MMIG
29 Mar 06 Minutes
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ATTENDEES
Attendance noted via telephone
Ms. Mona Bacon, Army MEPRS POC*
Ms. Jane Cunningham, Navy MEPRS POC*
Mr. Darryl Dorrian, AF MEPRS POC
Ms. Burma Barfield, Army support*
Ms. Nicole Meyers, Navy contract support*
Mr. John Babicki , AF MEPRS SME
TSgt Jody Callender, AF Consultant
Mr. Eric Meadows, TMA-OCFO (PSGS)
Mr. Randy Van Nostrand, TMA-MEPRS (PSGS)
Ms. Linda Hancock, TMA MEPRS (PSGS)
Ms. Dee Baker, TMA-MEPRS (SRA)*
Ms. Debbie Kochubka, TMA MEPRS (SRA)
Ms. Rachel Snoddy, TMA-MEPRS (PSGS)
HANDOUTS –
 Meeting Agenda
 External Workload Methodology Proposed by Army
 Appendix 7- v12_29 MAR 06 Matrix Comparison Data Quality Statement General Observations
 Examples of NonClinical Duties
 Copy of DMIS ID FIELD_DESCR_W_CHCS_DMIS_vs28Mar06
 Issue Papers
o Priority A Issues
o SCR_MAR_AI
o SCR_ISSUE PAPER Minutes for 03_07_06
DISCUSSION (Commenced at 09:00)
External Resource Sharing
 DMIS ID Data Elements – Mr. Meadows opened the discussion by referencing the
document titled, Copy of DMIS ID Field_DESCR_W_CHCS_DMIS_vs28Mar06. He
explained this is in response to a task to identify the minimum required data elements needed
to support requesting a Child DMIS ID in the DMIS ID Model for Capturing External
Resources Sharing. Points made during the discussion are as follows:
o The document was created by Ms. Cindy Vance (SAIC) and identifies the DMIS ID data
elements, CHCS Field Purpose, and whether the data element is required in the CHCS
Data Dictionary and needed for CHCS Workload Assignment Module (WAM).
o Mr. Meadows appended the document with a TMA Recommendation, and whether the
data element is required by the Navy, Army and AF. He also compared this document
with the Tri-Service DMIS ID Request Guide, and the most recent DMIS ID Data
Dictionary. In addition, he already captured draft Navy input. The areas colored in
yellow are the data elements that need further clarification and research:
 Facility City Name, Facility Command Code, Facility Name (made a
recommendation for standardizing the names), Facility State Code, Installation
Name (need UBU determination on who owns the medical record), MEPRS Unit
ID, Service Area Code (need to verify with TMA POCs) and US Flag Code.
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Ms. Hancock questioned whether additional fields can be added to the DMIS ID Data
Dictionary as she thought a combination of data elements could better denote the Facility
Name. Mr. Meadows asked the MMIG members to review the document and
recommended minimum mandatory fields and submit their input to TMA for final
resolution.
Army Update on Reporting External Workload with Alternate Proposal On Capturing
and Reporting External Workload Performed at Civilian or VA Medical Facility – Mr.
Meadows referenced the document and explained that the Army tested the DMIS ID “A***
SADR” approach at Eisenhower Medical Center, Ft Gordon GA, received feedback from the
site personnel on the approach and recommended alternatives from the Army.
o At Eisenhower Medical Center the Army identified problems with: 1) creating inpatient
ward locations and inpatient “A***” MEPRS FCCs to generate admissions which will
allow the capture of the A**SADR, 2) issues with bogus admissions, occupied bed days,
and dispositions, which will be reported in CHCSI/AHLTA, EASIV, WWR, and the M2,
3) issues with the creation of a medical inpatient record which generates RWPs for the
entire professional and institutional care and 4) issues with reporting RWP values in the
M2 for PPS when the patient was not admitted to the MTF.
o Other issues identified involved the requirement to track Active Duty soldiers admitted to
an external facility and the current PASBA methodology to use YYY* codes which
doesn’t distort professional an institutional reported workload and you can’t use the
DMIS ID A*** SADR methodology for these patients. They also identified issues with
their outpatient MTFs not having enough support staff (inpatient specialized coders) to
support the additional coding requirement.
o They recommended still utilizing the DMIS ID approach, but capturing the professional
component in a “B***” MEPRS FCC account, which would be done manually as a
“Walk-In” and generate a SADR. They noted however, that this would generate a
“count” visit for “ward rounds” that are considered “non-count”.
o Their other alternative was to use a MEPRS F*** FCC to capture the ward round and
provider man hours for the external workload.
o The Navy does not support capturing of external resource sharing ward rounds in the
“B***” MEPRS FCC account and stated that the Army paper lacked specific guidance on
capturing inpatient workload performed external to the MTF. They want guidance from
the UBU on what data elements will be necessary for capturing institutional and
professional workload in the future. They also want the process to be automated as
opposed to manual capture.
o As stated in the paper, the Army does not support the “A*** SADR MEPRS FCC capture
of inpatient professional services from external resource sharing facilities. They do
support the use of the DMIS ID approach, but with a B*** or F*** MEPRS FCC.
o The Air Force agrees with the Army and does not want to capture bogus inpatient
admissions, RWPs and SIDRs in order to capture the professional component of an
external resource sharing ward round.
o The Navy discussed a long-term solution of creating a new “H***” MEPRS FCC which
had previously been discussed with the Army PASBA personnel. All three Services
agreed to continue discussion and research on the concept and methodology for using the
new MEPRS FCC to capture all external resources sharing FTEs and workload via this
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concept. Mr. Meadows requested a write-up from the Services on the “H***” MEPRS
FCC concept.
The Air Force recommended the three Services meet to review the three approaches, and
decide on the agreed upon methodology, data requirements and process flow for
capturing workload for external resources sharing.
o
Issue Papers
Priority
031002
A
Change Assigned FTE to
Endstrength
Concurs to addition of
new data element.
Concurs to addition of new
data element.
051008
A
ED**
Originated
Concurs tentatively subject
to advice from SMEs.
Concurs tentatively
subject to advice from
SMEs.
051009
A
Nutrition Accounts
Originated. Army will
resubmit paper,
separating two issues.
Concurs tentatively subject
to advice from SMEs.
Concurs tentatively
subject to advice from
SMEs.
061002
A
Centrally Funded
Contracts
Take offline
Take offline
Take offline
061206
A
Depreciation
Originated
Concurs to Time period
change.
Withdraws concurrence.
Requests all depreciation
issues be addressed.
060125
A
Comp Time Earned
Originated
Concurs with Army
recommendation #2.
Concurs with Army
recommendation #2.
060316
N
RVU Credit for
IDC/IDMT
Non-concur.
Concurs with Navy
requirement, but notes AF
does not have the same
requirement.
051006
A
Virtual Colonoscopy
Reviewing Paper
Reviewing Paper
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Short Title
Army
Responses
Air Force
Number
Navy
Originated. Will revise to
reflect addition of new
data element rather than
removal of Assigned FTE.
Originated 07/12/2005.
Navy will distribute copy
dated 11/3/2005.
Issue 031002 “Change Assigned FTE to Endstrength”
o Discussion: All services agreed that endstrength definition is basically the same, the end of
month availability.
o Army and Air Force concur to the addition of a new data element for endstrength rather than
changing Assigned FTE to endstrength. Navy agreed to revise the issue paper to add a new
data element.
o Action Item Mar06_01: Navy will revise the issue paper to address addition of a new data
element for endstrength rather than changing Assigned FTE to endstrength. Open.
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Issue 051008 “Service Requesting Change to Titles, Descriptions, and Allocation Performance
Factor of ED** FCC/MEPRS Codes…”
o Discussion: Air Force and Navy concur tentatively subject to consultation with subject matter
experts to verify change will create little to no impact on current processes. This issue
involves changing the unit of analysis from hours of service to square footage in keeping
with civilian practice. Air Force thought this issue involved realignment of plant services
which is a different matter.
o Action Item Mar06_02 (Replaces Action Item Oct05_01): Air Force and Navy will confer
with SMES. Open.
Issue 051009 “Inconsistent Guidance and Reporting for Nutrition Accounts”
o Discussion: Discovered there are two issues at work here. First, Army proposes deactivation
of FCC EIC*. Second, Army proposes FCCs EIA* and EIB* remain unchanged.
o Air Force and Navy tentatively concur to the deactivation of EIC*. Army agreed to simplify
issue paper and resubmit.
o Action Item Mar06_08: Army will resubmit simplified issue paper. Open.
Issue 061206 “Depreciation”
o Discussion: At last Issue Paper meeting, all services agreed to the concept of changing the
reporting timeframe from 8 to 5 years but instructed to read the issue paper to make sure they
concur to what was written in the document. Army is already at 5 years which is in line with
their Chief Financial Officer’s financial statement and with the Defense Medical Logistics
Standard Support (DMLSS) program.
o Navy withdraws concurrence because there are many depreciation issues (e.g., thresholds)
and does not want to approach management with one issue at a time. Also, Navy notes that
the question of why we are collecting depreciation in the first place has not been addressed.
Navy agrees to investigate the impact of changing from 8 to 5 years will have on the system.
o Action Item Mar06_05: TMA will provide Services related Depreciation issue paper(s).
Open.
Issue 060125 “Comp Time Earned”
o Discussion: Navy and Air Force concur with Army recommendation #2 which states “EASIV
should accept the hours without having to add costs in EASIV.” Navy will send concurrences
to TMA via email.
o Action Item Mar06_09: Navy will send it’s and Air Force concurrences to TMA via email.
Closed.
Issue 060316 “RVU Credit for IDC/IDMT”
o Discussion: In branch clinics (remote areas), Independent Duty Corpsmen (IDC) operate as
providers (like Physician Assistants). They are billeted to the MTF. IDCs are certified to
provide care but not credentialed. Major difference between similar role in Army vs. Navy, in
the Army patients are enrolled to the MTF not to the Battalion Aid Station (BAS) while in
the Navy patients are enrolled to the ship not to the MTF.
o Air Force concurs with the Navy requirement but does not share issue. Army is researching
issue.
o Action Item Mar06_10: Army will respond to after reviewing the issue paper. Open
04/06/2006.
Issue 051006 “Virtual Colonoscopy”
o Discussion: Navy has already acquired interim approval to proceed. According to the Issue
Paper Database, the 07/12/2005 issue paper was to be updated taking into consideration
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comments from Mr. Wesley. Navy did have a paper dated 11/03/2005 which did not appear
to be forwarded to TMA.
o Navy will forward updated issue paper to TMA and asks Services to review with a focus on
the process.
o Action Item Mar06_11: Navy will forward 11/03/2005 issue paper to group. Open.
o Action Item Mar06_12: Upon receipt of updated paper, Services will review focusing on the
process.
Appendix 7 of MEPRS Manual
 Ms. Meyers provided a copy of the Appendix 7 matrix that the Army and Navy had jointly
coordinated. Mr. Van Nostrand reviewed those business rules that had changed since the last
version to ensure that The Air Force was aware of changes, as well as to provide an opportunity
for the Services to further discuss the issues.
 The three Services agreed to all business rules in the document with the exception of business
rule 3A. Some Discussion included:
o Rules 2B, 2C, and 2D require description modifications to better fit the table structure. This
will be accomplished by TMA.
o Rule 6A #4 (civilian AWOL) was agreed to be moved to rule 20. Ms. Cunningham agreed to
this modification with the understanding that military members do not return to the work
center when determined to be in an AWOL status, while civilians can return to the work
center. TMA will make this adjustment.
o Rule 12 description was changed to "Conducting or attending Peacetime Disaster
Preparedness or Response, including training.". The Services agreed that account EBG
should be deleted. They further agreed that GGB should be deleted. All activity for these
accounts should be included in account GGA*.
o Rule 15 was expanded to allow the capture of civilian students in the GME/GDE accounts.
Army proposed that this be captured in FAMM. Navy and Air Force concur, although Navy
also indicated that their Service does not have civilian students in these two programs.
o The Services agreed to business rule 16. They also indicated that two additional skill type
suffixes should be created to identify these types of students. The Army will develop an
issue paper to recommend these additions, which will be vetted through the Table Update
process.
 The Services could not agree on Business Rule 3A. Each of the Services had different opinions
as to how administrative time should be treated, whether it should be included in the benefiting
FCC, or placed in EBC*. The Services agreed to create lists to better define what they believed
should be included within the benefiting FCC versus the overhead account, as well as define
what activities should be considered clinical versus non-clinical. Ms. Meyers provided a Navy
list to the Services during the meeting to help facilitate this task.
Other Issues
 The Services expressed concerns about the number of EAS IV versions that had been released
this Fiscal Year due to errors. This issue has burdened the MTFs in completing their MEPRS
products. The Services would like an explanation as to why this issue has occurred. TMA will
coordinate with EAS PO on response.
 The Services indicated that the number of releases available for table updates is insufficient to
meet operational requirements. The Services wanted to know what the actual contractual
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requirements are for Fiscal Year version releases. TMA will coordinate with EAS PO on
response.
The Services requested a list of all new system change requests that will be included in EASi.
TMA will coordinate with EAS PO on response.
Conclusion
 The group approved the 19-20 October 2005 MMIG minutes. These minutes were distributed to the
MMIG a final time on 2/24/2006.
 Mr. Wesley was not available to participate in this MMIG session. He will review issues and provide
feedback as warranted.
 The meeting was adjourned at 1600.
ACTION ITEMS
 UBU: Need determination on who owns the medical record (MTF or VA/Civilian Hospital)
 Services: Review DMIS ID Description Document and provide TMA their recommended
minimum mandatory fields.
 UBU: Guidance on what data elements will be necessary for capturing institutional and
professional workload in the future.
 Services: TMA requests a write-up on the “H***” MEPRS FCC concept.
 Services: The Air Force recommended the three Services meet to review the three
approaches, and decide on the agreed upon methodology, data requirements and process flow
for capturing workload for external resources sharing.
 Navy: Navy will revise the issue paper (031002) to address addition of a new data element for
endstrength rather than changing Assigned FTE to endstrength.
 Navy/AF: Air Force and Navy will confer with SMES regarding issue paper 051008.
 Army: Army will resubmit simplified issue paper 051009.
 Navy: Navy agrees to investigate the impact of changing from 8 to 5 years will have on the
system (Issue Paper 061206).
 TMA: TMA will provide Services related Depreciation issue paper(s) (Issue Paper 061206).
 Navy/AF: Services will send their concurrences to TMA via email (Issue Paper 060125).
 Army: Army will respond to after reviewing the issue paper (060316).
 Navy: Navy will forward 11/03/2005 issue paper (051006) to group.
 AF/Army: Upon receipt of updated paper (051006), Services will review focusing on the
process.
 Army: Provide Services/TMA paper outlining proposed additional suffixes for Skill Type table.
 Services: Create lists to define clinical versus non-clinical activities, as well as proposed
expensed FCC (Benefiting work center vs. Overhead).
 EAS PO: Services want explanation of cause for number of error related EAS IV version
releases.
 EAS PO: Services want to know the number of releases the vendor is contractually required to
provide in a Fiscal Year to accommodate table releases.
 EAS PO: The Services requested a list of all new system change requests that will be included in
EASi.
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Patrick Wesley
MEPRS Program Manager
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