Capturing and Funding the Patient Journey: an Organisation-

Wide Approach

Michelle StevensAssistant Coding and Casemix Manager

Auckland District Health Board

New Zealand

Overview

• A patient’s journey through the healthcare system

• New workshop introduced into ADHB Linking the patient journey Understanding and knowledge Benefits

New Zealand

• Population of 4.3 million

• Auckland Population of 1.3 million New Zealand’s largest city Largest Maori population Is the largest Polynesian city

District Health Boards (DHBs)

Auckland District Health Board (ADHB)

• Auckland City Hospital (ACH)

• Greenlane Clinical Centre (GCC)

• Auckland City Hospital (ACH) Provision of specialist services 9,000 staff 130,000 inpatient discharges annually 2 million patient contacts annually

• Greenlane Clinical Centre (GCC) 500,000 outpatients annually

Auckland District Health Board (ADHB)

Health Information Management Service at ADHB

Health Information Management Service at ADHB

Assistant Coding and Casemix Manager

Casemix education

• Data analysis

• Clinician liaison

• Coding

• Clinical forms management

• Medical terminology course

My Role

Capturing and Funding the Patient Journey

Capturing and Funding the Patient Journey

• Unique concept

• Targeted at senior managers

• Understanding the business

• Analogy

Capturing and Funding the Patient Journey

• Control expenditure and optimise revenue

• “Living within our means”

• Big picture perspective

• Key concepts

e.g. Casemix and WIES

• Subject matter experts Finance Payroll Materials management Decision Support Coding and Casemix

Capturing and Funding the Patient Journey

Clinical Coding and Casemix Component

• Snapshot of Clinical Coding

• Clinical documentation

• ICD-10-AM and DRGs

• Variables influencing DRGs

• Casemix and WIES

Interactive exercise

• Group work

• Identify diagnoses and procedures

• “Building the WIES”

• Documentation, DRG and WIES

Clinical Coding and Casemix Component

Data Quality

• Maintaining data quality

• Focus Duplicate National Health Index (NHI)

numbers Ethnicity data collection Demographic details

Clinical Coding and Casemix Component

Duplicate NHIs

• A complex problem

• Implications Clinical risk Administration inefficiencies

Clinical Coding and Casemix Component

Ethnicity data collection

• Funding linked to treatment of specific ethnic groups

Clinical Coding and Casemix Component

Demographic details

• Inter-District Flows (IDFs)

• 50% of ADHBs funding comes from IDFs

• Accurate identification is vital

Clinical Coding and Casemix Component

Concludes with

• Uses of coded data

• Action points for managers

• Resources

Clinical Coding and Casemix Component

Workshop Evaluation

• The content was relevant to my role

• The methods used assisted my learning

• The facilitator created a positive learning environment

Strongly Disagree Strongly Agree

Clinical Coding and Casemix Component

Feedback• Facilitator easy to listen to. Made a complicated

process a lot easier to understand• Easy to understand, relevant, excellent. Very

relevant & good tool to take back to staff who will also now be able to understand importance of documentation

• Good methods and presentation. Very clear

Clinical Coding and Casemix Component

Benefits

• Targeted information direct to services

• Establishes relationships and contacts

• Where to go for information

Clinical Coding and Casemix Component

Coding Service Profile at ADHB• Increased as a result of Capturing and

Funding the Patient Journey

• Increased understanding of the role Clinical Coding plays

• Increased understanding of the role participants play

Conclusion

• Increased understanding of the business

• Rise of the Clinical Coding Service profile

• Increased understanding of the Clinical

Coding Service role

• Influence and educate senior managers

who can affect change

Questions?

Please contact me:

Michelle Stevens

Assistant Coding and Casemix Manager

Auckland District Health Board

mstevens@adhb.govt.nz