Introducing our industry experts:
|Dr William Holubek
CarePoint Health System
|Dr Henry Glennie
|Prof. Martin Connor
Centre for Health Innovation
|US Healthcare System - How Did We Get Here and Where is it Going?||Why We Do What We Do: An Empowered Patient’s Story of Beating Incredible Odds||Electronic Health Records: The Key to Effective Healthcare||Hospital Performance Analytics: A Revolutionary Disruption?|
Australian Centre for Health Innovation
|Dr Paul Tridgell
National Health Revenue Consultant
|Dr Douglas Fahlbusch
|Development of Wayfinding at Alfred Health||Digital Health Trends - Where's my Health Service At?||Gaining Significant ABF Revenues from Coding Auditing and Re-coding||Reimagining the Pre-admission Process|
|Quebec's Approach to Patient Level Costing||Fire Up Your Presentations|
Costing & Revenue Speakers
|Health Performance -
Neglect Revenue at Your Peril!
|Power Up the Value|
- Analysis in ABM - the Clinical Variation Tool
- ABC Project - Improvement on Overall Resource Reflectiveness
- ABC Project - Improvement on Emergency Department Costing
Sydney Childrens Hospital Network
|iBill - Billing Made Simple||Funky Features||Debt Management and Recovery - the ASNSW Experience||eHealth NSWH Training and Support|
|Medicare Ineligible Revenue Recovery|
Dr William (Bill) Holubek, CarePoint Health System
US Healthcare System - How Did We Get Here and Where is it Going?
- Beginning of employer based healthcare
- CMS, VA, private
- Insurance companies – for profit, MLR, premiums
- Misalignment – hospitals & physician payment by Medicare
- Medicare/Medicaid – move to VBP, RAC
- Private payers – medical necessity denials
- For-profit & NFP
- Obamacare & Trumpcare
- Right or privilege - EMTALA
Dave deBronkart, ePatient Dave
Why We Do What We Do: An Empowered Patient’s Story of Beating Incredible Odds
In the best of all worlds, medicine creates miracles. A new model of care called “participatory medicine” is helping produce unprecedented results, as empowered patients (“e-patients”) share the work with clinicians.
When “e-Patient Dave” faced Stage IV kidney cancer with desperate odds, he got the best of care but didn’t stop there; he connected with other patients online, and found invaluable information that his oncologist believes may have made the difference.
A marketer and business analyst before his disease, he has devoted his “life after near-death” to spreading the word about this movement. He’s an inspiring global keynote speaker and business advisor with over 500 events in seventeen countries, his TED Talk has been translated into 26 languages, and his book Let Patients Help has been translated into nine.Return to top
Dr Henry Glennie, Medilink
Electronic Health Records: The Key to Effective Healthcare
Careful medical record-keeping is one of the most important duties of a clinician. How else can a patient’s history be documented, the clinical findings recorded, the provisional diagnosis entered, the investigation results be displayed and the chosen treatment pathway defined?
Doctors today have the ability to treat each patient effectively so long as they make the right diagnosis. If not sure what they are dealing with they have the ability to access huge amounts of information to make the right call. EHR, if used to its potential, is the means of pulling all this data together and getting it right every time!
Unfortunately all this knowledge is not being harnessed effectively. The EHR systems in use today have many shortcomings and are destined to be obsolete within the next few years. All the current problems will have been ironed out. To see how this will be achieved it is necessary to look at what healthcare is now and what it will be with optimally functioning EHR systems. When there is talk of “healthcare” this is largely a misnomer. It is actually “illness care.” Worse still, it is illness care of the “snapshot” variety. Hospital admissions, office consultations, home care visits, are all “snapshots” in the ill-health of a person. What is required is effective healthcare.
The only way it can be shown to be effective is by tracking every person in a community at times they are thought to be “healthy” as well as the times they are in poor health. This requires a chronological sequence, a longitudinal record, on every person in that community, where all health care events, from birth to death, are recorded in “real time”, when and where they occur. Achieving this requires new solutions and modifications of existing solutions.
This paper explores the utilisation of business intelligence systems to provide the very best care wherever and whenever it is required, within the right timeframe and at the right cost.Return to top
Professor Martin Connor, Centre for Health Innovation
Hospital Performance Analytics : A Revolutionary Disruption?
Public hospitals worldwide face extraordinary challenges of leadership and management. Amidst the daily maelstrom of competing demands, political pressures, cultural challenges, demand and supply mismatches and resource constraints, achieving sustainable high performance represents a major challenge. Yet the requirement to do so is greater than ever, with health programs globally representing an ever greater proportion of total government spending and facing the escalating expectations driven by new care technologies and massively broadening patient access to information about what is possible.
Hospital leaders faced with these challenges are also contending with the perhaps remarkable fact that there is no international standard definition of the appropriate data required to operationally manage a public hospital (as there is, for example, relating to airports or nuclear reactors). Nor is there even a consensus about the conceptual framework that might be developed to achieve such a standard.
The practical goal is twofold: firstly, to define the standard analysis that should govern hospital management and instantiate this into generalisable software, thus relieving even the best hospital leadership groups of the task – necessary to their success but impossible in their context – of reinventing the information strategies required to guide their actions and interventions to optimise outcomes at any given level of resource. And secondly, to code this analysis at the appropriate frequency to deliver actionable information to clinical and managerial leaders.
In this presentation, Professor Connor will describe how we are at a point of technological convergence between data management power, visualisation technologies and statistical methods where such an analysis can find a generalisable expression. He will present a new conceptual framework for the development of an international standard for hospital performance data, with a novel logic presented here for the first time. He will then demonstrate the application of the new framework in an innovative software product presently operating in 51 hospitals in Queensland focused on the ‘big ticket’ performance challenges of outpatient and surgical waiting lists. He will also demonstrate working extensions of the framework just out of their incubator stage and due for roll-out covering ED flow, outpatient clinic schedule monitoring, theatres schedule monitoring and bed management.Return to top
Frank Smolenaers, Alfred Hospital
The Development of Digital Wayfinding at Alfred Health
Good wayfinding results in less use of volunteer and staff time (fewer interruptions) to direct people, and a better experience for everyone. It empowers the visitor to help themselves and assists in reducing stress and anxiety. It is expected to improve the patient and visitor experience since they can locate clinics in a more timely manner and find conveniences like the nearest rest rooms, the cafeteria and car parks, with ease.
The Alfred Hospital was seeking ways to improve the existing wayfinding modalities such as physical signage and volunteer help. This digital wayfinding solution augments those initiatives and aligns with the objective of providing timely, high quality care to all Alfred Health patients. Additionally, it will provide useful navigation for new staff orientation.
Alfred Health formed a strategic partnership with PowerHealth in 2016, to deliver a health-customised, smart device app, through clinical and consumer end user engagement, by utilising the in-house services of the Alfred’s “Australian Centre for Health Innovation”. Development has spanned from early prototype testing in the Centre’s simulated hospital and Digital Health Design Lab, to Alfred campus deployment to all public areas for a pilot and ultimate go live.
This presentation will cover aims, drivers and methodology applied to develop and deliver the app from the customer’s perspective, and provide a status update of the project progress to date.Return to top
Digital Health Trends - Where is my Health Service At?
What are the latest trends, business performance initiatives and technologies in Healthcare? What are the drivers and benefits that are being targeted within healthcare organisations, jurisdictions, across the nation and internationally? What is the latest hype in digital health, and where are the real patient health related health care improvements? What do all the buzz words mean, and where is the disruption that is driving real measurable benefit outcomes? Align your business and digital strategy with the market, navigate your way thought the ever increasing landscape of digital and process enablers for your organisation, and where are you really at in comparison with other organisations? Gain an understanding of the best way to measure where you are at, and understand the best way to align your digital initiatives with your models of patient care.
What do you know about the risk and investment required in cyber security, maturity models, research, genomics, continuity of care, national initiatives, privacy, population health, digital hospitals, jurisdictional ICT directions, machine learning, robotics, cloud services, My Health Record, HIMSS EMRAM? Are you honestly in tune with best practice in digital healthcare practice, how do you navigate through this, what does this all really mean? Can you really continue to reactively manage your operational needs while strategy is left at the wayside! Can you be left behind at an exponential rate and can you afford it? Will you ever catch up?Return to top
Dr Paul Tridgell, Tridgell Consulting
Gaining Significant ABF revenues from Coding Auditing and Re-coding
Over the past two years, Paul Tridgell has used linkage of clinical (e.g. pathology, pharmacy) and coded inpatient data to identify missing diagnosis codes with a focus on adjacent DRGs. This work has been conducted across three states/territories, mostly in the public sector. The implications of these missing codes can be significant for funding and other applications for this data.
This presentation will discuss another method that has a range of other characteristics to identify records for review, examining the variation in coding and introducing a set of tools to assist with targeted auditing. The implementation of iEMR systems is providing an increasing capacity to use IT algorithms to check for missed diagnosis codes. Some of these missed codes require documentation to meet coding standards while others have been missed in the coding process.Return to top
Dr Douglas Fahlbusch, Perioperative Solutions
Reimagining the Pre-admission Process
In this presentation Dr Douglas Fahlbusch will present the findings from his involvement in the 'Reimagining the Pre-admission Process' project.Return to top
Patrick Power, Managing Director, PowerHealth
Quebec and its approach to patient level costing
The province of Quebec in Canada is implementing Activity Based Funding, which they call "Financing Axed on the Patient" or FAP. As part of this implementation, they have instigated a concurrent three-year project to deploy patient level costing across the entire province. This deployment is interesting as it introduces several new initiatives that I believe have never been seen in a patient level costing deployment before, namely:
- The project is to cost all patient activity including acute, sub-acute and non-acute, and specifically includes primary care, which is generally never included in any costing studies.
- The project is to focus on timely and transparent costing information so that all healthcare institutions have access to meaningful costing information regarding the sites that are under their jurisdiction, as well as timely comparative information that spans all other healthcare institutions across Quebec, through a comparative costing portal that sites can load with their data for comparative purposes on an almost real time basis.
- The project also encompasses Lean Six Sigma training to clinical champions within each healthcare institution. Lean Six Sigma is a methodology that relies on a collaborative team effort to improve performance by systematically removing waste and reducing variation. The project will take individual participants firstly to green belt and then to black belt in an effort to optimise the ability of each healthcare institution to make effective use of the resulting costing information.
- Finally, the project allows PHS to evaluate the resulting costing information in its own right, in an effort to drive efficiencies throughout the province through clinical engagement, by looking for areas to better normalise clinical practice. This engagement will be driven by PHS clinicians and supported by a data analytics team, who will work with nominated clinical champions in each healthcare institution in an effort to normalise clinical practice
My presentation will focus on these unique aspects of this project, its difficulties, both technical and political in their implementation, as well as the potential rewards that the project is expected to deliver if it can be driven to a successful completion.Return to top
Evie Kariagiannis, PowerHealth (AU)
Fire-up Your Presentations!
Whether you consider yourself to be a strong presenter or it scares you to death to be successful, almost every profession requires delivery of effective presentations and the ability to speak well in public. This presentation will cover what it takes to be an outstanding presenter, how to tap into the power to communicate persuasively and how to do this without changing your individual style of presenting!Return to top
Micheline Maddaford, Sydney Children's Health Netwok (SCHN)
Comparing Apples with Apples
Children’s Healthcare Australasia (CHA), a not for profit charity, is the peak body for hospitals' healthcare for children and young people in Australia and New Zealand. Benchmarking is one of the most highly valued services CHA offers to its members. Insights derived from benchmarking can facilitate service improvement and delivery in an already struggling health system. Historically, CHA Member Hospitals would extract and manipulate data in an excel template to submit files as part of the benchmarking program - a manual process that was extremely time consuming.
As most of the CHA Member Hospitals were using Power Performance Manager (PPM) for costing, the CHA approached PHS to develop a reporting module which would simplify the Benchmarking process and provide consistency for members. PHS donated this work in kind to CHA. The automated process has helped improve data standardisation and in turn, data comparability. CHA has dashboard, a Tableau portal which delivers easy to use visualisations of the data.
This presentation will outline the collaborative journey between the CHA, PHS and its member hospitals in support of “excellence in health care for women, babies, children and young people.
SCHN IFRAC ToolDespite considerable advancements in costing specificity, fractioning cost centre expense continues to be a key requirement and determinant of costed results.
In NSW, there has been a recent audit focus on the fractioning process given the strong dependency between Activity Based Funding & Block Funded Expense.
At SCHN, the Costing Team has been working closely with Finance to establish rigor within the fractioning process by aligning expense as closely as possible to patient activity in the costing process. A program has been developed that automatically populates an excel template with Payroll FTE, General Ledger and Activity information by Cost Centre. Decisions in regards to fractioning expense are now based on data evidence. We are also able to demonstrate transparency in the determination of fractioned results. This presentation will demonstrate our local ‘IFRAC’ tool, outlining a brief history of development and sharing thoughts on further enhancements.Return to top
Analysis in ABM – the Clinical Variation Tool (CVT)
The Business Information and Performance Unit at North Metropolitan Health Service (NMHS) has developed a CVT tool. The tool consolidates clinical, costing and administrative information to raise the profile of healthcare variation with a strong focus on patient safety. The initial analysis targets on factors that contribute to variation in LOS for high volume procedures. A strong correlation is identified between episodes with an Onset condition and high variation to benchmark LOS. I will present the worksheets in the tool and provide an analysis that focuses on the variability at a clinician level, focusing on LOS and Cost. I will also provide an analysis that focuses on the variability at a clinician level, focusing on LOS and HAC.
ABC Project – Improvement on Overall Resource Reflectiveness
Activity Based Costing (ABC) is an important element in the ABM environment and there has been an increase in the use of costing data to analyse hospital performance. The quality of the costing data is essential when it is presented and analysed as part of the decision-making process. The North Metropolitan Health Service Business Intelligence (NMHS BI) team in Western Australia has undergone a revolutionary change on the costing process to ensure costing data is more resource reflective. The change is an improvement on aligning activity with the general ledger for resource reflectiveness and it is also a standardised and scientific approach to perform calculation on program fractions.
ABC Project – Improvement on Emergency Department (ED) Costing
PPM assisted the North Metropolitan Health Service Business Intelligence (NMHS BI) team to implement a refined costing methodology to improve the ED allocation process. A group of cost drivers including clinical and non-clinical focus were identified by the clinical representatives to define resource consumption on a patient level. PPM is able to handle the sophisticated ED costing methodology and produce the expected cost outcomes.Return to top
Health Performance - Neglect Revenue at your Peril
The ongoing challenge for health care organisations is to provide more cost efficient and quality care in an ABF environment, where there is limited revenue or funding available. Whilst patient costing is the key accountability tool to measure, monitor and manage the cost of health care services, it is even more beneficial for health care organisations to match revenue to costs to properly understand the performance of all activities.
I will explain how you can get the most out of PowerPerformance Manager (PPM) functionality by covering the easy alternative methods that can be used for revenue allocation. Most importantly, I will cover practical examples of how matching revenue and costing information enables the identification of previously missed billing opportunities to improve your bottom line. Typically health organisations neglect to bill hundreds of thousands of revenue dollars, so you can’t afford to miss this presentation!Return to top
Power Up the Value
Global healthcare funding is trending towards payment for outcomes, both at a patient and organisational level. This approach (“value based care”, “value management”) is seeking to move away from a volume based payment system to a more accountable process focussing on “value”.
Value based care and subsequent opportunities for system efficiencies can offer higher quality of care, and enhance the patient experience, at lower cost.
Strong engagement strategies must be developed between clinicians and corporate management to administer and deliver this value approach. Decision making must be supported by sound data analytics from both clinical and corporate systems. Modelling the impacts on care delivery and costs is vital to the decision making process. This presentation will explore some engagement strategies and data analytics that have delivered “value”.Return to top
iBill - Billing Made Simple
iBill is an easy to use cross-platform application/App specifically designed for clinicians to be able to bill their private patients. The application was developed in-house at the Sydney Children’s Hospitals Network (SCHN) in close collaboration with clinical and finance staff to determine the appropriate features, functionality and security of the software. Leveraging from existing infrastructure, the application imports from the database containing all SCHN patient demographics, staff and billing data and then sends billing directly to PBRC, the patient billing system.
The application has the potential to significantly improve revenue by improving billing completion rates while reducing overheads by removing paper based forms, therefore saving administration costs.
Billing Made Simple
Clinicians can find their patients by specialty, ward, financial class, by their name or MRN (Medical Record Number). Once the patient has been selected, the clinician then selects the billing encounter and the item code/s from the presented drop down list noting the full MBS list is available. Billing can also be made retrospectively with custom reports generated to enable follow-up of any outstanding billing.
iBill was introduced in 2014 with the application piloted in Oncology, Neurology and General Medicine. The application was favourably received by clinicians and is available via mobile devices and desktops. Future development is planned to capture clinical notes through the application which would feed into the electronic medical record. Billing would then be a by-product of the clinical note.Return to top
Are you keeping up to date with all the latest funky new features that have been introduced since your site went live with PBRC? This session will showcase new features, promoted by client demand and is currently available for all sites, including:
- Work In Progress General Ledger Extracts
- Private Practice Revenue Splits
- Rapid Data Entry Enhancements
- Provider Payments
Debt Management and Recovery - the ASNSW Experience
Is your debt recovery managed by a third-party debt collection agency? Accelerate your debt collection cycle by implementing a complete asynchronous integration between PBRC and your debt collector. This session will introduce the ASNSW experience in implementing their Debt Management and Recovery strategy to integrate PBRC directly to a third-party debt collection agency. The session will also cover how PBRC functions to generate the Debt notices, issuing and managing the fee recovery orders, including reviews, queries and processing payments.Return to top
eHealth NSWH Training and Support
This presentation covers the importance of staff training. I have used my experience as Team Lead of eHealth PBRC Support to provide an example of a well-thought-out plan for PBRC implementation and its execution. I have examined the actual training and whether in the grand scheme of implementing a billing system across NSWH it worked.
- What happens after the project has completed the time-frame?
- What happens if the training is not ongoing?
- What is the impact on support staff if we don’t make the right assumptions during the implementation of PBRC or our thought processes were not aligned with Local Health Districts’ resources and capacity to train.
This presentation outlines the training tasks in the Learning Strategy, Implementation Plan, Pre Go-live, Post Go-live, Program Completion and the issues faced in supporting the product without trained users.Return to top
Medicare Ineligible Revenue Recovery
This presentation is an introduction to Medicare ineligible revenue recovery, covering the following:
- Proactive approach to what is a growing risk to the Australian health care system
- Unique onsite consultation service
- Expertise in dealing with Private Health Insurance and overseas insurers
- Why a “one size fits all approach” is leading to write-offs which could have been avoided
- Resourcing benefits in the current environment characterised by budgetary constraints
- Integration with PBRC