AHRQ support and best practices

Nov. 14, 2022 / By James Sewell

Quality indicators are becoming a larger part of every provider organization’s clinical documentation integrity (CDI) and quality review process. The Agency for Healthcare Research and Quality’s (AHRQ) quality indicators: patient safety indicators (PSI), neonatal quality indicator (NQI) and pediatric quality indicators (PDI) are a critical part of this, and I wanted to provide you with some additional information to help your teams take better advantage of the available functionality. 

Background 

AHRQ quality indicators are created by AHRQ and released every year in late summer, for the current fiscal year (FY). The software is released by AHRQ and can be integrated directly into coding and CDI technology. AHRQ uses a retrospective analysis model, meaning it uses the MS-DRG grouper from the prior fiscal year (i.e., for FY 2022 AHRQ uses MS-DRG version 39 and for current FY 2023 they use MS-DRG version 40). 

So, by the time the updated AHRQ logic is released, it’s necessary to complete a process that runs the current FY visits back through the quality indicator engine and update the database with the newest AHRQ indicator results. It is important to have a technology partner that allows this process to happen automatically when you make version or feature updates. 

This also means that, since we’re in FY 2023, the AHRQ PSI results that can be seen currently for visits are only preliminary, and the final FY 2023 PSI results won’t be available until AHRQ releases its updates next summer. This is important to remember as you may not want to spend a lot of time reviewing PSI results until these updates are available. 

Troubleshooting AHRQ quality indicators

Only AHRQ creates and manages the clinical logic behind these indicators. Technology partners cannot make judgments about the correctness or incorrectness of an individual indicator result. When you have questions or concerns about a specific case, try the following: 

• View the AHRQ case detail report for the patient and review the inclusion and exclusion rule results for that patient.  
• Check the present on admission (POA) values for all diagnosis and procedure codes. 
• Review the AHRQ technical specifications.  
• Review the log of coding changes for the current year.  
• Email AHRQ technical support (qisupport@ahrq.hhs.gov) with the visit details and your question. They’re very prompt and usually reply within a day or two with a detailed explanation for a given example. They can also provide clarification for issues regarding the interpretation of a specification.  

If you continue to have questions, 3M personnel in support, consulting services and development are available to assist you.  

James Sewell, product owner for 3M™ 360 Encompass™ Quality Measure Analytics at 3M Health Information Systems.