Can Episode-of-Care Grouper Software be Used to Augment the Military Healthcare System Modeling Efforts

Abstract

A computer model that behaves like the healthcare system would be a valuable tool enabling administrators to evaluate the impact of changes to the healthcare system prior to implementation. The Military Healthcare System (MHS) is the leader in creating computerized models that represent large complex healthcare systems. Despite the potential benefits of modeling a healthcare system, modeling remains in its infancy. The fundamental building block of a healthcare system model is the quantification of care that patients received as they maneuver their way through the system. Newly-developed software programs known as episode groupers uncover these patterns and organize them into clinically meaningful packages. This study is an exploratory glimpse into the obstacles within the MHS that makes utilizing one of these software products particularly challenging. A year's worth of healthcare records from San Diego's direct care system, as well as the network, were gathered, formatted, and processed through the episode grouper. MHS data did not perform as well as civilian healthcare data; 23% of the records were ungroupable vice 14%. The majority of these orphan records (70%) were ancillary and pharmaceutical records that could not be linked to the outpatient visit that generated them. Some of the contributing factors include inadequate capture of data within the MHS, the mobility of the population served, military-unique medical codes, and inadequate coding. The MHS has made improvements since the time frame of this study that should vastly improve its performance with episode groupers. After additional reliability and validity testing has occurred, episode groupers could be utilize to uncover healthcare delivery patterns and incorporated into the next wave of MHS healthcare computer models.

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Document Details

Document Type
Technical Report
Publication Date
Dec 10, 2001
Accession Number
ADA478031

Entities

People

  • Ann L. Forrest

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Computer Programming
  • Computer Programs
  • Computers
  • Delivery Of Health Care
  • Health Care
  • Health Services
  • Information Systems
  • Laboratory Tests
  • Medical Personnel
  • Pain
  • Patient Care
  • Patient Care Management
  • Physicians
  • Reliability
  • Standards
  • Therapy

Fields of Study

  • Medicine

Readers

  • Computational Modeling and Simulation
  • Medical or Health Care Field.
  • Software Engineering.