Day 1

Costing & Revenue

Day 2

Christine Fan — Performance Unit Manager, Sydney Children’s Hospital Network

Christine Fan, Performance Unit Manager, Sydney Children’s Hospital Network Christine Fan is the manager of the Performance Unit at the Sydney Children’s Hospital Network, where she heads Medical Records, Patient Administration, Costing & Business Intelligence. Her team are committed to improving patient experiences & outcomes through service delivery excellence; data relevance & accessibility and ensuring equity & efficiency of resourcing. She has extensive health industry experience across both public and private sectors and holds tertiary qualifications in computing, statistics, mathematics and health. Christine has a keen interest in advocating for a better understanding of the unique properties of providing health services to children and young people.

Matthew Gow — Clinical Nurse Specialist, The Children's Hospital at Westmead

Matthew Gow, Clinical Nurse Specialist, The Children's Hospital at Westmead Matthew has worked at The Children's Hospital at Westmead for 7 years, 6 of which have been in the Emergency Department. Matthew is a Clinical Nurse Specialist currently performing in the role of Navigator, which is a role specifically developed to assist with patient flow through the Emergency Department. Matthew has been integral in the process of incorporating the NEAT dash board into the navigator role in the CHW Emergency Department, in order to incorporate real time data into clinical practice. As a result, the Emergency Department has seen a significant improvement in Emergency treatment targets (previously referred to as NEAT).

How NEAT is Data Collection & Use

How can routinely collected data be transformed & hospital processes established to improve the delivery of health services?

The Sydney Children’s Hospitals Network (SCHN) is committed to “Children First & Foremost”. The achievement of this vision in the Business Intelligence (BI) space is challenged not only by the translation of data to information, but also by the willingness of staff to change business process. Since June 2014, The Children’s Hospital at Westmead (CHW) has made significant improvements in the management of patients through the Emergency Department (ED). This has been facilitated by the provision of a "real-time" emergency patient data dashboard (structured around the NEAT performance indicator) and, more importantly, by restructuring key staff in ED in new roles who are able to interpret information provided from the dashboard into patient management changes that improve the delivery of emergency care.

CHW will cover aspects of the paediatric emergency department work environment, contrasting historic and current data use and processes. The impact of performance improvements to patient care will be discussed and quantified. The lessons learnt from this success underpin BI philosophy and highlight the importance of establishing a partnership arrangement between analytical and clinical teams to ensure improved patient outcomes. What opportunities can be explored in the PPM space, which offers comprehensive service utilisation data? How can we leverage health service improvements with this data use?

Garry Crispin — Director of Finance, St Andrew's Hospital

Garry Crispin, Director of Finance, St Andrew's Hospital Garry Crispin is the Director of Finance at St Andrew's Hospital in Adelaide. He has over a decade of experience in both public and private health from his previous work with the SA Health service and Calvary Wakefield and Rehabilitation Hospitals.

Garry has a keen interest in costing systems with expertise developed in the manufacturing sector, working with international corporations like Sola Optical and Tenneco Automotive. Over a period of twenty years, he implemented ERP software, developed product costing systems and re-engineered business processes to improve product and service cost performance.

After graduating in Accountancy from the University of SA, Garry studied with the Australian Institute of Management and is now completing his Masters of Health Administration at Flinders University.

Sharon Kendall — Dir Business Performance & Development, St Andrew's Hospital

Sharon Kendall, Director Business Performance and Development, St Andrew's Hospital Sharon Kendall is currently Director Business Performance and Development at St Andrew's Hospital in Adelaide, a 209-bed not-for-profit hospital providing a broad range of acute medical and surgical services. Ms Kendall recently held the position of CEO of one of the Calvary Health Care Adelaide Hospitals. Sharon has over 20 years experience in the SA health care industry and has held a number of senior management positions in Nursing, Finance, Administration & Information systems. She has a diverse range of experience in both the public and private sectors and has undertaken a number of reviews in relation to service planning, design and sustainability.

She has been working in clinical costings and casemix across both public and private sectors since the late 1990’s and is passionate about quality and safety and how data can support the monitoring of performance and drive efficiency. She is a Surveyor with the Australian Council of Healthcare Standards with an interest in Governance, Strategic Planning, Consumer Engagement, Service Development and Redesign, Leadership Development, ICT, Funding Models and embedding quality improvement. Sharon is currently studying Law part time.

Costing, Pricing and Contract Negotiations

When negotiating prices for your services, you need the best available information. Being informed and prepared is critical to successful pricing and business outcomes.

For private hospitals, Hospital Purchaser-Provider Agreement (HPPA) pricing negotiations can be somewhat difficult, with Health Funds being in a position of market dominance, particularly with smaller independent hospitals. So you need to fully understand what contract pricing terms and conditions you can or cannot accept.

Costing information is vital in this process. If you do not understand your financial position then you cannot confidently negotiate, nor can you determine which offer is acceptable and which you have to refuse. An understanding of your services costs is vital in other aspects of your business. Negotiating the prices and conditions for out-sourced Government contracts may be an area where you have greater ability to negotiate prices but you will be in a competitive bid process and need to be prepared with keen and accurate costing.

Are you confident that your services can be delivered more efficiently than in a Public Hospital or in comparison to other private providers in a tender process?

Is your self-insured customer pricing fair and competitive? This is an area of business where you may have more ability to set your pricing but you're probably still in a competitive situation, even if you are a regional based service.

All of the situations above require you to have a good understanding of your business and the cost of providing specific services. You need to consider a marginal costing method as the basis for pricing to attract incremental business. Does your current financial reporting set-up allow you to do this?

Stephen Cole — Director ABF Financial Reporting, Gold Coast Hospital and Health Service

Stephen Cole, Director ABF Financial Reporting, Gold Coast Hospital and Health Service Stephen Cole was originally qualified as a radiographer, and after a time working predominantly in rural Western Australia, obtained a degree in Health Computing. He has worked in the private Health IT sector developing and implementing hospital information systems in WA, SA, Victoria as well as South East Asia. Since 1995 Stephen has worked in senior ABF roles in WA, Queensland and England, as well as lecturing at Griffith University. In 2010 Stephen joined Gold Coast Hospital and Health Service as Director of ABF Financial Reporting.

Building Budgets with PPM

Stephen will share with us some of the technical steps associated with using the PPM database to build an ABF Budget.

The underlying data structures within PPM allows the identification of resources from each Cost Centre that contributed to the output activity. Using the proportion of these costs for each type of activity, Gold Coast Hospital and Health Service have developed a set of budget weights for apportioning target activity back to discrete cost centres. Using basic SQL, together with MS Excel, Stephen has explored the possibility of developing an ABF Budget model that provides an evidence base to support the conventional budget build.

Erica Cole — Activity Based Costing Manager, Gold Coast Hospital and Health Service

Erica Cole, Activity Based Costing Manager, Gold Coast Hospital and Health Service Erica has worked in Queensland Health since 2006, firstly with the Department of Health in Finance and Activity Based Funding, then for the last 3 years at the GCHHS as Activity Based Costing Manager. Prior to that she had extensive experience in software development and applications implementation in the IT industry.

Making the Most of Automatic Loads — Less Handling, More Timely Data, More Quality Time

In response to the board's request for weekly costed activity data, Gold Coast Hospital and Health Board (GCHHS) moved from the very old TII costing system to PPM, with intentions to load and cost as frequently as possible.

It is theoretically do-able and we are well on the way — all core extracts are year-to-date weekly loads, with work underway to load the remaining Ancillary Services (that are currently monthly).

GCHHS has worked to ensure that loading large volumes of data into PPM can be as painless as possible by making use of pre-processing and automatic receipts into a staging area. We have also begun to build solutions dashboard and data warehousing reporting solutions from PPM data.

Suellen Fletcher — Costing Manager, ABF Taskforce, NSW Health

Suellen Fletcher, Costing Manager, ABF Taskforce, NSW Health Suellen Fletcher has 16 years experience in healthcare working in both the public and private sectors primarily in the areas of costing, funding and performance. She is currently the Costing Manager in the Activity Based Funding Taskforce within NSW Health.

The Activity Based Funding Taskforce is part of the health funding reform introduced by NSW Health which aims to achieve the objectives of increasing efficiency, improving transparency of funding, strengthening accountability and performance and improving patient outcomes.

Suellen is an integral link between the NSW Ministry of Health and Local Health Districts and Specialty Health Networks to facilitate the standardisation of the costing processes. She was actively involved in the development of the costing server and the Activity Based Management Portal which has streamlined the costing submission and reporting requirements for NSW Health.

Sharon McFarlane — Costing Manager, ABF Taskforce, NSW Health

Sharon McFarlane, Costing Manager, ABF Taskforce, NSW Health Sharon McFarlane has 22 years experience in healthcare in the public sector starting as an Emergency Department Clerk and working across all areas of hospital administration. She worked as an Administration Manager of a rural base hospital for 10 years prior to moving into the area of clinical costing. She is currently the Clinical Costing Manager of Southern NSW Local Health District as well as working with the ABF Taskforce on an AdHoc basis.

The Activity Based Funding Taskforce is part of the health funding reform introduced by NSW Health which aims to achieve the objectives of increasing efficiency, improving transparency of funding, strengthening accountability and performance and improving patient outcomes.

Sharon led the development of the methodology for processing revenue at a patient level in PPM. She undertook all the testing of PBRC extracts, feeder creation of non PBRC revenue and final allocation methodology of all revenue including PBRC, DVA, MAA, Commonwealth and ABF Funding. She developed the Revenue Processing manual for inclusion in the NSW Cost Accounting Guidelines.

The Inevitable Impact Event When PPM and PBRC Collide

Throughout history major impact events have significantly shaped our universes history. An impact event is a collision between celestial objects causing measurable effects. In 2014 it was inevitable that PBRC would collide with PPM. Let us discover the science behind how these two objects collided and the resulting impact event.

Let us imagine that planet PPM has been in existence for thousands of years. PPM is a peaceful planet and its inhabitants known as the “Costers” spend their days and some nights producing the DNR crop. Each year their life is getting easier as technology has enabled the DNR to be cloned, produced and transported using a simplified matrix. This is all about to change ...

It has been reported that the meteor PBRC is approaching planet PPM at a rapid rate. Impact is unavoidable the Costers must prepare for the impact event. They must:

  • Determine the difference and or similarities between the two celestial bodies
  • Prepare for impact and any collateral damage
  • Anticipate the creation of impact structures.

Graham Bushnell — Clinical Costing Analyst, Western Health

Graham Bushnell Graham Bushnell is the Clinical Costing Analyst at Western Health in Victoria. He is responsible for cost and revenue modelling for a rapidly growing health service. For the past 12 months he has also been Chair of the Victorian Clinical Costing User Group.

Previously he has worked at Alfred Health where he held a number of positions over a seven year period dealing mainly with performance data and costing. He has also worked at Barwon Health and Wesley College where he continues to be a part-time rowing coach.

Using Your Costing Data — The Western Health Experience

Two and a half years ago, clinical costing was an outsourced compliance exercise for Western Health. What prompted bringing the operation in-house and what use has it been so far? What challenges have been surmounted and how many haven’t?

Graham Bushnell will provide some insights into the experience and also talk about how having cost and revenue data is becoming a great tool for management.

Brett Michael — Director of Development, PowerHealth Solutions

Brett Michael, Director of Development, PHS Brett heads up the PHS Development Division with all Product Development Teams (PPM, PBRC-IE, PBRC-AE) and the Testing Unit reporting to him. Brett is responsible for the design, development, testing, maintenance and support for all PHS products.

Brett has over 16 years experience in healthcare IT, with skills in software development, business analysis, systems architecture and project management. At PHS, Brett has been responsible for standardising the tools and development methodology used by all of his teams, as well as being involved at the outset of many major software projects.

PPM Enhancements Voting

PowerHealth Solutions is commited to ensuring that PowerPerformance Manager (PPM) in continually enhanced to meet our clients' needs. To this end, we run polls at each conference to allow attending client sites to vote on which enhancements best suit their needs.

The resulting client preferences directs PHS Development in prioritising the implementation of the enhancements. Brett will describe each enhancement, answer any questions and conduct the polling process.

Andrew Shearer-McBride — Costing Consultant, PowerHealth Solutions

Andrew Shearer-McBride, Costing Consultant, PowerHealth Solutions Andrew has a Bachelor of Health Science and a Master of Public Health, with skills in clinical research, economic evaluation, cost benefits modelling, and healthcare economics & its role in healthcare policy. Andrew joined PHS 4 years ago, and has since applied his knowledge to casemix funding and activity based funding, and their importance in hospital funding and efficiency.

At PHS, Andrew has been implementing PPM in VIC and QLD, as well as the state-wide implementations in SA and NSW. Andrew regularly provided outsourced data costing services, and assisted with the implementation of the DNR state costing reporting system for NSW. In addition, Andrew has co-authored a paper on quality assurance in health costing, and has been the lead consultant for skills transfer to our international partners.

Introduction to PPM New Features

There have been many new enhancements introduced to PPM in the last 6 months, ie from versions 1.4.2 to 1.5. This training course will cover the following features:

  • Digital Dashboard — displays results from the library reports, queries and charts
  • Library new features — including library context, exporting and sharing of items between sites
  • Health Roundtable processing
  • Reporting parameters
  • CHADx
  • Datix integration
  • Generic incident data load
  • Relative Value Unit Builder enhancements
  • Post cost weight adjustment.