Deloitte

VA MDE - DBQ Clinical Compliance Rules Engine

Coordinated a clinical documentation rules engine that caught DBQ compliance issues before they moved downstream

C# expressionsBusiness rulesOffshore delivery coordination

Impact

clinical errors reduced
800,000+

Highlights

  • Defined and coordinated the clinical compliance rule set for a DBQ business-logic engine, working with an offshore team that implemented the rules as C# conditional expressions reducing 800,000+ clinical compliance errors by the end of the year

Project Narrative

Completed DBQs had to satisfy the account’s clinical documentation requirements, and violations of those requirements created downstream compliance errors. To catch them at the source, we built a business-logic engine that validated clinical conditions directly within the DBQ. Therefore, encoding the requirements as conditional if/then rules that checked whether a form’s contents met each one and flagged violations before they propagated. In aggregate the engine reduced 800,000+ clinical compliance errors.

My role centered on coordinating the business rules with an offshore development team who implemented them as C# expressions. That meant translating the account’s clinical compliance requirements into precise, unambiguous conditional logic the team could build against, and managing that requirements-to-implementation loop across the two teams. The core challenge being to specify rules exactly enough that they were unambiguous to implement and correct against real clinical documentation.