Tuesday, September 29, 2015

I10 Progress Report #8: V33 Support Validated

Hurray, our DRG Assignment Engine (DAE) correctly handles the CMS test set with ICD10 codes and v33 code attributes and logic.

Now we just have to roll out the DAE into our pared-down product catalog and overhaul our web sit and on-line store and we will be all set.

Next stop: CSV support for the new DRGFilt.

Monday, September 28, 2015

I10 Progress Report #8: Masks File Has Been Built

We have built and validated the v33 masks file, so we are ready for integrated testing as soon as the logic module has been updated. We expect the logic upgrade to be done by midday tomorrow.

I10 Progress eport #7: So Far, So Good

We have finished our assessment of the v33 upgrade and we have started the work:
  • the attributes seem to be only minor different between v32 and v33
  • the logic seems somewhat different between v32 and v33
We expect to have have masks file built first thing tomorrow, so that when the software update is done mid-day tomorrow, validation can begin.

Currently, our goal is to have our DRG Assignment Engine (DAE) will be upgraded to support v33 by end the of the day on October 1, 2015.

I10 Progress Report #6: on to V33

We are hard at work on support for v33, which currently is moving along three different tracks:

DRGFilt Upgrade
We are upgrading DRGFilt to handle CSVs as well as fixed-width input. (We may also get to adding support for the very simple equation format: one line per column, each line of the form "col_name=value")

V33 Masks File
To support v33, we need to support logic and the ICD10 code attributes, which we call "the masks" and some people call "the tables." We encode the logice in our software and we create a database of attributes which we call "the masks file." We are hard at work creating the masks file.

V33 Logic Support
Of course we are upgrading our logic module to match the v33 logic module so that our software can work in conjunction with the v33 attributes to assign v33 DRGs.

Saturday, September 26, 2015

DRGFilt10 New Control File Format

The version of DRGFilt which supports ICD10-based DRG assignment is called DRGFilt10. Since we are overhauling our product line, we decided to knock a very long-standing item off the list: the DRGFilt control file format.

The control file tells DRGFilt how to parse the incoming data records to pick out the data elements needed to assign a DRG:
  1. patient age
  2. patient sex
  3. patient discharge status
  4. list of diagnoses
  5. list of procedures
The control file also tells DRGFilt where to put its output:
  1. Grouper Return Code (GRC) -- what, if anything, went wrong
  2. Major Diagnostic Category (MDC)
  3. Diagnosis Related Group (DRG)
The original control file format was based on the old IBM punch cards (!) so it was definitely time to ditch the 1960s. For our first upgrade, we decided to move on up to the 1990s by supporting a .INI-like format.

Our first step along the moderization path is Specifically, this is the control file we are using to validate the new DRGFilt against the CMS test data set:

; control file for new DRG filt
format = fixed
; fixed-width input variables: name = length@offset
age =    3@0
sex = 1@3
ds =  2@4
dxl=8        ; dx length does not require an offset
poa= 7
dx = 200@23
sgl=7@0     ; pr length, offset is optional & ignored
surg= 175@223
exmp = 1@6
; -----
; these are already present from the CMS grouper:
; you could overwrite the incomin values if you wanted to
; drg = 3@603
; mdc = 2@600
; rc = 2@598
; -----

; these are written out by DRGFilt
rc  = 2@1760
mdc = 2@1762
drg = 3@1764

; eof

We hope to roll out the long-awaited CSV support very soon.

Thursday, September 24, 2015

I10 Progress Report #5: Success

At last, x32 has been validated, confirming that our new ICD10-based development path is working:

Processing version X32...ICD10 config
9187 records read with 0 errors.
All done.

So we are immediately starting work on v33, which will be our first production version for ICD10.

We are also changing our DRGFilt control file from its very 1980s fixed-width format to a very 1990s .INI file. (We hope to have support for a very 2000s XML format very soon.)

Thursday, September 17, 2015

I10 Progress Report #4

Yesterday we finished porting the attributes handling subsystem to our new development environment. We validated x32 against the CMS test data and x32 matches 97% of the time.

We are chasing that 3% but since I10 v32 was not an official release, we think that some of the discrepancy is due to last-minute changes. We are looking into running the official Grouper software so we can confirm their results.

We expect to be done with x32 no later than the end of the week and to start v33 Monday.

Tuesday, September 15, 2015

I10 Product Catalog

We are overhauling our operations as part of the switch from ICD9cm to ICD10 and one of the areas we are overhauling is our product catalogue.

Many of our products are holdovers from when our customers were mostly information system developers who wanted software development tools, such as shared objects and hash table look-ups.

In recent years we find that fewer and fewer of our customers are programmers and more and more of our customers are analysts or end-users.

We plan to continue to support developers, but on a custom and case-by-case basis: there is no longer any need to clutter our catalogue with estoteric items.

Our ICD9cm catalogue had 30 items and we wanted to get down to 10 items. We think that we have done it; here is our proposed catalogue so we can get your feedback before we make the final decisions.

Items We Plan to Keep

CDLLVisual C-callable DLLy
DASJUMBODRG Assignment Jumbo Data set"y
DASLARGEDRG Assignment Large Data set"y
DASMEDIUMDRG Assignment Medium Data set"y
LINUXFILT6464 bit Linux DRGFilty
VBDLLVB-callable grouper DLLy
WINFILTDRGFilt for 32 bit Windowsy
WMASKSWin32 DRG Masksy

Items We Plan to Retire

CICDICD9 Name-finding C-callable DLLn
COBJ32SO32 bit C-callable shared objectn
DASSMALLDRG Assignment Small Data set"n
ICDTABICD9cm short filen
ICLUPICL Run-time Environment Upgraden
LINUX32CGIDRG32 bit Linux CGI DRG Assignern
LINUXFILT3232 bit Linux DRGFiltn
PERL32SO32 bit Perl-callable shared objectn
PERL64SOPerl-callable shared objectn
PHP32SO32 bit PHP-callable shared objectn
PHP64SO64 bit PHP-callable shared objectn
VBICDICD9cm Name VB-callable DLLn
W32CGIDRG32 bit Windows CGI DRG Assignern
WICDTABWin32 ICD9cm short filen
XLDRGMS-Excel DRG Assigning spreadsheetn

Items We Are Considering Keeping

COBJ64SO64 bit C-callable shared object?
LINUX64CGIDRG64 bit Linux CGI DRG Assigner?

I10 Progress Report #3

We almost got the code attribute data file building process ported from our old environment to our new one.

We are grateful to have our out-going guru's help today and we are confident that he will be able to get us over the final hump: if not today, then tomorrow.

Monday, September 14, 2015

I10 Progress Report #2

We did not quite meet our goal of building x32 yesterday; we completed the logic part but not the code attribute part (which we call "the masks" and which many other organizations call "the tables").

We expect to finish the basic x32 DRG Assignment Engine (DAE) today, build DRGFilt x32 on top of the DAE and then start on v33.

Sunday, September 13, 2015

I10 Progress Report #1

Many of you have enquired about the status of our support for the upcoming grouper release. This post is intended to answer those questions.

This coming October 1st we are due to release v33, which will be the first version which is only ICD10 (i10). Starting with v33, we will no longer provide ICD9-based (i9-based) grouping support, so v33 is our first non-experimental release which is i10-based.

Up to now, our versions have all been i9-based except for the experimental i10-based products. We designated the experimental versions with an 'x' instead of a 'v', so v31 was the i9-based grouper and x31 was the i10-based grouper.

Last year's grouper was the last grouper with both, so v32 is the last i9-based grouper and x32 is the last time that i10-based grouping is considered 'experimental.'

On top of the very large shift from i9-based to i10-based grouping, our in-house grouper guru retired, which forced us to revamp our development process.

This is our plan to migrate us from the i9-based to i10-based development:
  1. Technology turn over from departing guru to new team
  2. Re-create x31 with the new process and new team
  3. Create x32 with the new process and new team
  4. Create v33 with the new process and new team
We are happy to report the step (1) was completed in early June and that step (2) was completed yesterday.

We expect to complete step (3) today and have an x32 DRGFilt available for evaluation by first thing Monday morning.

Currently, we feel that we are on track to be ready to provide our DRG Assignment Service for v33 on October 1st.

We are currently reviewing our product line to see which products we want to port from i9 to i10. As soon as we can we will put up an on-line survey to allow our customers to weigh in on which products to keep and which to leave behind.