Developing a National Allied Health Dataset Catherine Stephens Jan Erven
National Allied Health ehealth Membership: Collaborative National Allied Health Advisory Committee National Allied Health Classification Committee (NAHCC) Allied Health Professions Australia (AHPA) Health Informatics Society of Australia (HISA) Australasian Allied Health Benchmarking Consortium (AAHBC) Services Australia Rural and Remote Allied Health (SARRAH) Indigenous Allied Health Association (IAHA) Other jurisdictional and international representatives involved in implementing ehealth initiatives at a service level
Why develop a specific allied health dataset? To answer the questions: Who are allied health professionals? Which patients and which conditions do they treat? What do allied health services cost?
Why cont. And the more complex questions What contribution do AH services make to health care? Do they: prevent hospital admissions and/ readmissions? decrease length of stay? improve health outcomes? offer a cost effective alternative in treatment provision? And, if so, for whom and when are allied health interventions most beneficial?
Who are allied health?/ to whom does the dataset apply? There is no universally accepted definition of the allied health professions. The dataset applies to a group of professions whose assessment and treatment processes follow a similar pattern e.g. PT, OT, SP, D&N, SW, Psych. Not applicable for MRP, clinical measurement scientists, pharmacists.
What has already been developed? In 2001 the National Allied Health Casemix Committee (NAHCC) developed the Health Activity Hierarchy, including the Allied Health Minimum Dataset, to support allied health in the move to casemix funding. This dataset includes administrative data, activity data and some clinical information. Never recognised as a national standard.
Top Tiers of the Activity Hierarchy
How can this be used? In an ABF context this data can: Assist with costing the allied health time contribution to a DRG, a sub-acute care type or a Tier 2 non-admitted clinic. Inform costing studies Assist in classification development.
Recent work NAHeHC: Has refined the activity dataset (clarified definitions, reviewed administrative data elements). Reviewed the clinical data collected at a jurisdictional level (SA, NSW, Qld) developed to assist in the move towards electronic medical records. Looked for consistency in the clinical datasets.
Recent work cont. Proposed the introduction of a number of clinical data elements.. Clinical Finding - The discipline specific diagnosis based on allied health clinical assessment. Clinical Activity Assessment Intervention Plan
Example Only Patient presents to physio with knee pain Diagnosis/Clinical Finding: OA knee causing decreased mobility Assessment: Pain Intensity; Timed Up and Go Intervention: Targeted exercise programme Plan: Discharge to community hydrotherapy programme
What will the expanded dataset provide?
Measure outcomes of allied health intervention. Determine which patients and health conditions benefit most from AH services and which interventions should be used.
Assist with resource allocation: Is it worthwhile employing more allied health professionals in some areas and less in others? Where can efficiency be improved by allied health professionals working to full or extended scope of practice?
Additional benefits National Allied Health Dataset will also assist with: Identifying drivers for demand of allied health services Workforce planning for new or expanding services Benchmarking between allied health services.
Where to next? Preliminary consultation has already occurred support for a consistent dataset but highlighted the need for robust definitions that may be consistently applied across professions. National consultation across the public health sector to gain agreement on the data elements. Profession specific consultation to identify the values that sit under these data elements. Recognition as a National standard.
Challenges Gaining consensus across jurisdictions-particularly as some jurisdictions have already developed their own datasets. Gaining consensus across the broad range of professions. Information systems to collect the data. Ongoing funding to develop and implement.
Contact details: Thank-you Catherine.Stephens@health.qld.gov.au