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Northern Territory Department of Health Library Services Historical Collection
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LTHS Casemix Clinical and Resource Management Projec Information Technology Strategy and other Casemix Related
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INFORMATION SYSTEMS PROJECT UNIT
+ Coordinated Care Trials System
+ Community Care + Pathology
- ..
ORIZONS
May & June 1997 - Edition No. 12
Special Information Bulletin for reporting on the THS Casemix Clinical and Resource Management Project, Information Technology Strategy and other
Casemix Related Projects I N S I D E
Information Systems Project Unit ... Pg 3-5 CareSys Update ... Pg 6 Coding Update ... Pg 6 Computer Support ... Pg 7 Education ... Pg 8 Marketing ... Pg 9 Hospital Updates ... Pg 1 O Clinical Initiatives ... Pg 11 Clinical Coder Retention ... Pg 12 Casemix Conference ... Pg 12
FRONT COVER:
THE TEAM
+O+
FRONT: Margie McLean, Joanie Evans, Steve Pearson and Doreen Dyer
MIDDLE:
BACK:
Paul Gooding, Carolyn Wilson and Murray Ba
Peter Krau
PAGES
3, 4
AND5
INFORMATION SYSTEMS PROJECT UNIT
New unit created to tackle large and complex projects. Information Systems Project Unit is up and running ... Page 3, 4 & 5
CARESYS UPDATE
Booking functionality has been enhanced with the implementation of billing and appointments module ... Page 6
CODING UPDATE
New diagnostic and procedure codes ICD-10- AM, to be more user friendly ... Page 6
COMPUTER SUPPORT C
Busy, Busy, Busy! THS doubles the number of PCs in 18 months ... Page 7
EDUCATION
Presentations are GO! Casemix education in high demand with new projects being rolled out. ... Page 8
Central Library
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~ ... / ... /1997
:AL INITIATIVES
1arge Summaries, Morbidity Coding Audits, National Quality Indicators and Episodes of Care ... Page 11
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With the number of large and complex projects to be undertaken over the next two to three years the Executive have formed a new unit, Information Systems Project Unit (ISP), to specifically focus on the development and implementation of approved IT projects.
The broad structure of this unit is as follows:
Ass Sec I Corporate Services
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Director ITS Director ISP I Murray Bates Director BIMProject Officer
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Project Manager I Steve Shave Snr Project Manager I Paul Gooding Snr Project Manager I Coralie Christie
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Data Management Project (DRUID) Implementation I Training Team Application Software Projects Team
From the above diagram it can be seen that the unit has close ties with Information Technology Services and Business Information Management. At the time of writing the following projects are underway and their status is described further in this article:
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Coordinated Care Trials System*
Community Care*
Pathology*
Pharmacy*
CareSys Stage III*
Data Management (DRUID)DATA REPOSITORY FOR UNIFIED INFORMATION DELIVERY (DRUID) DATA WAREHOUSING PROJECT
The processes of extracting and analysing information from business systems, such as CareSys, is not new to THS however as the requirement to provide a rich source of business an clinical information to the people who need it grows, so will the management, security and knowledge of this information become increasingly important to THS.
The DRUID project has been initiated to improve the Information Service Environment that will enable access to corporate information for business and clinical analysis. This project will provide the basic tools, for use by THS staff, to access information and manage that information such that a User may understand the meaning, accuracy and history of the information available to them.
The first two stages of the DRUID project will be completed by December 1997, providing THS with the technical environment and information management tools for use by THS staff. Stage three of the project, to commence early 1998, will provide THS staff with the software tools to facilitate analyse of the corporate information, with the least User effort.
existing Pathology System
to a new version for all NT public hospitals. This
project will include:
Contract development and negotiation with the system vendor.
Specification and development ofTHS specific functional requirements.
The development of interfaces to CareSys for results reporting of Pathology services.
The development of an interface to the Trendstar Clinical Costing System for costing of Pathology Services at the patient level.
Implementation of the system is planned by the end of the 4th quarter, 1997.
Preselection of systems that meet THS functional requirements.
Selection of system (tender).
Contract development and negotiation with selected system vendor. - - -....
Specification and development ofTHS specific functional requirements.
new Pharmacy Information System for NT public hospitals.
This project will include:
The development of interfaces to Care Sys for results reporting of Pharmacy services.
The development of an interface to the Trendstar Clinical Costing system for costing of
Pharmacy Services at the patient level. --~
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Implementation of the system is planned by the end of the 2nd quarter, 1998.
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IS Development of a ~
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Community CareS
Information System. This
project will include:
Finalisation of functional specification documents.
Finalisation of development strategy and module delivery timeframes.
Contract development and negotiation with selected system vendor.
Development of core modules.
Development of specific business modules.
The development of interfaces to Care Sys for referrals and discharge summary information.
Implementation of phase 1 of the system is planned by the end of the 2nd quarter, 1998.
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Development of a~
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Coordinated Care $r0 ~
U Trials system to
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support the trials being undertaken in the Tiwi and Katherine regions.
The project will include:
Specification of functional requirements.
Gap analysis of the Barunga Trial System and functionality required for the Coordinated Care Trials.
Development of the system using the Barunga Trial System as the base.
Implementation of this system is planned for Tiwi islands by end of December 1997 and West Katherine by end ofF ebruary 1998.
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Business case to expand the usage of ANSOS staff
management system to other areas (medical, pathology, etc).
Based on the Barunga Test System, it
is to be implemented
for the Tri-
Birthing module.
Discharge Summaries.
A tracking system will be
implemented, based on the Barunga Test
System.
Further
development of requirements for computerised discharge summaries.
MURRAY BATES-DIRECTOR ISP - TELEPHONE 89 992822
Further development of
CareSys is planned in the following key
areas:
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The project iscj
developing a database to manage the CommunityProfile Information.
Gillian Hall is coordinating the
delivery of the overall project.
Upda~e
During July new functionality for patient billing and appointment scheduling is being implemented to support the new Patient Classification and Charging policies and enhance appointment booking functionality.
The Billing module will provide the ability to generate accounts for paying clients via CareSys using the patients financial classification and specific service costs as defined in the system.
The Appointment Booking Module has been developed to use graphical screens that operate in much the same way as a diary, providing users with great flexibility in how they make appointments, find free appointment slots and record() when patients have arrived, been seen and leave the clinic.
It is planned to use the new Appointment Booking Module for all clinics that operate within hospitals, although initially the focus will be on Specialist Outpatient Clinics. Consultation with Allied Health clinics will be undertaken to determine if the module can meet their needs.
Further information can be obtained from Jan Robbins, Hospital Systems Manager on 8999 2973 .
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~~~--- CO DING UPDATE
MORBIDITY CODING
Things have been busy down in the Centre ...
At the end of May, I attended a two day workshop in Adelaide on ICD-10-AM which introduced the new diagnostic and procedure codes to the
members of the NCCH Coder Educators Network.
It was an excellent workshop.
The trauma coding section looks quite different and there has been a vast improvement in Disease classification in certain specialist areas such as orthopaedics and renal diseases. The new procedure codes are based on the Medicare
Benefit Schedule codes and therefore will be more user-friendly for doctors. The new procedure codes are far more extensive for specialist areas such as Plastic and Orthopaedic surgery
classification.
The next two day workshop will be in
September/October. Territory Health Services
will be organising education sessions for ICD-10-
AM over the next few months.
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I also attended a Trendstar Course in Darwin with Andrea Morrison, Pam Hall and Susan Paltridge.
I have also been working with Elizabeth Moss and Jack Luchjenbroers in "cleaning up" the current ICD-9-CM Table in Caresys, so that ICD-9 data for the next financial year will be of an improved quality.
During May-June, Alice Springs Hospital had a Coder from the Women's and Children's Hospital come to work for us while she was on holidays.
She was amazed at the variation in Casemix we had in Central Australia and her efforts in coding have helped us to not fall too far behind with our coding while I fill in as Patient Services Manager.
JANINE CASSIDY -HEALTH INFORMATION MANAGER- TELEPHONE 89517866
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COMPUTER SUPPORT
Haven't we been busy ! ! ! !
In January 1996 there was a total of about (accurate figures were impossible to get at that time) 950 PCs in the Department. Many of these
only had 4MB or 8MB of memory (RAM) and many were also old '286' and '386' processor configurations . Today, we have a total of 1946 devices, all of which are of at least a 486 processor configuration with 16MB RAM. We have 1723 PCs and 223 Laptops. The Department has doubled the number of PC's in just on 18 months and we are still ordering approximately ten PCs and laptops a week. When is it going to stop??
Nearly half of the Department's PCs are on the new Computer Support Package, the breakdown being 927 on a package and 1019 purchased prior to the packages being available.
We have essentially doubled the number of PCs in the Department and have maintained existing
example, we are bolstering the existing nominal single position on the Help Desk to four full time staff and providing a position to focus full time on managing and improving the level of service provided at the Help Desk.
In conjunction with the restructure of Computer Support, a number of new software support tools are now coming on line to enable our staff to be more efficient. For example, in the immediate future you may be asked to enable the Help Desk and other support staff to take "remote control" of your PC to fix problems over the network without having to physically visit your PC.
Information Technology (IT) staff are no different to any other area of the Department. We also have to continually
look at ways of taking on the challenge of
improving our level of service, without additional resources, to an increasing ( ')mputer support staff levels. Computer Support
are in the middle of a restructuring process to allow us to even more efficiently and effectively support this enormous number of devices. For
number of clients and in an increasingly complex technical environment.
It is a challenge we are determined to meet.
PAUL HENDERSON - COMPUTER SUPPORT - TELEPHONE 89228383
Horizons Bulletin welcomes letters to the Editor regarding topics of interest, information that would be of interest to our readers or any queries or concerns that you may have
about previous articles.
Kay Cook - Editor
cc:Mail address - Cook, Kay - Health email address - [email protected]
With the build up to the new financial year, there are many projects that have been taking off, and as you can imagine education for these projects has been extremely busy.
CLINICAL INITIATIVES
EPISODES OF CARE, AUTOMATED DISCHARGE SUMMARIES AND MORBIDITY CODING
ASH has now been completed even though there were a couple of wards that were unavailable for these presentations as emergency call-outs restricted them from attending. Gove District Hospital has also had presentations to an excellent attendance of around eleven doctors with many questions on this new direction.
The presentations will continue with the other hospitals and look forward to completing as soon as possible.
ORIENTATION
Again Orientation in relation to Casemix has been presented to large groups of new staff including nurses and Allied Health Care professionals. Feedback from the evaluations has been very positive in providing these new staff with a complete overview of where THS is, in regard to Casemix and its related projects.
CASEMIX EDUCATION
Many of the Community Care Centres have had education sessions on Casemix and the remaining Centres have been booked during the next few months. Many of these Centres are hungry for information and I have advised them that I will give ongoing presentations in regard to the current status of Casemix and its related projects.
PROJECT OPTIMISATION - BOOKING AND BILLING MODULES
I facilitated a four day workshop for Patient Services Managers and some of their staff plus the IT Trainers who are responsible for the training of staff for these two new modules.
The workshop's objectives and benefits were to:
• Increase Hospital Revenue through identification of private, interstate, compensable & ineligible patients.
• Change work culture to achieve an informed staff show focus on revenue optimisation.
• Introduce incentives for revenue optimisation.
• Implement changes in work practices to support timely & accurate data capture.
• Implement reporting methods/tools.
• Achieve consistency in financial data collection throughout THS hospitals.
The workshop covered all of these areas and there were many issues and concerns that were brought up by participants in relation to their own unique hospital environment. I recorded all of the issues and concerns into an action plan which Coralie Christie presented to the Steering Committee for resolution.
Following on from the workshop, I then undertook a series of presentations to all hospitals for their Patient Services Providers to inform them of these policies and guidelines that are to be implemented into all hospitals from the new financial year.
These presentations were back to back with the IT Trainers so staff were firstly taken through why THS was implementing these policies and guidelines and then they undertook their 'hands-on' computer training.
Both the presentations and 'hands-on' training were from 4 June to the end of June 1997.
I have had a very busy two months however I am looking forward to further education sessions and presentations in the future under the Casemix umbrella.
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MARKETING
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I hold a variety (only small however) of Casemix
information in the form of books and bulletins.
If
anyone would like to glance at any of these please give me a ring.The Central Library situated at RDH Campus, Building Four, hold a much wider range of Casemix articles both in printed form and through the Library Database. Give
them a ring and they will assist you in your needs.
KAY COOK
EDUCATION AND MARKETING COO RD INA TOR TELEPHONE 89 992749
The ICD-10-AM Implementation Kit has been
designed to enable Australia prepare for the introduction of ICD-10-AM on 1July1988 ....
For further information contact Janelle Craig on telephone (02) 9351 9345
Christopher 'Cookie' Jensen, tireless worker in the Katherine Hospital Storehouse, was awarded the Katherine Regional Territorian of the Year
by the Hon. Mike Reed MLA, during Territory Day celebrations held in Katherine.
The former 'Mr Cookie', now to be known as 'Sir Cookie' was recognised for his contribution to Rugby League in the Katherine
District. and particulaliy for his involvement in establishing the Junior and later Midget competitions.
~ATHERINE ~OSPITAL
MICHELLE PHILLIPS.-TELEPHONE 89 739233
Hospital Budgeting Models and Performance Agreements have been on top of the agenda for the past few weeks, along with all the end of financial year procedures. Fortunately for Katherine Hospital, Jan Marlborough was able to come down and do a presentation to the Hospital Executive Team about some of the finer points of the Modt:El and the Performance Agreement. This provided the relatively new Team here in Katherine with some useful information and was well received. Many thanks Jan.
Kay Cook presented a number of information sessions in Katherine recently, in an attempt to capture and advise all the staff of the new modules which are to be implemented from 1 July onwards.
Unfortunately attendance numbers did not break any records, but for those staff who did attend, they are aware that there is a lot of work (and interesting times) ahead for us all!
J\,LICE ~PRINGS ~OSPITAL
CHRIS BURROWS - BUSINESS MANAGER - ASH - TELEPHONE 89517598 Since our last report, the Patient Processing & Revenue Optimisation Project has been most active in workplace process re-engineering projects in Alice Springs. Ruth Coles and Rose Murphy have reviewed and documented work flows and practices and identified gaps in current data collection.
Their recommendations included improvements designed to assist patients such as improved signage, privacy in waiting and reception areas, communication and coordination of travel from remote areas.
In addition, consideration has been given to improving work flow and impact of new billing
requirements. Rose will continue to smooth the transition process over the next two to three months, whilst Ruth has returned to her role as After-hours Nursing Coordinator. At the time of writing, training is under way to prepare staff prior to implementing the new CareSys modules.
ASH has had a number of visitors and opportunities to contribute to policy and practical changes to improve hospital revenue collection and information management. Thanks to Jan Marlborough, Jan Robbins, Kay Cook, Kerry Hanrahan and Karen Weston for their redoubtable efforts.
Our hard working Medical Records Administrator, Janine Cassidy, has found time to write reports on inpatient activity and morbidity into Trendpath to satisfy clinicians' inquiries. Janine has found Trendstar a powerful data management tool that provides local reporting and feedback from all those discharge summaries and morbidity coding. Trendstar also proved useful in providing some interesting data to impress the Commonwealth Grants Commission in their visit to ASH in June. During 1997 /98, our Hospital will utilise Trendstar' s data management and reporting capabilities to provide financial management reports.
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CASE MIX NEWS AND UPDATES
If you have some information for Casemix News and Updates that would be beneficial and stimulating to our readers in regard to our current environment, please let me know. Or alternatively, if you wish to know more about a certain aspect of Casemix and/or Casemix related projects, funding, financing or Information Technology, contact me and I will endeavour to seek answers for you or at least point you in the right direction ... .
I KAY COOK-TELEPHONE 89 992749
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CLINICAL INITIA TIVBS
CLINICAL DATA COLLECTIONS
REVIEW OF DISCHARGE SUMMARIES, PRACTICES AND DOCUMENTATION
Responses have been received with regards to a request for input from Medical Superintendents and Divisional Heads in all NT hospitals. The request sought opinions on auditing processes, intentions regarding identified deficiencies and responses to review other aspects of their discharge summaries.
( .. request came forward for an informal audit on discharge summaries for Airmed patients brought to Emergency Department at ASH, but not
admitted, during the month of May. This audit has been completed and a report will follow.
These informal audits will be of value to the doctors and coders in each hospital and gauge progress in working to improve quality of discharge summaries.
EPISODES OF CARE CLASSIFICATION SYSTEM
Presentations on the Episodes of Care
Classification Policy have been delivered to Gove and Royal Darwin hospitals. This week
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presentations will be delivered to Alice Springs and Tennant Creek hospitals. The following week Katherine hospital will be visited. These
presentations will be available on an ongoing basis to educate staff about Episodes of Care
Classifications.
The implementation of this policy will further classify the work performed for the length of stay for each patient. All episodes of care will be linked by the automatic allocation of a code identifying the statistical discharge and the statistical admission.
NATIONAL QUALITY INDICATORS AND OUTCOMES MEASURES
The draft Policy and Guidelines for Hospital Performance Indicators document has been
finalised and copies will be circulated to members of the Casemix Clinical and Resource
Management Project Steering Committee for comments. This document has been included in the Performance Agreements for each hospital.
KERRY HANRAHAN - A/CLINICAL PROJECT MANAGER - CASEMIX - TELEPHONE 89228258
DR JAMES JARVIS
'A
PIONEER IN THE CLINICAL CASEMIX ARENA FOR TERRITORY HEALTH SERVICES'James was both loyal to his profession and Territory Health Services and committed to the successful introduction of Casemix whilst ensuring health
outcomes were not compromised.
Colleagues remember James as a quiet achiever whose outstanding courage is a lesson to us all.
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CLINICAL CODER RETENTION IN TOP END HOSPITALS
The recruitment and retention of Clinical Coders was a difficult task in the Top End and the solution to the problem was to draw upon the existing workforce to meet our needs. I was able to attract people to
undertake the HIMAA Distance Education Course in Medical Terminology and ICD 9 CM Coding (Basic).
Fortunately with the assistance of the Business Information Management Unit, selected students were able to have their course fees reimbursed upon successful completion. I have been involved in the education of 19 students, 15 of which are Territorians. Almost all of the Clinical Coding positions (including the Private Hospital) in the Top End are filled by students of the Distance Education Course. This successful campaign to use the talents and skills of interested or existing employees in the NT shows that effort, innovation and thoughtful planning has been advantageous to Territory Health Services.
The HIMAA Distance Education Centre is a professional body engaged in providing comprehensive educational and training courses for the health service industry. The Centre conducts courses in:
• Medical Terminology course
• ICD 9 CM Coding (basic) course
• Accelerated ICD 9 CM Coding (basic) course
For further information contact Andrea Morrison (Health Information Manager) - Royal Darwin Hospital Telephone 89228621 or via cc:Mail.
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HORIZONS BULLETIN PRODUCED BY:
BUSINESS INFORMATION MANAGEMENT BRANCH HEALTH HOUSE, MITCHELL STREET DARWIN DIRECTOR
EDITOR/PUBLISHER DESKTOP PUBLLISHING ENQUIRIES
PRINTED NEXT EDITION
STEPHEN MOO KAY COOK MICHELLE FIDOCK STEPHEN Moo 89992847 OR KAY COOK 89992749 GOVERNMENT PRINTER OF THE NT JULY/AUGUST 1997 - EDITION NO. 13
THE NINTH CASEMIX CONFERENCE IN AUSTRALIA
BRISBANE CONVENTION &
EXHIBITION CENTRE 7 - 10 SEPTEMBER 1997 The 1997 Casemix Conference in Australia will be the ninth in the series of conferences held nationally in this country.
Quality, Continuity and Cost- effectiveness will be the three key themes of the Casemix Conference to be held in Brisbane from 7 - 10
September 1997. The Conference will address major contemporary issues in enhancing quality, cost-effectiveness and continuity in health between the hospital and the community.
The conference will also provide a forum for discussing Casemix developments in both the public and private sectors and Conference sessions will be devoted to providing updates on development in classification and Casemix activities at the State and Territory level. The Conference program will include plenary sessions, panel discussions and workshops on particular issues, including practical traininlZ in the use ofICD-10.
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