Subject: Re: DRG WG
From: "sofiko belkania" <[email-masked]>
To: Kristiina Kahur <[email-masked]>
Date: Mon, 23 Oct 2017 16:43:06 +0400

Dear Kristiina,

You can call us on Nino Berdzulis skype.

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 <[email-masked]>
To: sofiko belkania <[email-masked]>, "HABICHT, Triin" 
<[email-masked]>
Date: Mon, 23 Oct 2017 12:07:04 +0000
Subject: Re: DRG WG

> Dear Sopo,
> 
> 
> Could you clarify who I will contact via Skype on Thursday? I have 
Maia
> and Nino in my Skype contacts's list. Will I contact them (or one of
> them)? Or would you or anyone else I will contact with? If so, 
please
> let me know your Skype name or contact me by using my Skype name
> kristiina.kahur before Thursday's call.
> 
> 
> Thanks,
> 
> Kristiina
> 
> 
> ________________________________
> From: Kristiina Kahur <[email-masked]>
> Sent: Monday, October 23, 2017 2:29 PM
> To: sofiko belkania; HABICHT, Triin
> Subject: Re: DRG WG
> 
> 
> Thanks :)
> 
> Talk soon.
> 
> 
> Kristiina
> 
> 
> ________________________________
> From: sofiko belkania <[email-masked]>
> Sent: Monday, October 23, 2017 2:17 PM
> To: Kristiina Kahur; 'Nino Berdzuli'
> Cc: 'Zaza Sopromadze'; 'Maia Khomeriki'; [email-masked]; 
'marina
> darakhvelidze'; 'Ketevan Goginashvili'; [email-masked]; 
'Sarah
> Thomson'; 'Marijan Ivanusa'; 'HABICHT, Triin'; 
[email-masked];
> [email-masked]
> Subject: Re: DRG WG
> 
> 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 <[email-masked]>
> To: Sopo Belkania <[email-masked]>, 'Nino Berdzuli'
> <[email-masked]>
> Cc: 'Zaza Sopromadze' <[email-masked]>, 'Maia Khomeriki'
> <[email-masked]>, "[email-masked]"
> <[email-masked]>, 'marina darakhvelidze'
> <[email-masked]>, 'Ketevan Goginashvili'
> <[email-masked]>, "[email-masked]"
> <[email-masked]>, 'Sarah Thomson' <[email-masked]>, 
'Marijan
> Ivanusa' <[email-masked]>, "'HABICHT, Triin'" <[email-masked]>,
> "[email-masked]" <[email-masked]>,
> "[email-masked]" <[email-masked]>
> 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 <[email-masked]>
> > Sent: Friday, October 20, 2017 7:04 PM
> > To: Sopo Belkania; 'Nino Berdzuli'
> > Cc: 'Zaza Sopromadze'; 'Maia Khomeriki'; [email-masked];
> 'marina
> > darakhvelidze'; 'Ketevan Goginashvili'; [email-masked];
> 'Sarah
> > Thomson'; 'Marijan Ivanusa'; 'HABICHT, Triin';
> [email-masked];
> > [email-masked]
> > 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 <[email-masked]>
> > Sent: Friday, October 20, 2017 5:42 PM
> > To: 'Kristiina Kahur'; 'Nino Berdzuli'
> > Cc: 'Zaza Sopromadze'; 'Maia Khomeriki'; [email-masked];
> 'marina
> > darakhvelidze'; 'Ketevan Goginashvili'; [email-masked];
> 'Sarah
> > Thomson'; 'Marijan Ivanusa'; 'HABICHT, Triin';
> [email-masked];
> > [email-masked]
> > 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:[email-masked]]
> > Sent: Friday, October 20, 2017 6:01 AM
> > To: Nino Berdzuli
> > Cc: Zaza Sopromadze; Maia Khomeriki; [email-masked]; marina
> > darakhvelidze; Ketevan Goginashvili; [email-masked]; Sarah
> > Thomson; Marijan Ivanusa; HABICHT, Triin; [email-masked];
> > [email-masked]; [email-masked]
> > 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
> <[email-masked]<mailto:[email-masked]>>
> > Sent: Saturday, October 14, 2017 5:39 AM
> > To: Kristiina Kahur
> > Cc: Zaza Sopromadze; Maia Khomeriki;
> > [email-masked]<mailto:[email-masked]>; marina
> > darakhvelidze; Ketevan Goginashvili;
> > [email-masked]<mailto:[email-masked]>; Sarah 
Thomson;
> > Marijan Ivanusa; HABICHT, Triin;
> > [email-masked]<mailto:[email-masked]>;
> > [email-masked]<mailto:[email-masked]>;
> > [email-masked]<mailto:[email-masked]>
> > 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
> > <[email-masked]<mailto:[email-masked]>> 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
> <[email-masked]<mailto:[email-masked]>>
> > Sent: Monday, October 2, 2017 9:39 PM
> > To: Nino Berdzuli
> > Cc: Zaza Sopromadze; Maia Khomeriki;
> > [email-masked]<mailto:[email-masked]>; marina
> > darakhvelidze; Ketevan Goginashvili;
> > [email-masked]<mailto:[email-masked]>; Sarah 
Thomson;
> > Marijan Ivanusa; HABICHT, Triin;
> > [email-masked]<mailto:[email-masked]>
> > 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
> <[email-masked]<mailto:[email-masked]>>
> > Sent: Tuesday, September 19, 2017 5:08 PM
> > To: Nino Berdzuli
> > Cc: Zaza Sopromadze; Maia Khomeriki;
> > [email-masked]<mailto:[email-masked]>; marina
> > darakhvelidze; Ketevan Goginashvili;
> > [email-masked]<mailto:[email-masked]>; 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
> <[email-masked]<mailto:[email-masked]>>
> > Sent: Friday, September 1, 2017 5:04 PM
> > To: Triin Gmail
> > Cc: [email-masked]<mailto:[email-masked]>; Zaza 
Sopromadze;
> > Maia Khomeriki; 
[email-masked]<mailto:[email-masked]>;
> > marina darakhvelidze; Ketevan Goginashvili;
> > [email-masked]<mailto:[email-masked]>; 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
> > <[email-masked]<mailto:[email-masked]>> 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
> > <[email-masked]<mailto:[email-masked]>> 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
> > <[email-masked]<mailto:[email-masked]>> 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
> > <[email-masked]<mailto:[email-masked]>> 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<http://www.moh.gov.ge>
> >
> >
> >
> >
> >
> >
> >
> > <DRG next steps.docx>
> 
>