Medical Management Guide, 2009, Version 3.0 - Tricare

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Page 136Medical Management Tools Version 3.0Medical Management GuideSummary of Data Systems for Use in Medical ManagementData SourceUtilizationManagementCase ManagementDiseaseManagementPopulation HealthDMSSM2MCFASCDMMEWACSMHS PortalPDTSSADRSIDRTMA Purchased CareTMA-RTTOCService Sources:AFP2R2Army PASBAFig. 37 – Summary of Data Systems for Use in MMMHS Data RepositoryTRICARE Management Activity Reporting ToolsTMA Reporting Tools (TMA-RT) comprise thefollowing seven applications:1. Military Health System Management Analysis andReporting Tool: http://www.mhs-helpdesk.com/Pages/m2.aspThe Military Health System Management Analysisand Reporting Tool (M2) is used to obtain summaryand detailed views of population, clinical, andfinancial data from all MHS regions. Access isgranted at six levels of report from Level 1 (MTFleveldata) through Level 6 (personally identifiableinformation).Fig. 38 –MHS Data Repository
Medical Management GuideVersion 3.0Medical Management ToolsPage 137M2 includes MTF and commercial network claimsdata integrated with eligibility and enrollment data.It allows users to perform trend analyses, conductpatient and provider profiling studies, and conductbusiness case analyses to maximize health planefficiency. Many corporate measures are derivedfrom M2.Comprehensive data sets are compiled from varioussources including, but not limited to:• MTF data sets.• Expense Assignment System, Version 4 (EAS IV).• Standard Ambulatory Data Record (SADR).• Standard Inpatient Data Record (SIDR).• World Wide Workload Reports (WWRs).• External data sets.• Health Care Service Record (HCSR) — Networkinstitutional and professional services claims.The name HCSR has been changed to“TRICARE Encounter Data” (TED); however,any claims submitted prior to contract changesremain an HCSR record.• Pharmacy Detail Transaction Service (PDTS)— A centralized data repository that allows theDoD to build a common patient medicationprofile for all DoD beneficiaries, regardlessof the point of service they use (excludingStandard TRICARE).• National Mail Order Pharmacy (NMOP).• Patient (i.e., beneficiary) demographic data.• DEERS eligibility data.• TRICARE enrollment data.• TRICARE longitudinal enrollment data.• TRICARE Mail Order Policy (TMOP).2. Defense Medical Surveillance System: *Restrictedaccess3. Defense Medical Epidemiology Database:http://afhsc.army.mil/The Defense Medical Surveillance System (DMSS)and Defense Medical Epidemiology Database(DMED) are operated by the Armed Forces HealthSurveillance System (AFHSC).As the DoD’s premier epidemiologic resource, DMSSprovides the MHS with a longitudinal record of upto-datehistorical data related to:• Medical events (e.g., hospitalizations,ambulatory visits, immunizations, reportablemedical events, health risk appraisals,deployment health assessments).• Individual/demographic characteristics.• Military experiences (assignments, deployments,casualty information) spanning a Servicemember’s entire career.The DMSS is an excellent source for processing Tri-Service epidemiologic queries on disease burdensand injury rates, and can be used to demonstrateService trends and potential for disease/conditionmanagement initiatives. Features include the abilityto create results in tabular, line graph, or bar graphformats. DMSS also has the ability to save, export,and print query results.The DMED application enables Web-based, userdefinablequeries of de-identified DMSS datasubsets. Its user-friendly interface provides data onpopulation statistics, disease summaries, detailedqueries, and Top 10 diagnoses for Active Dutypopulations. Data can be obtained for inpatient
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Medical Management Guide, 2009, Version 3.0 - Tricare

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