Codefile Quarterly Newsletter of the

Codefile Quarterly Newsletter of the Queensland Coding Committee Contents Page E-Bulletin Volume 24 Issue No. 36 Inside this Issue 1 2 3 Coding Auditing/ Education Update Codefinder Update Performance Indicators for Coding Quality (PICQ) Update 4 Coding Standards Advisory Committee (CSAC) Update 5 ICD-10-AM 7 th Edition 6 QCC Update 7 Pilot collection of MRIC & NACSC (Known in HBCIS as OCOI) 8 Coders InSite 9 Codefile Comments, Queries and Suggestions Queensland Coding Committee Statistical Standards Unit Health Statistics Centre 1. Coding Auditing/ Education Update Sadly, Harry Georgas has left the CAE team to join SIM 1 as an Applications Specialist. On a brighter note, Philippa (Pip) Way was recruited to work (temporarily) in the CAE team up to mid-february. Pip is a highly experienced coder, with a strong clinical background, from the Princess Alexandra Hospital. Pip brought with her a high level of expertise and a joyful attitude. Thanks Pip for coming over to us! Julie and Pip completed an audit at the Royal Brisbane and Women s Hospital. Audit reports for Townsville, The Prince Charles, Gympie and Caloundra hospitals are currently being reviewed. 2. Codefinder Update The Statistical Standards Unit (SSU) continues to provide Codefinder support to all public hospital clinical coding personnel. The 3M Codefinder version 5.2.4 roll-out to all Queensland Health facilities is underway. If after the roll-out you do not have version 5.2.4 installed on your PC, please contact the Help Desk on 1800 198 175. The latest Codefinder pathway issues list (the Bug list ) is now available on the Coders InSite Website: http://qheps.health.qld.gov.au/qhcs/home.htm Please refer to this list if you find an issue with a coding pathway or any other Codefinder functionality. The bug list is a very useful document containing work-arounds for known pathway issues in Codefinder. If you encounter an error with a Codefinder pathway that is not on this list, please contact Codefinder Support Officer at Codefinder@health.qld.gov.au or phone (07) 3224 7833. Clinical Coders in Queensland Health facilities who require Codefinder assistance should contact the Codefinder Support Officer at Codefinder@health.qld.gov.au or via phone (07) 3224 7833. Support issues include reporting faults or issues with any of the coding pathways and advice and assistance with the use of certain Codefinder features. Queensland Health GPO BOX 48 BRISBANE 4001 (PICQ2008 TM ) from the National Centre for Classification in Health (NCCH). 3. Performance Indicator for Coding Quality (PICQ2008 TM ) Update The Health Statistics Centre (HSC), has purchased a state wide licence for Performance Indicators for Coding Quality 2008

All Queensland public and private hospitals that supply Queensland Health with coded morbidity data are eligible to obtain a copy of PICQ2008 TM. The HSC has provided PICQ2008 TM free to all requesting public and private hospitals and Health Service Districts that provide coded hospital morbidity data to Queensland Health. The PICQ2008 TM version contains a series of indicators that analyse admitted patient hospital morbidity data coded using ICD-10-AM 6 th edition and the Australian Classification of Health Interventions (ACHI) 6 th Edition. If you have not yet asked for your copy of PICQ2008 TM, please see the Coders InSite website or the Queensland Coding Committee website to request a version of PICQ2008 TM. 4. Coding Standard Advisory Committee (CSAC) Update CSAC is currently essentially in hiatus as we have finished the changes for 7 th Edition. 5. ICD-10-AM 7 th Edition Education The NCCH has announced ICD-10-AM/ACHI/ACS Seventh Edition education for 2010. Education material containing all the changes that have been made to ICD-10-AM Sixth Edition to create the Seventh Edition will be provided via: 1. A downloadable PDF file via the web; and 2. One day face-to-face workshops A workbook with a number of case scenarios and clinical record abstracts, to help illustrate the changes, will be distributed to participants for completion prior to attending the workshop. A fee of $ 198 (incl. GST) will be charged for attending the workshops. The schedule for Queensland workshops is as follows: 13 May Rockhampton 1 June - Brisbane1 2 June Brisbane 2 3 June Brisbane 3 3 June - Cairns 4 June Toowoomba 23 June - Maroochydore All pre-education material can be accessed on the NCCH website. 6. QCC Update The Queensland Coding Committee has had a brief holiday and did not meet in January. The first meeting for the year was held on 11 th February. A large number of queries were addressed. The next meeting for QCC is scheduled for 11 th March at Redcliffe Hospital. If you are interested in being informed of a response to a query that is not yet available on the QCC website, please email your request to QCC@health.qld.gov.au. We will email you the query response when it has been ratified by the Committee. 7. Most Resource Intensive Condition (MRIC) Indicator and Non-Australian Coding Standard Compliant (NACSC) Indicator Pilot The volunteer pilot collection of the new indicators, the Most Resource Intensive Condition (MRIC) Indicator and the Non Australian Coding Standard Compliant (NACSC) Indicator (known in HBCIS as OCOI) continues. Participation in this pilot is only for hospitals that have been permitted by their District Managers/Chief Executive Officers to take part. All other hospitals are welcome to collect these indicators once they have appropriate executive approval. SSU is currently reviewing the data that we have received so far from the opt-in pilot.

There have been difficulties with the analysis of the data received so far. Collection of the indicators was not consistent amongst the volunteer facilities throughout the August December 2008 period. During August 2008 a fault in HBCIS functionality was identified, where the NACSC Indicator was incorrectly included in the DRG grouping and calculations. As a result, pilot participants were requested to cease collection of the NACSC and MRIC until the issue was rectified in September 2008. Additionally, throughout September and December 2008 industrial action impacted upon the collection of the MRIC and NACSC Indicators. As a result, data collected during this period was not reliable and could not be used in analysis. After these issues were resolved, six facilities continued to participate in the pilot. These facilities re-commenced collecting the MRIC and NACSC Indicators from 1 January 2009. The SSU is continuing to review the pilot data and considering options for the future. If you are interested in volunteering first ensure that your facility has permission from your District Manager / Chief Executive Officer to take part in the pilot of the MRIC and NACSC indicator collection. Once permission has been confirmed, then please contact the Statistical Standards Unit contacts: Corrie Martin via phone (07) 3234 1001 or email Sabina_Martin@health.qld.gov.au 8. Coders InSite The Coders InSite website http://qheps.health.qld.gov.au/qhcs/home.htm has been updated with new documentation on 3M Codefinder version 5.2.4. Also, information on PICQ2008 TM program has been placed on the website. Other changes to the website include the new version of the Summary of ICD to DRG version in Queensland and a revamp of the Membership page. Did you know that the Coders InSite website has a Clinical Coding Pool webpage? http://qheps.health.qld.gov.au/qhcs/html/careers_pool.htm This page offers a free service to individuals from Queensland Health facilities with relevant coding qualifications to submit their availability to the Coding Pool. Your information will be displayed on the intranet for any Queensland Health personnel to peruse and possibly contact you if they have any clinical coding vacancies (for example, short term contracts). There is also a vacancies page: http://qheps.health.qld.gov.au/qhcs/html/careers_vacancies.htm This is a free service for individuals from Queensland Health facilities to submit vacancies limited to short-term contracts, expressions of interest and temporary vacancies related to Clinical Coding. To register your details on the Clinical Coding Pool or the Vacancies webpage please do so via the Coders InSite website. If you have a coding resource you would like to submit to Coders InSite, or an event you wish to advertise, please contact the Data Quality team at qcc@health.qld.gov.au. There are also helpful guidelines on how to submit a resource, located on the Coders InSite website: http://qheps.health.qld.gov.au/qhcs/html/publish_process.htm 9. Codefile Comments, Queries and Suggestions Please forward your Codefile comments, queries or suggestions to: The Convenor, Queensland Coding Committee Statistical Standards Unit Queensland Health GPO Box 48 Brisbane QLD 4001 Telephone: (07) 3234 1001 I Facsimile: 07 3234 0564 I Email: QCC@health.qld.gov.au

Statistical Analysis Unit (SAU) Update Issue No. 24 Contents Page A guide to publications produced by the Unit One of the roles of the Statistical Analysis Unit (SAU) is to look for ways in which the data routinely collected by Queensland Health can help to inform the knowledge-base regarding health services and epidemiological issues. Results of analyses of the routine datasets are published in a variety of mediums: Statbites These are brief result-focussed reports. Go to: http://qheps.health.qld.gov.au/hic/products.htm. Government reports Along with the Statistical Output Unit, the Integration Unit and the Indigenous Information and Strategy Unit, SAU produces a lot of output for government reports. Go to: http://qheps.health.qld.gov.au/hic/esu.htm - reports are listed under point 9. Peer reviewed journal articles When we feel that an issue warrants a wider audience than the department, we publish results of analyses in peer reviewed journals. These projects are often conducted in conjunction with clinicians or other content area experts. Go to: http://qheps.health.qld.gov.au/hic/sau_journal.htm for a list of peer reviewed articles recently written by or contributed to by SAU staff. Technical reports These are longer reports that are produced when it is necessary to document methodological issues involved in a project. Go to: http://qheps.health.qld.gov.au/hic/products.htm#techreports. In addition, SAU staff regularly present at health research and policy themed conferences. Attending these events ensures that the work of the unit remains relevant and up-to-date. If you have any suggestions or feedback regarding these publications, please contact the unit Director, Trisha Johnston, on trisha_johnston@health.qld.gov.au.

Outpatient Data Collection (ODC) Project Update Issue No. 24 Contents Page PROJECT DESCRIPTION The objective of the Outpatient Data Collection (ODC) Project is to implement a State-wide corporate Outpatient Data Collection to deliver quality, timely and reliable Outpatient data to support Queensland Health s strategic directions and meet local, State and national reporting requirements for Occasions of Service data. PROJECT STATUS The ODC processing system will be implemented in February 2010, with specialist public outpatient data being initially extracted from hospital source systems (via SATr) and validated. Patient level data from other Qld Health outpatient services such as Cancer Care and Allied Health are in the future scope of the ODC. This will be the last update for the ODC Project prior to implementation. The ODC Project would like to thank the ODC Project Steering Committee for their support throughout this Project. 5. SUB-PROJECT STATUS 5.1 Data Collection and Feeder System Enhancement 5.1.1 HBCIS Enhancements All enhancements to the HBCIS Appointment Scheduling module funded by the ODC Project have been implemented. These enhancements have either improved existing functionality or created new functionality in the HBCIS Appointment Scheduling module to increase business process efficiencies and data quality. Enhancements that have been implemented are: Referral Transfers Active Referrals Enquiry Referral to Referral Linkage Unlinked Appointments Report Default Referral Expiry Date Inpatient Flag Bulk Seen REINSTATE Referrals Manual Referral Status of DIS Reason for Removal of Referrals Verify Discharge Status 5.1.2 ipm and OSIM Outpatient System Extracts OSIM Software development for the Cerner Standardisation Project for the Royal Brisbane and Women s Hospital (RBWH) and the Princess Alexandra Hospital (PAH) has been delayed as signoff of the Specification by the business areas is still being negotiated. The ODC is dependent upon the extract deliverable of this Project in order to be able to receive data from these two facilities. The ODC Team is working with the Hospital Access Unit (HAU) to progress a data extract from these facilities as soon as possible.

ipm The Mater Health Service has been testing the extract from ipm to SATr. Representatives from the Mater Health Service are meeting with isoft to finalise the extract. 5.1.3 Cancer Care Systems The ODC Project has been awaiting advice from the Queensland Cancer Control Analysis Team (QCCAT), as to when Queensland Oncology On-Line (QOOL) data will available. The ODC extract of cancer care data is dependent upon interfacing with QOOL. The ODC Project team continue to liaise with QCCAT to progress the extract. 5.1.4 Practice Management Systems (PMS) The ODC Project is working with Private Practice Support Services (PPSS) and the third party support service (StatHealth) of the existing PMS (PractiX) to establish an extract of private practice data for specialist outpatient services. The ODC Extract Specifications document is being finalised in conjunction with the PPSU and the vendor so that the extract can be developed. 5.1.5 SATr ODC data extract Testing of the SATr ODC data extract is almost complete for hospitals using HBCIS Appointment Scheduling and ASIM (Logan Hospital), with final load testing to be completed in early February. The ODC Team is working with HAU to progress an extract from the OSIM systems of the RBWH and the PAH. 5.2 Corporate ODC Processing System Developers managed by the Software Development Group (SDG), HSC, have completed the build of the core collection and processing system, and UAT is almost finalised with system faults being addressed by the developers as they are identified by the ODC Project. The end to end process testing of the ODC processing system includes the Generic Load Application, the SATr extract parameters menu, and the Electronic Validation Application (EVA Plus). The implementation of the ODC is scheduled for February 2010. 5.3 Data Quality 5.3.1 Data Quality Analysis and Development The ODC Project has undertaken much analysis of specialist outpatient data and worked with hospitals to improve their data quality. The ODC Project has provided Outpatient Information Training Sessions for hospitals within the scope of the ODC using the HBCIS Appointment Scheduling module. Sessions were delivered in July 2008 and July 2009 and in total, approximately 1000 people received training at these sessions. The information was very well received by attendees, however, it was evident that issues such as access to the right IT System training, knowledge transfer of best practice protocols and poor communication within Health Service Districts are a huge barrier to data quality. The ODC Project created a suite of data quality reports which are provided to hospitals monthly to enable them to monitor the standard of the data quality of their specialist outpatient information. These reports have highlighted numerous data quality issues including the proportion of electronic coverage of clinics (ie clinics still using paper-based and/or spreadsheets) and hospitals that are not using a corporately approved electronic appointment scheduling systems to schedule appointments. It will require significant work to collect data from these hospitals. The ODC Project continues to work with the staff of Specialist Outpatient Departments of hospitals in scope to improve data quality. Since the ODC has been promoting the benefits and usage of specialist outpatient information, there has been significant improvements in the data quality of this information. The table below contains some examples of these improvements comparing May 2008 (just prior to when the first ODC training sessions were provided) to December 2009 (following training and promotion through communication and data analysis).

Data Quality Measure The % of specialist outpatient Occasions of Service (OOS) recorded in HBCIS and ASIM (Logan Hospital) appointment scheduling systems. The % of specialist outpatient OOS where the final appointment status is seen at the end of a reference month. The % of specialist outpatient OOS where the final appointment status remaining is either booked or arrived (ie the status is not updated to a final status Seen, Discharge, Did Not Wait, Cancelled, Failed to Attend) and should not be counted as an OOS. May 08 Dec 09 82% 87% 33% 84% 68% 3% NB: OOS data reported in the Monthly Activity Collection was compared to the equivalent electronic appointment data from HBCIS and ASIM appointment scheduling systems in order to estimate the percentage. This comparison does not include the following hospitals: Innisfail Hospital (have the HBCIS Appointment Scheduling module but are not utilising it); PAH & RBWH (using the OSIM system - still waiting on finalisation of the data extract); Mater Hospitals (using the ipm system - still waiting on finalisation of the data extract); 6. OUTPATIENT CARE NMDS (PATIENT-LEVEL) STATUS Through the National Partnership Agreement the Sub-acute Care Working Group (SCWG) has begun a national sub-acute work plan for data development during 2010 that includes: new data elements for inclusion within the Admitted Patient Care NMDS; and development and implementation of a Non-admitted Patient care NMDS from 1 July 2011. The SCWG have provided submissions to the National Health Information Standards and Statistics Committee (NHISSC) identifying the data development work plan including timeframes for implementation. Queensland and other jurisdictions representatives on SCWG and NHISSC are seeking clarification from the Australian Government as to the scope of the Non-admitted Patient NMDS and the data set specification so that any impacts can be raised during intergovernmental negotiations. 7. OUTPATIENT POLICY (FRAMEWORK) STATUS As advised in the last update, the Model Business Rules for the Management of Outpatient Services (MBRMOS) has been endorsed by the Integrated Policy and Planning Executive Committee (IPPEC). The HAU are required to develop an implementation plan for deployment of the MBRMOS in Health Service Districts. The ODC, upon obtaining a copy of the final endorsed version, will review the MBRMOS to confirm that existing validation rules included within the ODC processing system are consistent. CONTACT DETAILS For further information regarding the ODC Project contact: Data Collections Unit Health Statistics Centre Queensland Health Phone: 3234 0726 E-mail: rodney_leeuwendal@health.qld.gov.au

VLADs Update (Variable Life Adjusted Display) Contents Page 2009 was a big year for the VLAD Team. VLAD CM Our new information system was developed, tested and implemented in under 12 months. Thank you to the pilots who assisted with this process, and thank you to all of you that have provided feedback about the new system. Thank you also to those who came along to our training day held on 5 October. We had great feedback and it was clear that everyone enjoyed the networking opportunities. We hope to bring our VLAD contacts together for another forum in 2010. We are excited about the improvements the system has already delivered, and look forward to continuously improving the service we provide. What is ahead in 2010? Maternity Indicator Review In conjunction with the Maternity and Neonatal Clinical Network, a working group delivered new indicators in episiotomy and instrumental delivery, re instated a revised perineal tear indicator, and also revised the definitions for the existing indicators. More information at: http://www.health.qld.gov.au/quality/docs/vlad_wrgrp_smry_0709.pdf The external review The final report from Deloitte will be tabled at the Patient Safety and Quality Executive Committee early in 2010. Thanks to those of you who participated in the survey component of the review. Staff from the VLAD Team will now work with the PSQEC to prepare an Action Plan to address the recommendations arising from this review. VLAD Notification Dates for 2010 Friday 29 January 2010 Friday 5 March 2010 Tuesday 6 April 2010 Friday 30 April 2010 Friday 28 May 2010 TIP Meeting the 30 day response time is easier if key staff are scheduled in advance to meet around these dates More indicator reviews In order to ensure our indicators remain clinically relevant and useful, the cardiac, laparoscopic cholecystectomy and paediatric tonsillectomy indicators are scheduled for review in early 2010. If you would like to be involved in any of these reviews, please get in touch with a member of the team. VLAD CM Feedback Survey Now that we have a new IT system, it is important for us to track your satisfaction with the system and incorporate your feedback. Keep an eye out for a survey in your email inbox in the new year, and in the meantime, please send any suggestions to VLAD_Queries. Revised Implementation Standard The implementation standard for VLADs will be revised in 2010. This implementation standard will clearly define roles and responsibilities for staff involved with VLADs, and will incorporate recommendations from the external review. Visit the website: http://www.health.qld.gov.au/quality/vlad.asp Contact us: VLAD_Queries@health.qld.gov.au Kirstine Sketcher Baker (Manager), Michael Findlay, Michelle Dinh, Graham Hall, Julia Connors