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Susan Dunn, Manager, ABF Workstreams Michael McDaid , Non Admitted Project Manager NSW ABF Taskforce May 2013

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)

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Susan Dunn, Manager, ABF Workstreams Michael McDaid , Non Admitted Project Manager NSW ABF Taskforce May 2013

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  1. Non-Admitted Patient Level data Collection in NSW Susan Dunn, Manager, ABF Workstreams Michael McDaid, Non Admitted Project Manager NSW ABF Taskforce May 2013

  2. 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(can’t cost if you can’t count them) • OOS to SE – relationship unclear (not transparent – LHD unable to unbundle) • Outdated policy directives and business rules • Obstacles to collection of patient level data: • Patient level data not required before – underinvestment • missing data due to lack of resources or reluctance to impact clinician time • lack of system extracts • many small clinical ‘off the shelf’ systems

  3. Coverage - NAPOOS • Risks Payment from Administrator is at Risk 37% 6%

  4. Current Data Collection Coverage $2 Billion State Data Respositiory (WebNAP) Unknown Unknown Known Unknown Known Systems not in WebNAP (eg ISOH) Patient Level Data 37%

  5. 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

  6. Key Challenge Service Event Concept Alien to clinicians Issue with immaturity of Tier 2 Clinic classification Complex/non Complex

  7. Key Challenge OOS to SE bundling Service Event 20.47 Rehabilitation Service Type 90 –Rehabilitation Provider type 13 – Medical Surgical Specialist Service Event 20.47 Rehabilitation Both receive NWAU = 0.0688

  8. Project Approach

  9. 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

  10. Project Approach- Roadshow & 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 • to identify LHD specific issues • to design solutions solutions and quick wins • building of a local implementation plan, risk register and business case

  11. 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 • follow up video conferences and visits • NAP project emails • all issues logged • solutions sheets with recommendations • Enabling of implementation plans • Populate a state plan

  12. Challenges arising from Roadshows and Workshops

  13. Challenges 5 Themes 150 issues logged during consultation • Data Collection • Data Extraction • Data Reporting • Resources • Change Management

  14. Solutions

  15. 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

  16. 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

  17. Evaluation Phase 1

  18. “Good day, topics flowed well. Very interactive” “Face to face opportunity to discuss NAP issues is much appreciated” “I now understand what I need to do, but I don’t know how to cost it” “It would be preferable to have a Statewide extract approach ” “more information on Community Health” “We need more sessions like this one” “Susan spoke to Fast”

  19. Questions?

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