Transcript non-admitted patient level data collection in NSW

Non-Admitted
Patient Level data
Collection in NSW
Susan Dunn, Manager, ABF Workstreams
Michael McDaid, Non Admitted Project Manager
NSW ABF Taskforce
May 2013
Current Environment in NSW
 Mismatch between activity and costing (can’t cost if you
can’t count them)
 OOS to SE – relationship unclear (not transparent – LHD
unable to unbundle)
 Outdated policy directives and business rules
 Obstacles to collection of patient level data:
o Patient level data not required before – underinvestment
o missing data due to lack of resources or reluctance to impact
clinician time
o lack of system extracts
o many small clinical ‘off the shelf’ systems
Coverage - NAPOOS
37%
6%
 Risks
Payment from Administrator is at Risk
Current Data Collection Coverage
$2 Billion
Known
Unknown
Unknown
Unknown
Patient Level
Data
37%
Known
Systems
not in
WebNAP
(eg ISOH)
State Data Respositiory
(WebNAP)
Motivation to improve Non Admitted data
 IHPA Non admitted Commandments (or is that Compendium!)
– NWAUs at Service Event levels
– Tier 2 clinic based on service unit
 As System manager NSW is working blind
– Minimal patient level data
– Inability to run Non admitted costing
 Interpretation of Guidelines
– Struggle between classification guidance and policy decisions
– Use of PHE
– OOS to SE algorithm
Key Challenge
Service Event Concept
 Alien to clinicians
 Issue with immaturity of
Tier 2 Clinic
classification
 Complex/non Complex
Key Challenge
OOS to SE bundling
Service Event
Service Event
20.47
Rehabilitation
20.47
Rehabilitation
Both receive NWAU = 0.0688
Service Type 90 –
Rehabilitation
Provider type 13 – Medical
Surgical Specialist
PROJECT APPROACH
Project Approach - Communication
 Aim: coverage and consistency
 Senior Executive support
– Demonstrated extent of issue at LHD level
 Engage with key working groups
– ABF Non Admitted Working Group (NAWG) members
– NAPP PCG
 Workshops aimed at NAP Coordinators, IT & ABF staff
 LHD Roadshows to Executive, Clinical
Managers, Data Managers, Clinicians
Project ApproachRoadshow & Workshop Content
 General Non admitted & ABF Education
 Review of updated Policy, Business rules etc
 Explanation of Tier 2 classification and linkage
 Engage clinicians, technical and admin staff via a redesign
process to identify and prioritise NA issues at the LHD
o to identify LHD specific issues
o to design solutions solutions and quick wins
o building of a local implementation plan, risk
register and business case
Summary - Roadshow and Workshop Follow Up
 Ministry’s role to be visible and available throughout the
change process
 Coordination of state-wide initiatives
 Ongoing communication and guidance
o follow up video conferences and visits
o NAP project emails
• all issues logged
• solutions sheets with recommendations
 Enabling of implementation plans
 Populate a state plan
CHALLENGES ARISING
FROM ROADSHOWS AND
WORKSHOPS
Challenges 5 Themes
150 issues logged during consultation
A. Data Collection
B. Data Extraction
C. Data Reporting
D. Resources
E. Change Management
SOLUTIONS
Possible Solutions
 Exploring innovative methods of data collection
– Bar code solutions, eMR
 Extract Development
– Review Core, constant, divergent systems
– State co-ordination and negotiation
– Train Local builders
 State wide ABF Management tools to make reported data
transparent and meaningful (eg SE unbundling)
 Focused communication and ongoing education
 Business Process Redesign
Home Delivered Services
 Patient level for each patient administrated service
 Unwilling to put this burden of data collection onto clinical
staff
 Met with Renal Network, Renal Dialysis Network and
individual stakeholders to out line issue and to discuss
proposed solution
 Gained support and commitment to work with the solution
 Design phase has now commenced on a reporting solution
based on prescription, census and leave option
EVALUATION
PHASE 1
“Good day, topics
flowed well. Very
interactive”
“I now understand
what I need to do,
but I don’t know
how to cost it”
“We need more
sessions like
this one”
“Face to face
opportunity to discuss
NAP issues is much
appreciated”
“It would be
preferable to
have a Statewide
extract approach
”
“Susan
spoke to
Fast”
“more
information on
Community
Health”
Questions?