Data Review:
Case Validation
Case Validation Overview
Purpose
• Ensures accuracy of data extracted into the local MPOG database
• Complements Data Diagnostics (see Module: Data Review – Data Diagnostics) to enable
comprehensive review of data
Key Functions
• Facilitates review of individual cases to ensure MPOG data accurately reflects documentation in
the electronic health record.
Why it Matters
• Identifies data issues at the individual case level
• Detects discrepances not visible through data diagnostics alone
How it Works
• Uses standardized set of validation questions
• Systematically verifies information for accuracy
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Case Validation – Case Sampling
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Best Practices
• Review a representative mix of cases to ensure comprehensive validation
• Include cases from all major surgical service lines (e.g. cardiac, ortho, OB/GYN, vascular,
transplant, etc.)
Key Considerations
• Validate emergent cases, as their data may extract differently than scheduled cases
• Use initial review findings and guidance from an MPOG Informatics Specialist to refine future
case selection
Ongoing Improvement
• Track findings over time to identify recurring trends and data issues (as needed)
• Focus on areas with identified issues (e.g., prioritize cardiac cases if mapping trends are
detected)
Case Validation – Requirements
Minimum of 5 Cases Validations per month are required for each
scenario:
• Monthly Upload – 5 case should be reviewed prior to each upload
to MPOG central
• Historical Data – 5 cases completed per month of data
• Initial Upload – 5 per month for 12 months of data, prior to the
initial MPOG Central upload
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Case Validation Application – Overview
• The left panel provides four options
for selecting and opening a case
• The right panel shows the number of
cases reviewed for each month
• Green indicates that the required
number of monthly case reviews has
been completed
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Application – Pick a Case for Review
• 4 Options
• Pick case by MRN and date
• Pick case by MPOG case ID
• Pick random unreviewed case
• Pick already reviewed case
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App: Picking Case – Select by MRN and Date
• Select the “Pick case by MRN and date”
option
• Enter both the MRN and Date of
Operation (required for this selection
method), then click “Validate Case”
• Dates must be entered in MM/DD/YYYY
format
• The Case Validation screen will appear
• Confirm that the MRN and Date of
Operation match the intended case, then
proceed with validation
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App: Picking Case – Select by Case ID
• Select the “Pick case by case ID”
option
• Enter the MPOG Case ID, then click
“Verify Case”
• The Case Validation screen will appear
• Confirm that the MPOG Case ID
matches the intended case, then
proceed with validation
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App: Picking Case – Pick random unreviewed case
• Select “Pick random unreviewed case”
option
• Chose the appropriate month, service
type and location from their respective
drop down
• Screenshots on next slide
• Then click “Verify Case”
• The Case Validation screen will appear,
proceed with validation
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App: Picking Case – Pick random unreviewed case, date
and service type
• Date is displayed in YYYY/MM format and
represents the full calendar month
shown
• For example, 2025/08 includes cases from
August 1–August 31, 2025
• Select a surgical service from the
dropdown menu
• MPOG recommends reviewing cases from
different service lines each month to ensure
variables accurately reflect local
documentation
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App: Picking Case – Pick random unreviewed case,
location
• Optional: Select a location from the
dropdown menu
• This allows validation of cases across
different locations based on your
location mapping, which is especially
useful for institutions with multiple
sites in the same Import Manager
instance
• Location Mapping must be completed
before this option becomes available
(see Module: Getting Started – Location
Mapping)
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App: Picking Case – Picking an Already Reviewed Case
• Select the “Pick an already reviewed
case” option
• Choose a case from the dropdown
menu; the Date of Operation and
procedure type will display
• Click “Validate Case” at the bottom of
the screen
• The Case Validation screen will appear
• Confirm that the selected case matches
the displayed details, then proceed
with validation
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Case Validation
• Select a case using one of the previously
described options
• The Case Validation questionnaire will
display.
• Proceed through the questionnaire
validating if each item is correct or not
*For this training, PHI has been removed.
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Case Validation – Intraop Medications
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• Intraop medications are
divided into two sections:
• Intraop Medications not
administered as infusions*
• Infusion Medications and Fluids
*To avoid confusion and better reflect
all possible medication administrations
(eye drops, PO meds, etc.), the word
“bolus” has been removed
Case Validation – Intraop Medications
How does MPOG determine if a medication is an infusion?
• This is determined by site documentation, but the medications that MPOG typically expects
to see as infusions are listed in the table below.
• If an end time is not populated, infusion dose will continue until the start time of the next
administration for the same medication. If an end time is not populated and there is not an
additional administration, the infusion will continue until anesthesia end time. If the
infusion start time is after anesthesia end, the end time will default to 5 minutes after
infusion start.
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Not infusion Infusion
Medications given via the following routes: SQ, PO, IM, ID
Any medications administered via IV infusion (i.e., heparin, insulin,
propofol)
Medications given via IV push (i.e., versed, fentanyl, labetalol,
morphine, ondansetron, rocuronium)
Typically documented with start/end times with rate (
ie: ml/hr,
mg/kg/min)
Antibiotics (including vancomycin and other antibiotics that are
given over a longer period of time may be
considered boluses)
Case Validation – Answering Questions
• Answer each question as
“Correct” or “Incorrect” unless no
data is available (rows without
data will be highlighted in red)
• Compare each item to the EHR
and add comments as needed to
explain any discrepancies.
• To type in a comment, click anywhere
under “add comments here” column on
the appropriate row
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Case Validation – Reporting a Problem
For issues requiring follow-up with the site
technical team or coordinating center, use the
“Save As Image” button to capture a
screenshot (PHI is automatically removed)
• When prompted, save the image—the MPOG Case ID will
auto-fill as the file name; choose a location where it can
be easily accessed and click “Save”
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Case Validation – Viewing Tips
• May need 3-4 programs open at a time to verify the data in the MPOG case validator
“matches” the information present in the hospital Anesthesia Information Management
System (AIMS)
• It is recommended reviewers have 2 monitors/screens available for use
• Most likely will need intra-op record open on one screen and the MPOG case validator on
the other
• The source of truth varies per institution depending on the electronic documenting system
• For example: At the University of Michigan Health System, multiple systems are used for case validation:
• Centricity contains the Intra-op record, Anesthesia H&P, Case details.
• Epic: Inpatient record, used for validation preop medications and admission status
• Carelink: Previous EHR used for validating cases pre-dating Epic implementation.
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Case Validation – MPOG Case Viewer
• Opening the Case Viewer within the MPOG Suite can be helpful during case
review
• From the Case Validation Utility screen, click the “Open Case in MPOG Case
Viewer” tab in the top-right corner
• For more information, refer to the Data Review: Case Viewer module
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Case Validation – Missing Information
• If information is missing in the MPOG
database, the case validator will highlight
the affected row in red and disable the
Correct/Incorrect options
• If multiple cases are missing the same type
of data, record the MPOG Case IDs
• This may indicate an extraction or
documentation issue—coordinate with the
MPOG Informatics Specialist to determine
next steps
• See example screen shot
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Case Validation – Submitting Form
• After completing all questions for the selected case, click the “Save Answers”
button in the bottom-right corner of the screen.
• Once submitted, responses cannot be edited.
• Be sure to complete the case before closing, as answers will not be saved unless
submitted.
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Case Validation – Reviewing Saved Results
• Displays a summary of case validation results, including each question
• It shows the number of cases for the selected month with “No” responses and the
number with comments
• A column also identifies who reviewed each case
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Case Validation – Review Saved Results
• Selecting a question displays detailed case validation responses for
each case
• Use this view to identify cases with “No” responses for further
review; click “Hide passing questions” to filter out “Yes” responses
• Double-click any MPOG Case ID to open the case in the Case Viewer
• Review for patterns or trends (e.g., by case date), which can help
identify underlying data issues
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Case Validation Tips – Age & Labs
• For patients older than 90 years, select “Correct” for the question “Was the
patient’s age at the time of operation 90 years?”
• MPOG caps reported age at 90 years to reduce the risk of patient identification, as most
patients are younger than 90
• In the labs section, only hemoglobin, hematocrit, and glucose are evaluated
• These labs are limited to results from one day before through one day after the procedure;
no other labs within this timeframe are included
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Case Validation Tips – Incision Time
• If “Was surgical incision NOT FOUND” is highlighted in red:
• Is an incision time not expected,(e.g. labor epidural)?
• This is expected and the question can be skipped
• Is an incision time expected?
• The case may not have completed handoff; check the Import Manager Assistant to
confirm
• If handoff is complete, review the Import Manager Assistant for missing days and contact
your local Technical Support for assistance
• If additional help is needed, contact the MPOG Help Desk at support@mpog.zendesk.com
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Case Validation – FAQs
• Why does the date and time of operation show up as 01/01/0000 - 00:00?
• This case has not yet completed the data handoff process
• You may either select a different case to validate or save the MPOG Case ID and return in a
few days once handoff is complete
• To check handoff status, review the Import Manager Assistant (see Module: Data Review – IM
Assistant)
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