there is no lapse.

How far in advance would you want to know that a provider needs to update their license

maybe 30 days or making this flexible for the system user to decide how early they want to look out?

The extreme end would be to have a list of all providers, with the expiration date of their licenses (from soonest to farthest out), but probably there's a version that would be more useful to you.

That seems like it would suffice :)

  • Outcome assigned to reviewed system documents (approved, pending additional information, rejected) I'm not sure what "system documents" means here. Can you expand?

Sure, so if I reviewed an attachment, expecting to see a provider's license, and the provider incorrectly attached a PDF of a book they are writing, I could reject that document. Or, perhaps, the provider is licensed in Maine, and I want to verify it, so I could bump the attachment into a pending status until I fully verified the license with Maine, I could... I would want to run a report to check and see how many enrollments are tied up in pending status or denied based on the documentation status...Perhaps instead of pending the document you would want to pend the entire enrollment - that might be a call you make on your system. If that's the case, then that aspect would be moot.

  • Reporting based on Providers enrolled, facilities enrolled, Owners enrolled... Can you be more specific about this? It's probably worth having a longer conversation about how you define "facilities," but what kind of information would you want to report about providers and owners?

In my mind facilities include locations where a client could be considered to be inpatient, receive nursing or LTC care. I was thinking that as a provider was enrolling, there would be an indication, or field of some sort, that would capture this. This would be a basic report to see the breakdown of how many fall into each "bucket" with a possible drill down into the detail of who exactly that would be.

  • You would also want to be able to report or search a provider based on demographic information. So far we don't track demographic information outside of age. That is, we don't ask any questions about provider gender and race. Are those what you're thinking of? Does Wyoming ask providers those questions when they apply?

Perhaps I am using 'demographics' incorrectly. When I think demographics I think of name, social, birthday... I would think that it would be helpful for the system to be able to pull providers based on their SSN, Name, NPI... so I could identify if there were duplicates in the system and could correct it. WY considers the source system to be the system of truth, so any discrepancies should be mitigated as early as possible. Having reports that could identify possible mis-keys would be helpful to correct any duplication (so we don't have two providers who key their SSN as the same). Perhaps this is more of a search function of the providers in the system than a report...

I realize too that most enterprise solutions will probably have a data warehouse and be able to run reporting out of it that would satisfy a lot of reporting needs as long as all of the captured fields were shared with the DW. I hope my two cents have been helpful.

Have a nice weekend! Sarah

Sarah Hoffdahl

Sarah Hoffdahl Lead MMIS Special Project Business Analyst Division of Healthcare Financing Wyoming Department of Health

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E-Mail to and from me, in connection with the transaction of public business, is subject to the Wyoming Public Records Act and may be disclosed to third parties.

ETA: Edited by @cecilia-donnelly to more clearly differentiate Sarah's responses in the GitHub UI.

cecilia-donnelly commented 6 years ago

Hey @chj124, the PSM doesn't currently have a way to mark the fact that a provider could be a PCP. That seems more like a management function to me. If not, we should open a separate issue to track that.

cecilia-donnelly commented 6 years ago

Thanks to @WyomingSarah and @chj124, it looks like we have an initial list of reports, pending feedback from other states:

Ideas about other ways to represent this information are welcome. See also #753 for a more detailed report front-end discussion. All reports will also be available as CSV downloads.

I opened #754 for reports that we might add in a later phase. To your point, @WyomingSarah, I think the demographics report is more of a search function. I didn't include it in the first list in #754, but we can certainly add it if there are aspects that wouldn't fit into search.

WyomingSarah commented 6 years ago

Great! Happy I could be helpful!

Have a nice weekend, Sarah

On Wed, Apr 4, 2018 at 2:42 PM, Cecilia Donnelly notifications@github.com wrote:

Thanks to @WyomingSarah https://github.com/WyomingSarah and @chj124 https://github.com/chj124, it looks like we have an initial list of reports, pending feedback from other states:

  • Timestamped information regarding who/what specific user is approving/denying applications
    • List of reviewed applications (approved/rejected) with user that reviewed them
  • Number of applications that were started but not finished by a provider, remaining in draft status
    • Line graph showing count of applications remaining in draft status at the end of the month, with option to click in to see the exact applications
  • Reporting based on provider types/taxonomies (how many dentists are enrolled) - able to break out provider types/taxonomies by say month (how many dentists enrolled in August of 2017)
    • Line graph showing the number of approved applications from all or a selection of provider types over time. x axis is time by month, y is number of approved applications. Legend with different colors or line types for different provider types. Alternatively, offer a dropdown so that users can choose one provider type to display on the graph at a time. (This would include a "total" option so that users can see the full number of applications approved.)
  • Number of system documents uploaded (such as licenses) that were reviewed
    • Line graph showing the number of licenses uploaded as part of applications that were reviewed (either approved or rejected) over time, with the option to click through for details about the applications.
  • Reporting based on CMS' provider risk levels (limited, moderate, high...)
    • Line graph showing count of applications (submitted and/or approved) by risk level over time. That is, one line for limited, one for moderate, and one for high over time. Use a different line type for submitted than approved, if showing both. (OR)
    • Pie chart showing the percentage of currently approved providers in each risk level.

Ideas about other ways to represent this information are welcome. See also

753 https://github.com/SolutionGuidance/psm/issues/753 for a more

detailed report front-end discussion. All reports will also be available as CSV downloads.

I opened #754 https://github.com/SolutionGuidance/psm/issues/754 for reports that we might add in a later phase. To your point, @WyomingSarah https://github.com/WyomingSarah, I think the demographics report is more of a search function. I didn't include it in the first list in #754 https://github.com/SolutionGuidance/psm/issues/754, but we can certainly add it if there are aspects that wouldn't fit into search.

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Sarah Hoffdahl

Sarah Hoffdahl Lead MMIS Special Project Business Analyst Division of Healthcare Financing Wyoming Department of Health 307-777-29 <307-777-2911>11 <307-777-2959> sarah.hoffdahl@wyo.gov sarah.hoffdahl@wyo.gov

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psmbot commented 6 years ago

@jasonaowen suggests that "Reporting based on CMS' provider risk levels (limited, moderate, high...)" could be a stacked bar graph, to show proportion and total number. Similarly, the draft/submitted status could be represented in a bar graph (leaving it to Jason to add details about this in a followup comment).

jasonaowen commented 6 years ago
  • Number of applications that were started but not finished by a provider, remaining in draft status

If we do this, I think it would also be useful to have its inverse: the number of applications finished but not started by a provider [this month]. I was imagining a grouped bar chart that clustered the two together, going in opposite directions along the y-axis, so that if I started an application last month and finished it this month we'd have a chart like:

finished ^
         |         x
         +------------> date
         |   x
started  v
           March April

Not in ASCII-art form, of course. :)

  • Reporting based on provider types/taxonomies (how many dentists are enrolled) - able to break out provider types/taxonomies by say month (how many dentists enrolled in August of 2017)

This might be best represented as a set of sparklines, each with the same axes and scales, as we have several dozen different provider types. I worry that trying to put more than a handful on the same chart would lead to an unusably busy chart.

  • Reporting based on CMS' provider risk levels (limited, moderate, high...)

This could be a stacked bar graph or a stacked line graph, with date on one axis and quantity on the other. That'd show both how many of each risk level had been submitted or approved, as well as how many overall.

jasonaowen commented 6 years ago

Number of system documents uploaded (such as licenses) that were reviewed

Line graph showing the number of licenses uploaded as part of applications that were reviewed (either approved or rejected) over time, with the option to click through for details about the applications.

This one is not clear to me right now. We don't have individual document review in the PSM at the moment; if a document is incorrect, the application is either rejected and the provider submits a new application, or a reviewer gets the correct document out-of-band and modifies the enrollment to upload the correct document. Is this report still useful, given that model?

cecilia-donnelly commented 6 years ago

@jasonaowen after talking to @WyomingSarah on our call, we can think of the count of documents as a comparison: how many documents were uploaded vs. how many were reviewed. I expect the count of uploaded documents should only include those in submitted applications (not draft). This probably relates to the work you did around facility licenses, Jason, though I can't find a link right now.

Also, we should add one of the reports from https://github.com/SolutionGuidance/psm/issues/754#issuecomment-378738308 to the initial list, per feedback from Louisiana: Mean and median time from submission to review by month. Louisiana said this would help them understand the following elements:

For us, this is all represented by the same information: time between submission and approval/rejection.

psmbot commented 6 years ago

child of #762