IDES Process Redesign Project
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Transcript of IDES Process Redesign Project
RESEARCH POSTER PRESENTATION DESIGN 2011
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Integrated Disability Evaluation System Process Redesign
PROGRAM BACKGROUND AND INTRODUCTION
NAVY MEDICINE WEST PATIENT CATCHMENT AREA
PROGRAM OBJECTIVES, CHALLENGES, AND ACTIONS
PATIENT ADMINISTRATION AND VA MSC TEAM IDES TIMELINE PROGRESS
IDES PROCESS REDESIGN RESULTS
CONTINUOUS PROCESS IMPROVEMENT
NMCSD is leveraging technology to meet the MEB Stage goal. NMCSD
conducted a multi-disciplinary Lean Six-Sigma Rapid Improvement
Event (RIE) in December 2011, resulting in an e-routing solution using
the IDES Tracker. The e-routing function electronically transmits:
IDES Referral form from Referring Physician to PAD
C&P Exam from PAD to Referring Physician
NARSUM from Referring Physician to Jr. Physician, CA, and to PAD
Addendums and Rebuttals from PAD to Physician and back to PAD
Case documents are immediately e-routed upon completion of action,
generating an automatic e-mail alert to the appropriate staff. CAC-
enabled signature and digital signature pads ensure secure, encrypted
data transfer resulting in 100% tracking and accountability for every
IDES case. All of NMCSD will be using e-routing by April 2012.
LT Ryan Shiek, LT Meg Potter, LTJG Sean Oehrlein, LT Johnny Oliva
46 Days (USN)
39 Days (USMC)
8 Days (USN)
7 Days (USMC)
MEB Stage (VTA) 106 Days (USN)
114 Days (USMC)
63 Days (USN)
57 Days (USMC)
MEB Average Open
Case (IDES Tracker)
115 Days 39 Days 76 Days
% MEB Cases > 35
Days (IDES Tracker)
80% 38% 42%
Open Cases (IDES
524 Cases 308 Cases 216 Cases
Average Days to Complete Referral (10 day) and MEB Stages (35 day)
Navy Medicine West (NMW)
provides medical care to more
than 675,000 beneficiaries. The
NMW patient catchment area
includes Navy Military Treatment
Facilities on the West Coast as well
as Hawaii, Japan, and Guam.
NMCSD is the regional Echelon III
command and processes more than
1,200 MEB cases annually.
Complicated cases are referred to
NMCSD for MEB processing. NMCSD
is a main recovery site for
Wounded, Ill, and Injured in
conjunction with the Combat and
Complex Casualty Care (C5)
PAD leadership critically evaluated the NMCSD IDES process and found
the following issues were causing delays:
- IDES team understaffed
- No detailed method to track IDES case progress
- IDES referral no shows
- IDES staff difficulty balancing different stage processes
- Addendums found necessary at end of the process
- Redundant signatures required on multiple documents
PAD Leadership used the Continuous Process Improvement (CPI)
methodologies Just-Do-It and Lean to make these sustainable
- Increased IDES staffing by 11
- Increased IDES supervision by 4
- Developed the IDES Tracker
- Created IDES escort to eliminate no-shows
- Specialized IDES staff in Referral Stage or MEB Stage
- Pre-screened files for Addendums
- Provided IDES Physician signature authority
NMCSD now meets the Referral Stage goal and reduced the MEB Stage
average. The result will save the military an estimated $11.9 million
in 2012 compensation (Pay, Subsistence, Housing).
- Referral Stage: $4.9M (((35 days x 1200 cases)/365 days)*$42,418.08**)
- MEB Stage: $7.0M (((50 days x 1200 cases)/365 days)*$42,418.08) **Compensation calculated for E-4, 4 years of service, CONUS average, 0 dependents
The Integrated Disability Evaluation System (IDES) process involves
multiple government entities, electronic tracking systems, and hand-
offs between stages within phases to complete a single IDES case for
our Wounded, Ill, and Injured patient population. The result of the
IDES process is a determination of fitness for duty; and if found unfit,
a disability rating percentage from the Veterans Administration.
The goal of this project was to align the processing times for Naval
Medical Center San Diego (NMCSD) IDES cases with the processing
times defined in SECNAVINST 1850. Specifically PAD leadership was
tasked to complete the following objectives in a sustainable manner:
- Reduce the Referral Stage average to 10 days
- Reduce the MEB Stage average to 35 days
JUL AUG SEP OCT NOV DEC JAN FEB