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Capturing Non-Admitted PatientActivity for ABF ReportingBill Vargas – Chief Information OfficerCredit to: Geoff Blanks, Ray Wang – EMR TeamSydney Children’s Hospitals Network (Westmead)
IntroductionActivity Based Funding (ABF) is a method of allocating fundsbased on the activity of an organisation/service.Non-Admitted Patient Activity by Health Care providers isrequired to be reported for each patient receiving care whereclinical documentation is recorded.As there was no State-wide statistical collection systemavailable in NSW, the Sydney Children’s Hospitals Network(Westmead) chose the integrated electronic medical record(eMR) to design a capture/extract solution for ABF reporting.
Challenges and Issues- As primarily a clinical information system, the eMR wasnot designed for statistics collection- Not all non-scheduled or ad hoc activity could suitably berecorded in a scheduled appointment- Any solution requires integration into the clinical workflowand should reduce the reporting burden on clinical staff
ObjectivesTo implement a non admitted ABF data collection solution utilisingexisting eMR functionality with minimal impact to clinical workflowand to comply with mandatory NSW Ministry of Healthrequirements
Method – PM & SchedulingScheduling: additional fields tocapture ABF statistics wereadded to the existing Schedulingdesign. Person information drawnfrom standard PM capture.This solution currently accountsfor approximately 85% of all eMRactivity reported (may reduce).
Method – PM and PowerChart (Clinical Documentation)PowerChart: at SCHN Westmead about 15,000 electronicClinical Documentation forms (excluding Allied Health) werealready charted each month so to minimise the data entryimpact we developed additional fields within existing forms toseamlessly integrate with workflow**A stand alone collection form was also developed for those who documentclinical notes in another format (e.g. on paper) but want to electronicallycapture statistics for the service
Method – PM and PowerChart (Clinical Documentation)Captures the ServiceUnit and derives other‘service event’ itemsCaptures Modality ofCare (Type ofConsultation)Include in extractThis form derivesABF information fromthe clinicaldocumentationworkflow
Click to edit Master title styleCaptures the Provider,Setting Type andSource of Referralitems to complete thedata capture- This conditional section captures the remainder of ‘service event’ items.- It is simple to use and complies to the ABF prerequisite forclinical documentation.- This solution currently accounts for approximately 15% of all eMRactivity reported (expected to grow). from 0% in January 2013.
Method – PM and PowerChartOutpatient Note:Capturescomprehensive clinicalinformationdocumented by staffand ABF dataInclude in extract
Method – System DeliverySystem Delivery-Executive sponsorship of initiativeStrategic planning and staff engagement for implementationIntensive User training (eLearning, Classroom, Workplace)Change Management
Findings – Clinical BenefitSystem design and build with focuson simplifying clinical system entry-Extensive clinical review:Nurses, Allied Health andMedical staff attendedevaluation sessions to assessthe design from a userperspective and providefeedback (some via Survey)including individual interviewswith senior staff specialists
Findings – Reporting BenefitSystem design and build enables extract of data as per specification. Thisallows easy access to patient level data for the Network to the NSW Ministryof Health.Activity (example) al Documentation
Conclusion and Improved OutcomesA clinically focused outpatient ABF data collection solution hasachieved- an efficient method to obtain the required information- embraced by most end users- sustainable for future development (re-use of components foradditional forms).-solution has been made available to HealthShare to incorporate intothe Cerner state base build for use by other LHDs.-sext step is to review solutions to add value/capabilitySeamless integration with existing clinical workflow means lessinterruption to patient care and improved data completeness andaccuracy.
(Westmead) chose the integrated electronic medical record (eMR) to design a capture/extract solution for ABF reporting. Introduction - As primarily a clinical information system, the eMR was . PM and PowerChart (Clinical Documentation) Method - PM and PowerChart (Clinical Documentation) This form derives ABF information from the clinical .
