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Northern Territory Department of Health Library Services Historical Collection
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Your guide to news on Information Managem Systems Technology Proiects.
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HORIZONS
July & August 1997 - Edition No. 13
Horizons ... Your guide to news on Information Management and Systems Technology Projects
I N ' S I I > E
Coordinated Care Trials ... Pg 3 Casemix News & Updates ... Pg 3 Coding Update - ASH ...• ; ... ;Pg 4 Hospital Updates ···~···Pg 5 Clinical Initiatives ... Pg 6 Coding Matters ...•... Pg 6 Education ... Pg 7 Post Graduate Study in Public
Health - MSHR: ... , ... Pg 7 Information Systems Project Unit ... Pg 8 Marketing ... Pg 8
FRONT COVER:
BERNARD TIPILOURA TIWI HEALTH BOARD
LIAISON OFFICER
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APRIL
1997 -
WORKING ON THE TIWIFORLIFE CAMPAIGN,A TIWI HEALTH BOARD INITIATIVE
COORDINATED CARE TRIALS
Jenny Cleary, Project Manager gives an update of the project. ... ... ... Page 3
CODING IN ALICE SPRINGS ICD-10-AM Update
Overview of the new ICD-10-AM to be
implemented in 1998 ... Page 4
HOSPITAL UPDATES
Tennant Creek Hospital and Katherine Hospital give an update of what's been happening in these smaller hospitals ... Page 5
CLINICAL INITIATIVES Updates on Discharge Summaries, Morbidity Coding Audits, National Quality Indicators and Episodes of Care ... ... .. ... Page 6
INFORMATION SYSTEMS PROJECT UNIT
Overview of the project.. ... ... Page 8
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COORDINATED CARE TRIALS
The Katherine West and Tiwi Coordinated Care Trials are developing at a hectic pace, with work proceeding in areas ranging from supporting the development of Area Health Boards to implementing data management systems.
The trials will enable Community-
Representative Health Boards in both trial areas to manage a flexible pool of funding which consists of what is currently spent on the health care of the trial population plus ( - 1edicare and Pharmaceutical Benefits
Scheme funding at a national per capita average rate of usage.
Functions associated with care coordination will be integrated into participating
Community Health Centres through a review of existing work practices and identification of resources required for professional staff to
take on extra functions. THS services are being developed to meet the demands of the new style of service delivery.
An information system, which is the next incarnation of the Barunga Test System, is being developed and installed along with the required staff training in participating Health Centres. The information system will support both care coordination, efficient services of purchasing and provision, and evaluation of the trials.
The external evaluator for both trials will be selected over the next few weeks by THS and Health Boards. The evaluation will involve quantitative and qualitative methodologies, looking at such areas as health outcomes, accessibility of services, clients' satisfaction with the health care system, and the level and quality of service provision.
JENNY CLEARY-PROJECT MANAGER, COORDINATED CARE TRIALS - TELEPHONE
89 227083
(! If you have some information for Casemix ~~~
! News and Updates that would be beneficial ~~
i and stimulating to our readers in regard to our '-_; ~A ..
! current environment, please let me know. ~~/A_
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~~
I I Alternatively, if you wish to know more about a certain
1
aspect of Casemix and/or Casemix related projects, <c,"b I funding, fi~ancing or Information Technology, contact ~
I me and I will endeavour to seek answers for you . ~Q
I or point you in the direction of a contact ~ ~
I person... ~
KAY COOK - EDUCATION AND MARKETING COORDINATOR -TELEPHONE 89992749
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CODING UPDATE
IN ALICE SPRINGS
June, July and August have been extremely busy months in Alice Springs. With staff shortages and a Vacant Patient Services Managers position, the coding fell behind and useful initiatives, like the regular Senior Clinicians audit of Discharge Summaries ceased altogether.
I was invited to participate in the ICD-10-AM Dual Coding Study in Sydney at the end of July but had to decline due to work commitments in Alice Springs. It would have been a great opportunity to use ICD-10- AM and get a "feel" for how much extra coding time will be needed when ICD-10-AM is introduced (which impacts on the NT coder workforce and deadlines for morbidity data). Now we will just have to wait for the results in November 1997.
On 28 July 1997 Julia Feleppa began work as our Patient Services Manager. Julia was a welcome sight for my jaded coders eyes. Julia had worked as a Patient Services Manager at Central Districts Hospital in Adelaide, having gained her degree in Health Information Management from La Trobe University in Melbourne in 1991. Julia seems to have settled in well (taking the continual staff shortages in her stride).
With Julia now ensconced in the Patient Services Managers office, Jill Burgoyne and myself have spent most of August whittling down the imposing coding backlog. When the backlog has gone, we hope to resume the Senior Clinicians audit of Summaries from September 1997.
ICD-10-AM WORKSHOP
As part of their brief from the Commonwealth
Government to " ... assess and quantify the impact of the introduction ofICD-10-AM", Coopers & Lybrand Consultants (Adelaide) held two Workshops in Darwin at the beginning of September to discuss what the Northern Territory was doing about introducing ICD-
10-AM. Various people were invited to the workshop including coders, IT, Epidemiology, and Casemix personnel from THS as well as personnel from Darwin Private Hospital.
At the workshops, five main areas were discussed:
• HUMAN RESOURCES -
assessing the extent of the Territory's Coder Workforce (THS has 7.5 FTE coders who will need intensive training in ICD-10-AM) and identifying that their output will likely decrease in the short-term when ICD-10-AM is introduced. The extent of how much out wi II decrease will be indicated when the results of the Dual Coding Study become available.• CASEMIX FUNDING SYSTEMS -
identifying there is an need to examine AN-DRG Version 4.0 and 4.1 and be aware that V 4.0 uses ICD- 9-CM for DRG allocation, and V 4.1 will read ICD-10- AM and then map back to ICD-9-CM for DRG allocation.
• INFORMATION TECHNOLOGY AND SYSTEMS -
be aware that IT systems will have to be adjusted to read and accept ICD-10-AM codes in a user-friendly format. This means Caresys (and its Morbidity extract), Trendstar and Healthscope's computer systems will need alterations.• EDUCATION & TRAINING-this
includes intensive training for Coding staff, and other education sessions for regular morbidity data users such as Epidemiology staff and some Clinicians.• ASSOCIATED CODING SYSTEMS -
examining how collections such as the Mental Health Service, the Cancer Registry and Perinatal Statistics may be affected by the change to ICD-10-AM.
The workshop highlighted many areas that will need work over the next year before ICD-10-AM is implemented for all patient discharges from 1 July 1998.
THS has started moving on this (mainly though the efforts of Elizabeth Moss) and has received funding from the Commonwealth to assist with ICD-10-AM Implementation.
Some of the interesting points to come from the Workshop included, the possible introduction of an Encoder to assist Coders allocate ICD-10-AM codes and maintain data quality.
JANINE CASSIDY
HEAL TH INFORMATION MANAGER TELEPHONE 89 517866
WENNANT C!IREEK~OSPITAL
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PAMELA HALL - CLINICAL CODER - TELEPHONE 89624257
The coding position at Tennant Creek Hospital has been upgraded from 1 July 1997 to incorporate the Patient Processing and Revenue Optimisation Project. This project will implement new patient classification and charges policies, ensure new patient processes and procedures are in place, and implement new National Quality Indicator measures. The outcome of this project will ensure accurate data collection, and reflect in optimisation of revenue collection for Territory Health Services.
Tina Heriot who is a permanent Registered Nurse at TCH has been released from her nursing duties for three months to assist with this major project. Tina has a good understanding of the work process in Emergency and Outpatient Departments and is capable of developing and implementing change management strategies to ensure the project is successful.
The coding for June discharges has been completed and July's coding is near completion. Both of these months have been busy for Tennant Creek Hospital, perhaps due to the influx of tourists at this time of the year.
Timely completion of discharge summaries is an ongoing challenge. The acting Medical Superintendent has been informed of the backlog of summaries and is endeavouring to overcome this problem.
Some staff at Tennant Creek have become aware of the availability of statistical information that can be retrieved from the computer system. This information is in the form of lists of disease/illness and has assisted some members of staff with projects that they are involved with.
Vera McMahon in a very relaxed mood after an intense workshop on Trendstar!! The awareness of the usefulness ofICD-9-CM coding for statistics as well as funding is rewarding for me.
tf[ATHERINE ~OS PIT AL
MICHELLE PHILLIPS - BUSINESS MANAGER - TELEPHONE 89624257
Katherine Hospital currently has a Project Officer for the next six months. Jacqui Fox has been appointed to this position to focus on the implementation of all new and proposed modules in Caresys including the coordination of the training (trainers have been well utilised and very co-operative in providing after hours training sessions for those requesting them, and this has been very much appreciated).
Business Process Re-engineering, Clinical Indicator reporting and troubleshooting have also been part of Jacqui's scope of work. Flow charts showing pathways relating directly to Katherine Hospital have now all been forwarded to Craig Margetts for review and collation.
A questionnaire relating to the Emergency Module was initiated by Katherine Hospital and sent to all Territory Hospitals. All responses have been collated and forwarded to Jan Robbins for comments and follow up action.
Initial reaction to the module was not entirely positive but seems to be improving with familiarisation.
The Appointment Booking Module has continued to run smoothly in Katherine, being the first of two hospitals which went live 12 July 1997. Small problems have been encountered but these are continuing to be ironed out.
Budget reports are now being produced out of Trendstar and Patient Costing reports should not be too far in the future. Thanks to those that have assisted in making this happen.
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CLINICAL INITIATIVES
CLINICAL DATA
REVIEW OF DISCHARGE SUMMARIES, PRACTICES AND DOCUMENTATION
In May 1996, the THS Executive endorsed the
Policy on Written Communications for Inpatient and Outpatient Separations from NorthernTerritory Hospitals. It
was developed by the THS Casemix Clinical and Technical Reference Group (CCTRG) and based on a number of previous
studies.The Policy Statement is supported by Principles and Recommendations. The Policy Statement and Principles are non-negotiable however the
Recommendations are guidelines only and require consideration by the
·implementing bodies withrespect to their usefulness in assisting hospitals to meet the policy objectives and principles.
The THS Casemix Clinical
&Resource Management Project (CCRMP) Steering Committee has approved a six week project to develop a formal implementation strategy for all THS hospitals to progress the implementation of the policy.
COLLECTIONS
EPISODES OF CARE CLASSIFICATIONS SYSTEM
Presentations on the Episodes of Care
Classification Policy have been delivered to all hospitals with general positive responses.
Requests to visit hospitals to present this policy again are being received and will be arranged over the next few weeks.
A proposed additional paragraph to the Unqualified neonate classificationhas been circulated for comments before being presented to the THS Data Committee for endorsement.
The implementation of this policy will further classify the work performed forthelength 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 Policy and Guidelines for Hospital
Performance Indicators which has been included in each hospitals' Performance Agreementhas been Adam Gallow, Kerry Hanrahan and Di Styant will circulated to key people collecting data for these be interviewing key stakeholders, seeking opinions indicators.
Ithas been identified there needs to be regarding necessary requirements specific to their more functionality available in CareSys for the areas to assist in implementing communications users to be able to collect and analyse the data 0
relating to referrals, admissions and discharges. more easily.
KERRY HANRAHAN - ACTING PROJECT MANAGER - CLINICAL INITIATIVES PROJECTS - TELEPHONE: 89228258
CODING MATTERS
CODING EDUCATION NETWORK
The aim of the 'Train-the-Trainer 2' sessions was to train members of the Coding Education Network (CEN), both current and new members, along with representatives from the State Coding Advisory
Committees, State Health Department, 3M Healthcare and the Schools of Health Information Management.
A total of seventy-one people attended the workshops nationally.
Those people that had applied to become new members of CEN were assessed on the first day of training, by preparing and presenting a chapter from the ICD-9-CM Australian Coding Standards. This process allowed the National Centre for Classification in Health (NCCH) to determine the suitability of applicants
membership of the Network.
(Source - Coding Matters, Volume 4, Number 1, July 1997: ppl 1)
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THE NINTH CASEMIX CONFERENCE IN AUSTRALIA : As I write this article, The Ninth Casemix Conference in Australia will have been held in Brisbane during the week of 7-10 September 1997 and in the next edition of Horizons I will give an overview of the discussions that took place at the Conference.
ICD-10 IMPACT ASSESSMENT:
( \n independent assessment of the impact of the ,atroduction of ICD-10-AM, an Australian modification of the World Health Organisation's International Statistical Classification of Diseases and Health Related Problems - Tenth Revision (ICD-10), is to commence soon.
The new Australian modification will be a clinical classification for all Australian hospitals which
encompasses both diseases and procedures. It will be accompanied by an Australian procedure classification, based on the Commonwealth Medical Benefits
Schedule.
Implementation of ICD-10-AM has been endorsed by the Australian Health Ministers' Advisory Council (AHMAC). The Australian clinical procedure classification is due to become the national standard for morbidity coding from 1 July 1998.
Coopers and Lybrand Pty Ltd have appointed as consultants to conduct the independent impact assessment.
Education and training will occur prior to the implementation of ICD-10-AM .
KAY COOK -EDUCATION AND MARKETING COORDINATOR-TELEPHONE 89992749
POSTGRADUATE STUDY IN PUBLIC HEALTH MENZIES SCHOOL OF HEALTH RESEARCH AND
NORTHERN TERRITORY UNIVERSITY
( fhe Menzies School of Health Research invites applications for postgraduate coursework for the Graduate Diploma in Public Health and Degree of Master of Public Health awarded by the Northern Territory University. These courses are offered part-time through distance education and taught by staff of the Menzies School of Health Research and other health professionals in the Northern Territory. The courses are designed for health professionals working in northern and central Australia and give particular emphasis to remote area and Aboriginal health issues.
The programs emphasise important health issues in the Northern Territory and northern Australia particularly Aboriginal health and communicable disease and aims to provide health workers in the Northern Territory with the opportunity to learn public health.
Delivery of the course is designed to make it accessible throughout the NT including the more remote areas.
MASTER OF PUBLIC HEALTH (MPH)
The MPH program by coursework and treatise requires the successful completion of core, compulsory and elective units of
coursework and the submission of a treatise reporting a supervised research project. The coursework component may be completed on a part-time basis in a minimum of four semesters and the full program completed in a maximum of five years.
GRADUATE DIPLOMA IN PUBLIC HEALTH (DPH)
The DPH coursework, assessments and standards are the same as those for the MPH program and differ only in there being no research and treatise requirement. The time allowed for the completion of the diploma is between four and eight semesters.
APPLICATIONS CLOSE 30SEPTEMBER1997 (THIS DATE IS SUBJECT TO A SECOND ROUND OF APPLICATIONS) For more information and application forms please contact Liz Stubbs, Menzies School of Health Research, PO Box 41096,
CASUARINA NT 0811. Phone: (08) 89228596; Fax: (08) 89275187; Email: [email protected]
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PATHOLOGY
Planning for a new NT wide Pathology system is well advanced and contractual negotiations are under way with TRAK Systems who will be supplying the new system.
Tentative targets are for implementation of TCH by November 1997 and the other hospitals in first quarter 1998.
PHARMACY
Pre-qualification of prospective suppliers of a specialist Pharmacy Information system has been completed.
Tenders have been called from the short listed suppliers and it is expected that a result will be known by the end of October 1997.
COORDINATED CARE TRIALS
Planning is now well advanced and the first lot of equipment will be installed on the Tiwi Island in October 1997. Training in Office Systems and Coordinated Care Information System (CCTIS) will proceed over November and December.
The Katherine West sites will proceed after Christmas (December 1997).
COMMUNITY CARE INFORMATION SYSTEM
The business specifications for the various modules of this system (FYCS, Mental Health Aged & Disability and Community Health) have been completed.
During September development strategies will be assessed.
ANSOS (NURSE RESOURCEMENT MANAGEMENT SYSTEM) The viability of using this system for other shift areas is being investigated.
MURRAY BATES -DIRECTOR ISB -TELEPHONE 89 992822
HORIZONS BULLETIN PRODUCED BY:
BUSINESS INFORMATION MANAGEMENT BRANCH HEALTH HOUSE, MITCHELL STREET DARWIN
DIRECTOR
EDITOR/PUBLISHER DESKTOP PUBLISHING ENQUIRIES
PRINTED NEXT EDITION
STEPHEN MOO KAY COOK MICHELLE FIDOCK STEPHEN Moo 89992847 OR KAY COOK 89992749 GOVERNMENT PRINTER OF THE NT SEPT/OCTOBER 1997 -EDITION NO. 14
Government Printer of the Northern Territory
NATIONAL CENTRE FOR CLASSIFICATION IN HEAL TH
1997 ANNUAL CONFERENCE
19-21 NOVEMBER 1997
ADELAIDE
The theme of this conference will be
"The Future of Coding" to focus on :
• The changes in classification systems
• Innovations in information technology for classification systems
• Implications of changes for coders and other Health Professionals Contact Ms Karen Peasley, Project Officer -Education Services on telephone (02) 93 51 9461, fax (02) 9351 9603 or E:Mail
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MENZIES SCHOOL OF HEALTH RESEARCH
Postgraduate Research Scholarships are available from the Menzies School of Health Research for study leading to a higher degree in a wide variety of health -related areas including :
• Aboriginal Health
• Health Services Research
• Social Science
• Cross-Cultural Research.
For more information please contact Liz Stubbs on Telephone(08)
89228596 or Fax (08) 89275187 or email [email protected]
