CLMI
MSgt Christopher A. Bartley
AF DoD CLIP Program Manager
202-782-2585/DSN: 662
Christopher.bartley@afip.osd.mil
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Why CLMI?
Data Requirements
Problem Areas
Fixes
CLMI Data: Where were we?
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CLMI Data: Where are we?
Quarterly Summary Report
How do I use CLMI?
Point of Contact
Questions
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CLMI is the laboratory benchmarking system in
use by the Air Force and Navy
◦ Army uses ASAMS
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It Provides tools to:
◦ Evaluate operational and financial performance
◦ Improve utilization of services, productivity, and cost
effectiveness
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Report due by the 15th of the next month
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Facility and General Information
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Clinical Lab
◦ Bed size
◦ Facility type (medical center, hospital, clinic)
◦ Month, FY, FY Quarter, End Date of report
◦ Workload Data
 In-house Reportable Tests (RT) for each lab section
 Broken down by CPT suffix
 00 – Tests performed in-house
 26 – Pathology Consults
 32 – Tests performed for another lab (shipped-in)
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Clinical Lab
◦ Off-Site Workload
 Clinical Lab, Histopathology and Cytology RT
referred out
 To Civilian Labs (including monthly cost)
 To Military Labs
◦ Utilization Data
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Outpatient RT
Outpatient Visits
Inpatient RT
Admissions
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Clinical Lab
◦ Staffing/Productivity Data
 Full time equivalents (FTE) by Grade
 O-6, O-4/5, O-3, O-1/2
 E-9, E-8, E-6/7, E-5, E-1/4
 GS-13/14, GS-10/12, GS-7/9, GS-4/6, GS-1/3
 Used with RT to calculate productivity
◦ Cost Data
 Supply costs (EEICs 600-619)
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Histology
◦ Surg Path, EM, Cytogen and Autopsies
 In-house, referred-in
◦ Specimens referred
 AFIP, Other Federal and Civilian Agencies
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Blocks
HE Stains
Special Stains
Immuno-Histo
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Histology
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Frozen Sections
Autopsy Backlog
FTE – same breakouts as clinical
Supply money spent
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Cytology
◦ Slides Examined (Gyn/Non-Gyn)
 Cytotechnologist
 Pathologist
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FTE – same breakouts as clinical
Total cases (Gyn/Non-Gyn)
Normal DXS (Gyn/Non-Gyn)
Abnormal Gyn
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Cytology
◦ Slides
 Unsat
 Limited
 QA
◦ Average in-house TAT (Gyn/Non-Gyn)
◦ Supply Money Spent
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1500 duplicate entries between FY07-FY09
◦ Example: one base had 34 entries for FY08
◦ Most didn’t duplicate all data fields-blanks/nulls
◦ Database didn’t recognize/restrict duplicate
months and gave each entry a unique number
◦ Duplicate entries included in CLMI calculations
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Wrong date for end of month
◦ Example: 10/30/2008 instead of 10/31/2008
◦ Entry not included in CLMI calculations
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Wrong year format
◦ Example: 09 or 9 for 2009
◦ Entry not included in CLMI calculations
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Wrong quarter
◦ Oct-Dec=1, Jan-Mar=2, Apr-Jun=3, Jul-Sep=4
◦ Entry not calculated in correct quarter
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No easy way to import data
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Website entries stored on one table
Report generated from local table
Importing difficult, handled by network person
Copy/paste ignored blank areas; data filled in from
left to right
No way to specify quarter or year for report
◦ Discovered during calculation validation
◦ Generated report for 2nd Qtr 2008, next day
generated 3rd Qtr 2008
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Unbundled chemistry data
◦ Data collected since 2005
◦ Calculations not updated
◦ CLMI reported bundled chemistry number
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No archival system
◦ All entries from 1999-2008 stored on website table
and local table
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Duplicate Entries
◦ Removed duplicate entries
◦ Website allows duplicates
 BRAC – losing website, at least temporarily
◦ Changed Local table - only allows one entry per
month (Checks End Date)
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Wrong date
◦ No automated fix – each month table scrubbed
manually for wrong end dates
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Wrong year format
◦ No automated fix – each month table scrubbed
manually for wrong end dates
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Wrong quarter
◦ No automated fix – each month table scrubbed
manually for wrong end dates
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Data import
◦ Email form – 4 mouse clicks
◦ Can be automated
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CLMI Form
Report generation
◦ Asks for Qtr/Year each time generated – printed in
header of report
◦ Can generate multiple quarters/years sequentially
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Unbundled chemistry
◦ All formulas updated
◦ Report shows which areas use unbundled data
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Archived data
◦ Archived by year
◦ 1999-2006 now stored in separate table
◦ Speeds up database, report generation
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May – Dec 09 – identified/fixed problems
14 Dec – started testing email form to replace
website (Travis/Buckley)
25-29 Jan 10 – server maintenance at AFIP
29 Jan – sent out 2009/2010 data entry
statistics
Quarter
Clinical Lab
Cytology
Histology
1st Quarter
71%
20%
23%
2nd Quarter
70%
33%
40%
3rd Quarter
62%
20%
33%
4th Quarter
53%
13%
20%
Annual
64%
22%
29%
As of 29 Jan 2010
80% of entries needed before report generated
Total Lab Entries per Quarter 219
Total Cytology Entries per Quarter 120
Total Histology Entries per Quarter 120
Quarter
Clinical Lab
Cytology
Histology
1st Quarter
43%
10%
10%
2nd Quarter
0%
0%
0%
Annual
11%
3%
3%
As of 29 Jan 2010
80% of entries needed before report generated
Total Lab Entries per Quarter 219
Total Cytology Entries per Quarter 120
Total Histology Entries per Quarter 120
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3 Feb – trouble ticket for CLMI website
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5 – 11 Feb – DC blizzard
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1 Mar – website still down email form live
Blizzard
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1 Mar – 19 Mar
◦ 91 entries for 09
◦ 119 entries for 10
10% of 09 data
14% of 10 data
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Email form has to be viewed as HTML
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Must press “reply” to enter data
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Cyto/Histo forms have to be designed
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Data needs to be validated at base level
◦ Compare data entered each month
◦ Use instrument test counts (if your instrument
keeps this data) to validate test counts on the SDR
◦ Use the Issue/Turn-In Summary Report in DMLSS to
validate supply charges
◦ Use current recall roster to validate number of
military personnel/ranks
◦ Talk to person in charge of timecards to validate
number of civilian personnel/GS levels
Quarter
Clinical Lab
Cytology
Histology
1st Quarter
78% (+7)
20%
23%
2nd Quarter
77% (+7)
33%
40%
3rd Quarter
73% (+11)
20%
33%
4th Quarter
70% (+17)
13%
20%
Annual
74% (+10)
22%
29%
As of 19 Mar 2010
80% of entries needed before report generated
Total Lab Entries per Quarter 219
Total Cytology Entries per Quarter 120
Total Histology Entries per Quarter 120
Quarter
Clinical Lab
Cytology
Histology
1st Quarter
67% (+24)
10%
10%
2nd Quarter
30% (+30)
0%
0%
Annual
24% (+13)
3%
3%
As of 19 Mar 2010
80% of entries needed before report generated
Total Lab Entries per Quarter 219
Total Cytology Entries per Quarter 120
Total Histology Entries per Quarter 120
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Clinical Lab
◦ 1-1: RT, FTE, productivity, and supply cost
 Added “Months Entered”
 Removed “Total Budget”, “Total $/RT”, “Salary” and
“Salary $/RT”
◦ 1-2: RT by section
 Added “Months Entered”
 Removed all section “RV”
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Clinical Lab
◦ 1-3: Civilian referrals/cost, Military referrals
 Added “Months Entered”
◦ 1-4: Utilization (outpatient, inpatient)
 Added “Months Entered”
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Histopathology
◦ 2-1: In-house, referred-in, referred out workload
 Added “Months Entered”
◦ 2-2: Procedures, FTE, productivity and supply cost
 Added “Months Entered”
 Removed “Total Budg $”, “Total $/Spec”, “Salary $” and
“Salary $/Spec”
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Cytology
◦ 3-1: workload and productivity
 Added “Months Entered”
◦ 3-2: QA data and costs
 Added “Months Entered”
 Removed “Total Budg $”, “Total $/Slide”, “Salary $” and
“Salary $/Slide”
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Data comparison between labs of similar
size
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RT/FTE (Section 1-1) is a gauge of how well
personnel are utilized
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$/RT (Section 1-1) can indicate need for a
new/modified reagent contract
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The individual RTs (Section 1-2) show how
your Total RT breaks down
Section 1-3 shows Clinical, Cytology and
Histology Civilian/Military Reference Lab
Costs/Totals
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An increase here could indicate a need for a
new/modified testing contract, need to refer
test(s) to a military reference lab or a need to
bring a test in-house
Section 2-1 provides the same data for
Histology (Total RT and Civilian/Military
Reference Lab)
Section 2-2 provides the same data for
Histology (RT/FTE, $/RT and Individual RT)
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Section 3-1 provides the same data for Cytology
(Total RT and RT/FTE)
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Section 3-2 provides the same data for Cytology
($/RT)
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It also can indicate a QA issue (Unsat, Limited, QA)
showing a need to evaluate technique/additional
training
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Using Total RT (Section 1-1) in the manpower
calculation (AFMS 5512)
◦ Linear Equation using Reportable Test Volume
◦ Step 1. Refer to the standard manpower equation
for formula
◦ Formula: X + Y + (R/1100) = Authorizations
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Step 2. Determine positions requirements Base
Cost (X) based on MTF Peer Group start-up cost
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Peer
Peer
Peer
Peer
1
2
4
5
Facilities: 2 authorizations
& 3 Facilities: 3 authorizations
Facilities: 4 authorizations
Facilities: 7 authorizations
Peer Rating comes from Max Available
Enrollment's
◦ Clinics
 PG 1 - less than 10,000
 PG 2 - 10,000 - 15,000
 PG 3 - greater than 15,000
◦ Bedded Facilities
 PG 4 - Non-GME Hospitals
 PG 5 - Grad Med Ed Hospitals
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Step 3. Determine positions requirements
earned from Additives (Y)
◦ Overseas: 1 authorization (overseas readiness
manpower additive)
◦ Isolation/BAT: 1 authorization (high readiness/BAT
in isolation, Kunsan only)
◦ Split Operations: In-house: 1 authorization (open
door cost), maximum of 2 labs
◦ 24 hr STAT Lab: 3 authorizations (open door cost),
maximum of 1 lab
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Step 3. Determine positions requirements
earned from Additives (Y)
◦ Shared Ops: 1 authorization (tech commitment to
sharing facility)
◦ Free Standing Lab: 2 authorizations (open door cost
- outside main MTF), maximum of 4 labs
◦ Active BDC: 4 authorizations open door cost + 1/50
units monthly
◦ Consultant/Flt CC: 1 authorization (activities must
consume >50% of time), maximum 1/MTF
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Step 4. Obtain a 12-month average for Reportable
Tests (R) using data from the Clinical Laboratory
Management Indicators (CLMI)
Step 5. Compute authorizations using the
equation
Step 6. MAJCOMs may submit proposed variances
to AFCQMI for review
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When do I bring a test in-house or decide to refer
it out?
◦ $/RT
◦ Productivity (RT/FTE)
◦ Add/reduce authorizations (RT)
◦ Instrumentation
◦ All tests counted equal
◦ Changes to authorizations start with Sq/CC
MSgt Christopher A. Bartley
christopher.bartley@afip.osd.mil
DSN: 662-2585
Commercial: (202) 782-2585
Fax: x6022
CLMI email update form
Type only in the areas designated for data entry. Your reply will be automatically processed. Therefore, it is important that the form or the message is not altered in any other way. For more information about filling out
this form, see the following:
Facility ID:
Type any combination of numbers and letters up to 50 characters.
End Date (Last Day of Month, ex. 7/31/2009):
Type either a date, a time, or a combination of both in the following format: 3/9/2010
Month (1-12):
Type a numeric value.
Year (Format: XXXX, ex. 2009):
Type a numeric value.
Quarter (1-4, Oct-Dec=1, Jan-Mar=2, Apr-Jun=3,
Jul-Sep=4):
Type a numeric value.
Chemistry, In-House:
Type a numeric value.
Chemistry, Pathology Consult:
Type a numeric value.
Chemistry, Shipped-In:
Type a numeric value.
Unbundled Chemistry:
Type a numeric value.
Hematology, In-House:
Type a numeric value.
Hematology, Pathology Consult:
Reference sheet for email form has
instructions/formats for End Date, Year and
Quarter
Where were we?