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Capturing and Funding the Patient Journey: an Organisation-Wide Approach

Capturing and Funding the Patient Journey: an Organisation-Wide Approach. Michelle Stevens Assistant Coding and Casemix Manager Auckland District Health Board New Zealand. Overview. A patient’s journey through the healthcare system New workshop introduced into ADHB

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Capturing and Funding the Patient Journey: an Organisation-Wide Approach

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  1. Capturing and Funding the Patient Journey: an Organisation-Wide Approach Michelle Stevens Assistant Coding and Casemix Manager Auckland District Health Board New Zealand

  2. Overview • A patient’s journey through the healthcare system • New workshop introduced into ADHB • Linking the patient journey • Understanding and knowledge • Benefits

  3. 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

  4. District Health Boards (DHBs)

  5. Auckland District Health Board (ADHB) • Auckland City Hospital (ACH) • Greenlane Clinical Centre (GCC)

  6. Auckland District Health Board (ADHB) • 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

  7. Health Information Management Service at ADHB

  8. Health Information Management Service at ADHB

  9. Assistant Coding and Casemix Manager My Role Casemix education • Data analysis • Clinician liaison • Coding • Clinical forms management • Medical terminology course

  10. Capturing and Funding the Patient Journey

  11. Capturing and Funding the Patient Journey • Unique concept • Targeted at senior managers • Understanding the business • Analogy

  12. 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

  13. Capturing and Funding the Patient Journey • Subject matter experts • Finance • Payroll • Materials management • Decision Support • Coding and Casemix

  14. Clinical Coding and Casemix Component • Snapshot of Clinical Coding • Clinical documentation • ICD-10-AM and DRGs • Variables influencing DRGs • Casemix and WIES

  15. Clinical Coding and Casemix Component Interactive exercise • Group work • Identify diagnoses and procedures • “Building the WIES” • Documentation, DRG and WIES

  16. Clinical Coding and Casemix Component Data Quality • Maintaining data quality • Focus • Duplicate National Health Index (NHI) numbers • Ethnicity data collection • Demographic details

  17. Clinical Coding and Casemix Component Duplicate NHIs • A complex problem • Implications • Clinical risk • Administration inefficiencies

  18. Clinical Coding and Casemix Component Ethnicity data collection • Funding linked to treatment of specific ethnic groups

  19. Clinical Coding and Casemix Component Demographic details • Inter-District Flows (IDFs) • 50% of ADHBs funding comes from IDFs • Accurate identification is vital

  20. Clinical Coding and Casemix Component Concludes with • Uses of coded data • Action points for managers • Resources

  21. 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

  22. 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

  23. Clinical Coding and Casemix Component Benefits • Targeted information direct to services • Establishes relationships and contacts • Where to go for information

  24. 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

  25. 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

  26. Questions? Please contact me: Michelle Stevens Assistant Coding and Casemix Manager Auckland District Health Board mstevens@adhb.govt.nz

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