INFORMATION ABOUT WORKSHOPS Pre conference workshops will be held on Tuesday 4 th October 2016. Details of the workshops are provided below. Please check the Programme for exact times of workshops. Please register your interest in attending one or more of the workshops when you register for the conference. PCSI Workshops Dublin, Ireland (4 th October 2016) 1/11
WORKSHOP 1 Managing performance under Activity Based Funding Presenter Stephen Duckett, Grattan Institute, Australia Health service managers This workshop aims to introduce concepts relevant to managing services better in the context of activity based funding. It provides a general introduction to Activity Based Funding, with a focus on how to manage hospital performance in an activity based funding environment. In this workshop you will be introduced to: The context of ABF Background to case mix measures such as Diagnosis Related Groups (DRGs) What to look for if your costs are greater than the payment rate PCSI Workshops Dublin, Ireland (4 th October 2016) 2/11
WORKSHOP 2 Patient Costing Everything you need to know Presenter Patrick Power, PowerHealth Solutions It will be relevant to PCSI attendees from all disciplines including clinicians, administrators, clinical coders and informatics professionals, as it will provide an overview of Patient Costing principles using worked examples and attendee participation. The workshop aims to provide participants with an understanding of patient costing principles and their application to different patient settings. This includes an understanding of: the GL Cost Allocation process; the patient level data feeds required and their elements; how to set up linking rules to allow feeder level data; Relative Value Units (RVUs) and their application to Patient Costing; the creation and use of services for patient costing; the methodologies to be used to reconcile Patient Level costs back to the General Ledger; and the concepts of loading, processing and reconciling patent level and general ledger data. Participants will take an active role in defining and running the GL and Patient Costing methodologies to be used in a worked example. Feedback from this process will be used to set up and run the Patient Costing application. Question and answer questions will be used to ensure that participants have a good understanding of each step of the process. Handouts will be provided. The workshop will assume that participants have an awareness of Patient Costing principles but little understanding of them. PCSI Workshops Dublin, Ireland (4 th October 2016) 3/11
WORKSHOP 3 The future of case mix how is it likely to change and why? Presenters Dr Mary E Black, Chair of Technical Advisory Board, Pavilion Health Pty Dr Vivek Muthu, Member of Technical Advisory Board, Pavilion Health Pty This will be relevant to all attendees at the conference The workshop aims to build awareness of the scope and scale of change that lies ahead for case mix. Following an overview on global trends in healthcare financing, the workshop will present ten of the top drivers that are changing the health sector and that will directly impact on case mix and how it is practised. There will be clear examples of these changes, some of which are already in train, plus an understanding of how they will evolve over time. These key trends are: 1. Rise in long term conditions and multiple morbidity will drive complexity in case mix. 2. Outcome based payments will increase, moving on from activity based payment. Outcome measures will become more sophisticated. 3. Risk share agreements will increase This could mean for example, that if a health care intervention does not work or causes harm, the provider is not paid. 4. There is likely to be an increase in quality and safety concerns, which will mean they will need to be embedded in case mix. 5. Moving to the median. As information is increasingly shared across the internet about case mix, variation is reducing. This is a global phenomenon and applies to all measurement systems not just case mix. 6. Shared data systems the increase of tools that sit in the middle between providers and payers. 7. Data collection will no longer be an ancillary activity but will be embedded within day to day work, generated from electronic health records and smart technology (including devices that can record/generate data directly from patients), and will increasingly be real time. 8. Machine learning, automation increases. The role of coders will change as some of the more routine tasks can be done automatically. 9. Personalised medicine may influence coding systems or require new coding systems 10. New skills will be required by coders moving to super coders, an increase in online learning and certification, and data science skills. The workshop will consist of interactive presentations, case studies and national examples. There will also be some group discussion time to further build on the work that is presented PCSI Workshops Dublin, Ireland (4 th October 2016) 4/11
and to have deep, technical discussions about case mix, tools and national efforts. This will be an excellent opportunity to take a step back, look at the major shifts that are taking place in health funding, information systems, technology and data itself in the health sector. The issues we will present will have relevance for all aspects of case mix and may profoundly change the place of case mix in health systems. PCSI Workshops Dublin, Ireland (4 th October 2016) 5/11
WORKSHOP 4 A Smooth Introduction to Case Mix for Newcomers Presenters Jean Marie Rodrigues, University Jean Monnet of Saint Etienne, Saint Etienne, France Dana Burduja, PCSI President Terri Jackson, Melbourne University, Australia Anyone new to case mix, from coders to decision makers The workshop aims to give to newcomers a basic knowledge, in French, of case mix and to inform them how to go further to PCSI international case mix schools in English language if they need. The following topics will be covered: Introduction and basic principles: DRGs and case mix (Jean Marie Rodrigues) Implementing case mix systems in different countries (Dana Burduja) Case mix and quality (Terri Jackson) Discussion The schools of the PCSI (Jean Marie Rodrigues, Dana Burduja) PCSI Workshops Dublin, Ireland (4 th October 2016) 6/11
WORKSHOP 5 The Economics of Patient Quality of Care Presenters Terri Jackson, Melbourne University, Australia Amanda Ling, Australia Health service managers, policy makers, analysts and other professionals concerned with quality and cost of care Internationally, it is recognised that poor quality patient care results in greater system costs over the long term and even in the short term (an inpatient episode). Few patient safety initiatives are evaluated for their cost effectiveness in the way that other treatment innovations are. This workshop reviews international systems using routine health care data sets to monitor and improve patient outcomes, with a particular focus on the costs of such care and the funding incentives that are used to motivate quality improvement. The questions addressed will include: What is the evidence on costs of poor inpatient care? How do patient classifications identify poor care? What do these systems miss? Are there other approaches to identifying poor care What should we do with data on poor care and higher costs? What developments will there be in the future? Dr Amanda Ling is a health service executive and medical practitioner with extensive experience in hospital management, patient safety, and patient classifications. A/Prof Terri Jackson is a health economist whose research focus over the past decade has been on the economics of patient safety. PCSI Workshops Dublin, Ireland (4 th October 2016) 7/11
WORKSHOP 6 Implementation of a System to Cost Patients in Ireland Challenges and Benefits Presenters Representatives of Healthcare Pricing Office, Ireland Representatives from Costing and IT staff from Mater Misericordiae, University Hospital, Dublin, Representatives from the E Health Division, University Hospital Limerick and Representatives from Activity Based Funding Programme Representatives from the St. James Hospital, Dublin. Relevant to most people involved in case mix coders, clinical costing staff, decision makers, IT staff, researchers, technical staff in case mix offices The workshop provides an overview of the national implementation of a Patient Level Costing(PLC) System within the Irish Health system Health Service Executive (HSE) from both a national and end user perspective. Prior to 2015 the HSE didn t have a system to support the costing of hospital activity at the patient level. The monitoring of financial information in the Irish acute hospital setting was structured around income and expenditure flows at individual hospital level. In 2015 the HSE introduced a PLC system to provide an accounting methodology that derives costs from identified resources across a number of departments in nineteen acute public hospitals across Ireland. This approach is viewed as an essential tool for hospitals to understand their costs and to effectively operate in a prospective, activity based funding environment in support of the implementation of the Government s 2013 hospital financing policy document Money Follows The Patient (MFTP). The new PLC system needs to interface with existing hospital systems such as the Patient Administration Systems (PAS) and Hospital Inpatient Enquiry System (HIPE). The system also provides a comprehensive suite of management reports that supports the pre existing PLC data interrogation tool QlikView. This nationally acquired solution has been implemented in both HSE and Public funded Voluntary hospitals on a phased basis between 2015 6. The first section will place a strong emphasis on the key areas from a national perspective Background to the Project of Project Methodology for the PLC Implementation system and; Costing Element of Implementation Process & Where to next. PCSI Workshops Dublin, Ireland (4 th October 2016) 8/11
It then will be followed by case studies from a three local perspective utilising a case study from three Hospital Groups. The first two case studies) will focus on the following areas: Challenges of the Implementation Process such as adopting data from historical IT feeder systems; Resource requirements e.g. staff and; What work well. The third case study will focus on Plan for the Future What a Hospital can do with the data The workshop will then conclude with a question and answer session to ensure participants obtain a clear understanding of the process. PCSI Workshops Dublin, Ireland (4 th October 2016) 9/11
WORKSHOP 7 A multidimensional approach to assessing the quality of clinically coded data Presenters Healthcare Pricing Office Ireland Pavilion Health Coders, decision makers, costing staff, case mix technical staff, ABF staff This workshop describes a novel approach to (1) the assessment the quality of activity data from multiple angles, (2) the results of the data quality assessment and (3) the development of SMART recommendations (Specific, Measurable, Achievable, Realistic, Timely) As part of the move to funding through ABF, the Irish Healthcare Pricing Office identified the need to assess the quality of activity data, to provide assurance that ABF is based on robust information and to identify areas for improvement where necessary. In collaboration with Pavilion Health, coded data was examined from multiple angles, including the assessment of data quality, the implications of variation in quality and actions needed to improve quality overall. In this workshop we will describe the methodology for each element listed below, our findings from the results, the interaction between the elements, conclusions drawn and action plan development. The elements are: an assessment of the financial implications of variation in capture of complexity using an ADRG benchmarking quantitative analysis; an objective assessment of compliance with coding rules and measurement of relative data quality using the PICQ tool; a comparison of coded activity to charts via a chart audit (sample from 10 hospitals); an assessment of coding service using a qualitative analysis with workshop, interviews and questionnaire; a combination of the results from the various methods to come up with a conclusion on data quality and the people and processes underlying its delivery; and the development of an action plan development with individual hospitals and at the national level. PCSI Workshops Dublin, Ireland (4 th October 2016) 10/11
WORKSHOP 8 Improving Population Health Management through Risk Adjustment Presenters Stephen Sutch, Bloomberg School of Public Health, Johns Hopkins University Alan Thompson, ACG International, Johns Hopkins HealthCare Solutions Policy makers, analysts, public health and other professionals concerned with whole population health and integrated care. As has been demonstrated in both public and private healthcare systems around the globe, risk adjustment contributes to improved clinical management of populations. It is used, for example, to estimate future resource use, establish equitable budgeting and to identify individuals most likely to require additional resources or specific types of care. The aim of this workshop is to provide insight into the methods and applications of risk adjustment in population health, and share experiences between the participants of the considerations, issues and challenges around the world. Applicable results will be presented demonstrating examples from several countries, including Canada, the US, Spain, Sweden Italy and the UK. Participants will experience first hand how to apply risk adjustment and case mix methods to financial, managerial and clinical management decisions. The workshop will open with an introductory presentation on the methods used in risk adjustment for population health, and the numerous applications of risk adjustment within the integrated and ambulatory care sectors. Depending on the interests of participants, the workshop would be divided into break out sessions based on the following applications: Case & Disease Management / Patient Identification Improving Coordination / Patient Identification Each session will comprise presentations illustrating real world case mix applications. The workshop would conclude by bringing participants back together to summarize the findings of the break out sessions and to provide an open forum for participants to discuss risk adjustment applications and/or challenges within their organisations. PCSI Workshops Dublin, Ireland (4 th October 2016) 11/11