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OPCS-4.7 Implementation

OPCS-4.7 Implementation. Preparing for implementation. Presented by Clinical Classifications Service. OPCS-4.7 checklist. Here’s a checklist to help you in planning and managing OPCS-4.7 implementation You may not find everything here necessary

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OPCS-4.7 Implementation

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  1. OPCS-4.7 Implementation Preparing for implementation Presented by Clinical Classifications Service

  2. OPCS-4.7 checklist • Here’s a checklist to help you in planning and managing OPCS-4.7 implementation • You may not find everything here necessary • But, it might help you identify what you need to happen. • Take what is useful for you and your organisation ….

  3. Topics covered • Overview of OPCS-4.7 • Implementation planning and strategies • Go live preparation

  4. Overview of OPCS-4

  5. Overview of OPCS-4.7 • OPCS Classifications of Interventions and Procedures, Version 4.7 • Commonly referred to as OPCS-4.7

  6. Overview of OPCS-4.7 What is OPCS-4? • Fundamental information standard and mandated for use by healthcare • Used to classify hospital interventions and surgical procedures for statistical purposes / secondary uses • Comprises list of alphanumeric codes organised into mainly anatomically based chapters

  7. Overview of OPCS-4.7 OPCS-4 applies to: • All “in-patient” episodes and day cases that contain surgical procedures and hospital interventions and must be coded to the mandated version of OPCS-4

  8. Overview of OPCS-4.7 OPCS-4.7 use cases include: • National data collections including Admitted Patient Care Commissioning Data Sets (CDS)   • Hospital operational and strategic planning to support business processes including reimbursement • NHS suppliers to build/update software to support NHS business functions and interoperability

  9. Overview of OPCS-4.7 OPCS-4 updating cycle: NHS implementation on: - 1 April 2006 1 April 2007 1 April 2009 1 April 2011 1 April 2014 OPCS-4 version: • OPCS-4.2 • OPCS-4.3 • OPCS-4.4 • OPCS-4.5 • OPCS-4.6 • OPCS-4.7

  10. Overview of OPCS-4.7 OPCS-4.7 compliance • 1 April 2014 • compliance date for NHS implementation of OPCS-4.7 • Inpatient episodes and day cases ending on or after 1 April 2014 will be coded using OPCS-4.7

  11. Overview of OPCS-4.7 NHS and system supplier formal notification • Advanced Notification (AN) – gives warning of update and implementation requirement published by the Information Standards Board on 10 May 2013: http://www.isb.nhs.uk/documents/isb-0084/amd-10-2013/index_html • Information Standards Notice – mandating implementation published by the Information Standards Board in November 2013

  12. Overview of OPCS-4.7 Impact of OPCS-4.7 change • Minor impact • Processes understood and in place • Requires upload of new data into systems • People ready and trained where appropriate

  13. Overview of OPCS-4.7 No change to architecture of OPCS-4 • new entries fall within existing chapters • Addition of new codes • Retirement of some codes • Modifications to existing code descriptions includes and excludes

  14. Overview of OPCS-4.7 New codes include: • Craniofacial procedures • Operations for disorders of sex development • Total ankle replacements • Subcutaneous cardioverter defibrillators • Peranal resection of rectum using staples (STARR procedure) • Leech therapy

  15. Overview of OPCS-4.7 Products delivered centrally • Draft Summary of Changes (Aug 2013) • OPCS-4.7 data files, technical specification and final summary of changes (7 Nov 2013) • OPCS-4.7 eVersion (Feb 2014) • OPCS-4.7 Tabular List and Index via The Stationary Office (Feb 2014) • National clinical coding standards Ref book (Feb 2014) • Coder self teach PowerPoint materials (Feb 2014) • Trainer materials (Feb 2014)

  16. Overview of OPCS-4.7 National Tariff • Healthcare Resource Groups will group to new codes • 2014-15 National tariff will include updates in OPCS-4.7

  17. Implementation planning and strategies

  18. Implementation planning and strategies Consequences of poor preparation • Compliance issues • Coding backlogs • Decisions based on inaccurate data • Incorrect reimbursement Problems can be mitigated with proper advance preparation

  19. Implementation planning and strategies Don’t delay getting started • Early initiation of the planning process, thorough preparation, adequate education and proper testing will result in smoother implementation and earlier realisation of benefits

  20. Implementation planning and strategies • Who is leading within your organisation to prepare a plan for implementation?

  21. Implementation planning and strategies Suggested timeline • Phase 1 – organisation readiness • Phase 2 – systems readiness • Phase 3 – coding readiness • Phase 4 – go live preparation Phases may vary, depending on the type, size and complexity of the organisation, phases may overlap

  22. Implementation planning and strategies Phase 1: • Project team established • Assess organisational readiness • Conduct survey of all business areas to determine extent of the impact • Analyse impact on all business processes Delay to impact assessment will jeopardise ability to complete all OPCS-4.7 implementation tasks by compliance date

  23. Implementation planning and strategies Phase 2: • Perform systems’ audit • Identify new or upgraded hardware or software requirements (if necessary) • Consider impact on electronic tools (eg encoders) • Ensure access to legacy data • Build flexibility of IT systems under development to ensure compatibility with OPCS-4.7

  24. Implementation planning and strategies Systems/applications potentially impacted include: Resource Utilisation Quality management Casemix systems Case management Financial Compliance software • Electronic Patient Record systems • Clinical systems • Patient Administration systems • Encoding software • Medical record abstracting systems • Decision support systems

  25. Implementation planning and strategies Determine your business readiness • Assess business associate readiness • Determine vendor readiness and timelines for software upgrades • Information Standards Notices are included in NHS Contracts but check: • Which systems upgrades or replacements are needed if any to accommodate OPCS-4.7? • Will upgrades be covered by existing contracts, what other costs are involved?

  26. Implementation planning and strategies Determine systemsupplier readiness • When will upgrades be available for testing and implementation? • What customer support and training will they provide if required? • How will their products and services accommodate OPCS-4.6 and OPCS-4.7? • How long will their products accommodate both code sets?

  27. Implementation planning and strategies Project plan is in place • Project lead to ensure all the activities and tasks required for local Trust implementation are included in the project schedule tracking tool and estimates for these tasks are regularly reviewed for accuracy

  28. Implementation planning and strategies Phase 3 • Review “draft summary of changes” available on NHS Classifications Service website from August2013 • Feedback where appropriate • Consider local impact of proposed changes and plan accordingly

  29. Implementation planning and strategies Gap analysis • Conduct gap analysis of coding professionals’ knowledge and skills • Assess coding professionals’ knowledge • Refresh coding staff’s knowledge as needed on basis of assessment results

  30. Implementation planning and strategies Assess quality of medical record documentation • Evaluate samples of various types of medical records to determine whether documentation supports level of detail found in OPCS-4.7 • Implement documentation improvement strategies where needed

  31. Implementation planning and strategies Coding and documentation - always work toward better documentation • Avoids misinterpretation • Provides a more accurate clinical picture of the quality of care provided • Supports current and future initiatives aimed at improving quality and improved patient care • Issues related to poor documentation must be resolved by the provider

  32. Implementation planning and strategies Determine education and training plan • Who will need education? • What type and level of education will they need? • How will the education be delivered? • Clinical coder training should not be provided until ? Months before implementation • Hospital inpatient coders require ? hours of training

  33. Implementation planning and strategies Consider education needs for data users Clinical department managers Data analysts Researchers Epidemiologists • Clinical coders • Information personnel • Clinicians • Senior management • Information technology • Finance • Auditors • Commissioners

  34. Implementation planning and strategies Data uses • Performance improvements • Corporate compliance • Data quality management • Data security • Clinical documentation

  35. Implementation planning and strategies Identify all implementation expenses and estimate associated costs including: • Education / training • Hardware/software upgrades if applicable • Staff time / Temporary or contract staff • Systems’ testing related costs • Data conversion • Maintenance of dual code set

  36. Implementation planning and strategies Additional implementation preparation steps • Refine project plan, timeline and budget as needed • Assess potential reimbursement impact • Develop strategies to minimize problems and maximise opportunities • Assess impact of • Decreased coding productivity • Decreased coding accuracy

  37. Implementation planning and strategies Register now …. • Agree the authorised person within the organisation to accept licence agreements on TRUD • Pre-register on TRUD for the OPCS-4 sub-packs in readiness to download the data files when released. Requestor to be notified when files become available.

  38. Go live preparation

  39. Go live preparation Phase 4 • Follow-up on readiness status of business associates • Develop contingency plan for continuing operations if critical systems or other problems occur when the OPCS-4.7 implementation goes live • Develop communication plan • Provide senior executives and stakeholders with updates

  40. Go live preparation Information Standards Notice (ISN) • Review ISN and Standard Specification and ensure business associates have read and are taking appropriate actions to meet planned deliverables (ISN published November 2013) • http://www.isb.nhs.uk/documents/isb-0084/amd-10-2013/index_html

  41. Go live preparation OPCS-4.7 data files • Download data files released via Technology Reference Update data Distribution (TRUD) in November 2013: • OPCS-4.7 codes and title • OPCS-4.7 metadata • OPCS-4.7 table of equivalences • Technical specification documents

  42. Go live preparation For terminology users • Download released data via Technology Reference Update data Distribution (TRUD) in March 2013: • SNOMED CT to OPCS-4.7 Cross-maps • Technical Specification document • Legacy data • Read Version 2 to OPCS-4.7 Cross-maps • Clinical Terms Version 3 to OPCS-4.7 Cross-maps

  43. Go live preparation Complete tasks identified in Phase 1 - during impact assessment • Implement system changes • Provide education to users • Implement and monitor documentation improvement strategies • Re-engineer processes and workflows identified in Phase 1 if necessary • Complete internal testing • Begin external testing once business associates are ready

  44. Go live preparation Training and education • Deliver local awareness sessions and training requirements previously identified • Ensure protected time for clinical coders • Download key learning points for coding departments • Register for: • Clinical Coding Standards – OPCS-4 • Purchase from The Stationary Office: • OPCS-4.7 Volumes I-II for clinical coders

  45. Go live preparation Data analysis • Determine impact on longitudinal dataanalysis • Will legacy data be converted? If so, how will it be converted? • Determine which data will be linked by using mapping applications and which data will be maintained separately according to the source code set

  46. Go live preparation Equivalences • Equivalences are mappings to assist users in navigating the complexity of translating meaning from the content of one code set to another code set • They should not be used for coding medical records • The OPCS-4 Table of Coding Equivalences is available in Excel from TRUD

  47. Go live preparation Continue to assess and improve coding documentation • Continue to assess quality of medical record documentation, implementation documentation and strategies as needed, and monitor impact of documentation improvement strategies • Coders should continue to gain familiarity with OPCS-4.7 codes and coding guidelines and improve skills in areas identified in gap analysis.

  48. Go live preparation Links to central resources Technology Reference Update data Distribution (TRUD) • http://www.uktcregistration.nss.cfh.nhs.uk/trud3 Health and Social Care Information Centre – clinical classifications service • http://systems.hscic.gov.uk/data/clinicalcoding/codingstandards/opcs4 New interactive environment that provides information about emerging and changing standards and encourages • http://www.infostandards.org Information standards helpdesk • Information.standards@hscic.gov.uk

  49. Go live preparation Lessons Learned • Implementation follow-up • What can you learn for next time? • What can we learn for next time? • Awareness Pack - let us know if it helped, and how we can improve

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