From : sbelkania@moh.gov.ge
To : Kristiina Kahur; Nino Berdzuli
Subject : Re: DRG WG
Cc : Zaza Sopromadze; Maia Khomeriki; itabatadze@ssa.gov.ge; marina darakhvelidze; Ketevan Goginashvili; lashanikola@gmail.com; Sarah Thomson; Marijan Ivanusa; HABICHT; Triin; kurtsikashvilig@who.int; kirvalidze.mariam@gmail.com
Received On : 23.10.2017 11:17
Dear Kristiina, It's fine to have Skype Call on 26th of October at 4pm (Tbilisi Time). Best regards, ______________________ Sopo Belkania Head of HR Management and International Relations Department Ministry of Labour, Health and Social Affairs of Georgia 144 A.Tsereteli Avenue, 0159, Tbilisi, Georgia Mobile number: +995 599 22 32 32 -----Original Message----- From: Kristiina Kahur To: Sopo Belkania , 'Nino Berdzuli' Cc: 'Zaza Sopromadze' , 'Maia Khomeriki' , "itabatadze@ssa.gov.ge" , 'marina darakhvelidze' , 'Ketevan Goginashvili' , "lashanikola@gmail.com" , 'Sarah Thomson' , 'Marijan Ivanusa' , "'HABICHT, Triin'" , "kurtsikashvilig@who.int" , "kirvalidze.mariam@gmail.com" Date: Sun, 22 Oct 2017 17:06:28 +0000 Subject: Re: DRG WG > Dear Sopo, > > > I get back to the time of our next Skype call once again. > > Would it be possible to start the call at 4pm (Tbilisi time) instead of > 3pm on Thursday 26th of October? > > > Looking forward to getting your confirmation. > > > Thanks, > > Kristiina > > > ________________________________ > From: Kristiina Kahur > Sent: Friday, October 20, 2017 7:04 PM > To: Sopo Belkania; 'Nino Berdzuli' > Cc: 'Zaza Sopromadze'; 'Maia Khomeriki'; itabatadze@ssa.gov.ge; 'marina > darakhvelidze'; 'Ketevan Goginashvili'; lashanikola@gmail.com; 'Sarah > Thomson'; 'Marijan Ivanusa'; 'HABICHT, Triin'; kurtsikashvilig@who.int; > kirvalidze.mariam@gmail.com > Subject: Re: DRG WG > > > Dear Sopo, > > > Thank you for your feedback. Next Thursday, 26th Oct at 3pm (2pm > Estonian/Finnish time), suits well. > > > Thanks and have a nice weekend, > > Kristiina > > > ________________________________ > From: Sopo Belkania > Sent: Friday, October 20, 2017 5:42 PM > To: 'Kristiina Kahur'; 'Nino Berdzuli' > Cc: 'Zaza Sopromadze'; 'Maia Khomeriki'; itabatadze@ssa.gov.ge; 'marina > darakhvelidze'; 'Ketevan Goginashvili'; lashanikola@gmail.com; 'Sarah > Thomson'; 'Marijan Ivanusa'; 'HABICHT, Triin'; kurtsikashvilig@who.int; > kirvalidze.mariam@gmail.com > Subject: RE: DRG WG > > > Dear Kristina, > > > > We have meeting today and discussed all the issues regarding grouping > results and agreed to have skype call on Thursday, 26th of October at > 15:00. Is it suitable for you? > > > > Looking forward for your confirmation. > > > > Best regards, > > > > Sopo Belkania > > Head of HR Management and International Relations Department > > Ministry of Labor, Health and Social Affairs of Georgia > > 144 A.Tsereteli Avenue, 0159, Tbilisi, Georgia > > Mobile number: +995 599 22 32 32 > > > > From: Kristiina Kahur [mailto:kkahur@hotmail.com] > Sent: Friday, October 20, 2017 6:01 AM > To: Nino Berdzuli > Cc: Zaza Sopromadze; Maia Khomeriki; itabatadze@ssa.gov.ge; marina > darakhvelidze; Ketevan Goginashvili; lashanikola@gmail.com; Sarah > Thomson; Marijan Ivanusa; HABICHT, Triin; sbelkania@moh.gov.ge; > kurtsikashvilig@who.int; kirvalidze.mariam@gmail.com > Subject: Re: DRG WG > > > > Dear Nino, > > > > Hope you made it home safe and sound. > > I also hope you have had time to discuss the grouping results and agree > on Skype call timing. > > Please let me know whether next Monday 23rd of Oct before 15:30 would > work with you. > > > > Thank you, > > Kristiina > > > > ________________________________ > > From: Nino Berdzuli > > Sent: Saturday, October 14, 2017 5:39 AM > To: Kristiina Kahur > Cc: Zaza Sopromadze; Maia Khomeriki; > itabatadze@ssa.gov.ge; marina > darakhvelidze; Ketevan Goginashvili; > lashanikola@gmail.com; Sarah Thomson; > Marijan Ivanusa; HABICHT, Triin; > sbelkania@moh.gov.ge; > kurtsikashvilig@who.int; > kirvalidze.mariam@gmail.com > Subject: Re: DRG WG > > > > Thanks, Kristina. I am currently in US, but in the office next week. We > will discuss internally the progress with grouping results review as > well as Skype call timing and get back to you mid-next week. > > > > Best, > > > > Nino > > Sent from my iPhone > > On Oct 13, 2017, at 9:44 PM, Kristiina Kahur > > wrote: > > Dear all, > > > > As we agreed in our last Skype meeting (2nd of Oct) we were planning to > have another one before the November mission (scheduled on the second > week of November) in order to let you reflect your > comments/questions/feelings about the grouping results, the overview of > suspicious cases in DRGs 468, 468O, 477 and 477O (in case you have had > time to have a closer look at those) and other issues related to this. > > In addition, we would be glad to learn what are your expectations for > the next mission in order to draft the agenda according to the this. > You may want to include other topic to our Skype meeting agenda if you > feel like. > > As for timing, I would suggest to have the Skype meeting on Monday, > 23rd of Oct any time before 15:30 (Tbilisi time), so that the call is > finished by 15:30. I suggest we reserve at least one hour for the > meeting. > > Please discuss the timing and the content of the Skype meeting between > yourself and let me know which time on 23rd of Oct before 15.30 would > suit you the best. > > > > Thanks, > > Kristiina > > > > > > ________________________________ > > From: Kristiina Kahur > > Sent: Monday, October 2, 2017 9:39 PM > To: Nino Berdzuli > Cc: Zaza Sopromadze; Maia Khomeriki; > itabatadze@ssa.gov.ge; marina > darakhvelidze; Ketevan Goginashvili; > lashanikola@gmail.com; Sarah Thomson; > Marijan Ivanusa; HABICHT, Triin; > sbelkania@moh.gov.ge > Subject: Re: DRG WG > > > > Dear all, > > > > This is to inform you that we had another Skype meeting today. > > The aim of the meeting was to present the preliminary results of the > grouping. > > Main findings were presented and discussed (and also attached to the > email). > > The whole database with information about DRG grouping results was > shared after the meeting (Triin to Maia). > > > > As for next steps, the data with grouping results should be analyzed by > SSA staff (by involving other specialists if needed). The main focus > should be on error DRGs and the content of the cases. Error DRGs have > grouped to DRG470. My suggestion is to use the results of Finnish > grouping for that because there are introduced DRG470 subgroups (470A, > 470B, etc) which provide more precise information about the source of > error. > > It has to be taken into account, that many ICD10 codes in Finnish > version (especially in chapter C and I) have 5 characters, while in > Georgian version most codes have 4 characters, and thus, the grouping > result with Finnish grouper is DRG470 subgroups. This necessarily does > not mean that there are coding issues. Instead, the reason is different > ICD10 versions in both countries. > > > > In addition, you may want to conduct some additional controls in the > hospitals based on the grouping results. It concerns the DRGs 468, > 468O, 477 and 477O where ca 140 cases were grouped (see separate sheet > in attached document). Those cases may have coding problems. But they > also can be rear cases where the combination of main diagnosis and > procedure is clinically meaningful. The best source to check it is > medical record. > > > > I will continue to work on data and submit the analytical report about > the grouping results and assessment of SSA invoicing data quality and > further use of them by the end of October/beginning of November. > > > > If you have any urgent questions, we can deal with them asap. Otherwise > you can gather your comments/questions/feelings about the grouping > results and we will discuss them as agreed during another Skype call > before November mission, preferable on week 47. > > > > Thank you, > > Kristiina > > > > > > > > ________________________________ > > From: Kristiina Kahur > > Sent: Tuesday, September 19, 2017 5:08 PM > To: Nino Berdzuli > Cc: Zaza Sopromadze; Maia Khomeriki; > itabatadze@ssa.gov.ge; marina > darakhvelidze; Ketevan Goginashvili; > lashanikola@gmail.com; Sarah Thomson; > Marijan Ivanusa; HABICHT, Triin > Subject: Re: DRG WG > > > > Dear all, > > > > We just had the Skype call today with Nino, Maia and colleagues and > discussed the first results of the data we were provided last week. > > > > I would like thank you (and Triin joins me) for the work you have done > to derive the data from your database and prepare them for first check. > > > > The general picture looks good. Data includes 108808 unique rows. > > Nevertheless, there are some things which need to be fixed before we > can proceed with the grouping exercise. > > In current stage we focus only for data needed for groping, and only > after that we start to deal with different tariffs and cost related > data. > > > > Here are the main findings followed by actions to be taken. The > findings follow the order of data-fields needed for grouping: > > 1. Case ID (column A). > > * CaseDistplayNumber is used. It’s a unique number and can be > used later for linking additional data if needed. > No action needed > > 1. Main diagnosis (column AA) > > * in 248 cases the main diagnosis is missing > Action: to find the main diagnosis for those cases. > * in 28 cases instead of diagnosis code “hemotransfusion” is > used. > Action: to find correct main diagnosis code for those cases and use > NCSP code for hemotransfusion (if there exist one in GEO version) > > 1. Secondary diagnosis (columns AB-AJ) > > * in some cases instead of diagnosis code “hemotransfusion” > and “haemodialysis” is used. > Action: to find correct secondary diagnosis code for those cases (if > coded) and use NCSP codes for those procedures (if there exist one in > GEO version) > > 1. Procedure codes > > * There are 16 columns for procedure codes > > * NCSP_ძირითადი_2- > NCSP_ძირითადი_8 (#7) > * NCSP_თანმხლები_1- > NCSP_თანმხლები_9 (#9) > Action: The names of the columns need to be clarified. In addition, it > should be checked whether or not some columns are duplicating each > other. If so, the duplicates need to be removed. > > 1. Gender (column C) > > * Information is there but it needs formatting > Action: If male -> use 1, if female -> use 2, if unknown –> use 3 > > 1. Age (column D) > > * AgeInDays, the age ranges from 0 to 35272 days (0-99 years) > and should be ok > No action needed > > 1. Discharge > > * For this the HospitalizationOutcome (column N) can be used. > This information should be mapped to four different characters needed > for grouping: > > * 1=any other including normal discharge to home or unknown > * 2=transferred to another hospital > * 3=left against medical advice > * 4=dead > Action: map every HospitalizationOutcome characteristic (9 different in > the table) to one of the above (1-4). Add respective column "Discharge" > in the table. Keep column "HospitalizationOutcome". > > 1. Length of stay (LOS) > > * Information is correct (minus one case). > Action: Check the case 3310497435, were LOS is -5540. > > 1. Birthweight (column S) > > * 1170 cases with birthweight information in the data. > * Birthweight ranges from 300g to 7000g? Is 300 and 7000g > correct? > * In 25 cases the birthweight information seems not to be > relevant because the age of those cases ranges from 18 to 39 years > Action: Check the age of those patients. If incorrect, correct the age. > If correct, there is no need for birthweight information. > > There is one more comment regarding the OrganizationType (column Y). > There are 62 cases where the organization type is Family Medicine > Center. Most of the cases (#49) are related to cataract issues, some of > them have procedure codes reflecting the cataract surgery. Are those > cases relevant to Family Medicine Centre? Can there be the coding > issues or do the ophthalmologist work in Family Medicine Centres and > provide respective services? > > > > We agreed that the corrected data will be provided by Friday 22nd Sept, > if possible. If not, then by Monday 25th Sept, as latest. > > > > The next steps (given that the data are ok): > > * Final preparation for grouping (week 39). > > * general check > * replacing the NCSP+ code with Estonian and Finnish NCSP codes > * replacing the birthweight information with respective ICD10 > codes which are currently missing in ICD10 version used in Georgia > > * Grouping the data with NordDRG grouper (EST/FIN) (week 39). > * Providing the preliminary results of the grouping to working > group (via Skype, preliminary meeting agreed on 2nd Oct) > * Providing feedback to SSA for additional check of certain cases > with suspicious coding quality (50-100 cases), based on the grouping > results (week 40). > * Agree on next steps regarding cost analyses by using current SSA > and providers’ tariffs (tbc). > > > > Thank you once again and looking forward to getting the corrected data > so that we can proceed with action our plan. > > > > Regards, > > Kristiina > > > > > > > > ________________________________ > > From: Nino Berdzuli > > Sent: Friday, September 1, 2017 5:04 PM > To: Triin Gmail > Cc: kkahur@hotmail.com; Zaza Sopromadze; > Maia Khomeriki; itabatadze@ssa.gov.ge; > marina darakhvelidze; Ketevan Goginashvili; > lashanikola@gmail.com; Sarah Thomson; > Marijan Ivanusa > Subject: Re: DRG WG > > > > Hi Triin, > > > > Thanks for your email and reminder. Just to clarify, have you received > data that was supposed to be send by August 31st? > > > > Initial deadline August 20th for data requested was too optimistic > given vacation times and amount of work related with data extraction. > Let's plan to catch up next week - I will also ask Zaza. > > > > Thanks! > > Sent from my iPhone > > On Sep 1, 2017, at 5:39 PM, Triin Gmail > > wrote: > > Dear Nino and colleagues, > > > > Hope you are all doing fine! Have you had a possibility to discuss the > data query related issues and to check initial due date was too > optimistic and we have to reconsider our initial action plan? > > Just let us know if you have any questions you would like to discuss or > if it would be helpful to have a quick call etc. > > > > With all the best, > > Triin > > On 25 Aug 2017, at 17:14, Nino Berdzuli > > wrote: > > Triin, thank you for a response and update. I very much hope that data > extraction and requested data set will be available for your review > next week. > > > > I am asking Maia to check the progress on data extraction early next > week and inform the group if there any challenges in this regard. > > > > Happy weekend everyone! > > > > Nino > > Sent from my iPhone > > On Aug 25, 2017, at 5:49 PM, Triin Gmail > > wrote: > > Dear Nino and all others, > > > > Formation of the working group is very much welcomed and definitely > helps to better coordinate activities between ourselves to be timely in > agreed activities and to discuss any obstacles that put timeliness into > threat. Thank you for doing that! > > > > Just a quick update of the recent developments. We got feedback from > Maia that data preparation takes a bit more time than initially > expected and hopefully data becomes available by next Thursday. At this > stage we don't need to revise due dates of next activities but we can > come back to that if data extraction is more challenging than was > assumed. This can be a case as most probably this data query format is > new for you and may need some more efforts. And if there are any > questions related to data then don't hesitate to contact to Kristiina > and me. > > > > We could agree also the teleconference time after we have got a data > and have had a first look on that. > > > > Let's be in touch! > > > > Best > > Triin > > On 24 Aug 2017, at 09:10, Nino Berdzuli > > wrote: > > Dear Triin and Kristin, > > > > Hope this e-mail finds you very well. Let me thank you both for a very > productive mission, practical work/recommendations provided, next steps > identified to start and advance DRG-related work. We are very much > looking forward to working with you and make the best use of resources > allocated through the UHC-Partnership program. > > > > We have created DRG working group (in the cc) so that communication and > exchange of information on DRG related work will be within this group. > This will also help to track progress of on-going work. I am also > enclosing in this e-mail translated in Georgian next steps/timelines to > remind the group deliverables and deadlines. > > > > Thanks again and look forward to hearing the work progress soon. > > > > მოგესალმებით DRG-ის სამუშაო > ჯგუფის წევრებს, > > > > გთხოვთ ძირითადი > კომუნიკაცია DRG-ისთან > დაკავშირებით აწარმოოთ > სამუშაო ჯგუფის ყველა > წევრის ჩართულობის > უზრუნველყოფით. > > ასევე, მინდა შეგახსენოთ DRG > -ის პროცესთან > დაკავშირებული შემდეგი > ნაბიჯები და დედლაინები > რომელზეც შევთანხმდით > კონსულტანტების ვიზიტის > დროს (იხილეთ ბმულში). > გთხოვთ, უზრუნველყოთ > დედლაინების დაცვა. > > > > გმადლობთ, > > > > ნინო > > > > > > > > > > > > > > > > Nino Berdzuli, MD, MPH > > Deputy Minister > > Ministry of Labor, Health and Social Affairs > > 144 Tsereteli Ave > > Tbilisi 0119, Georgia > > Tel: +995 32 251 00 27 ext 0502 > > www.moh.gov.ge > > > > > > > >