St Vincent’s Health – who are we?

1. Data Analysis vs Data Preparation – Adding more value to the organisation through the PPM scheduler 27/11/2006 Helen Rizzoli Manager, Clinical Information Unit

2. St Vincent’s Health – who are we? • A Major Specialist Teaching hospital in Melbourne • 3 campuses • St Vincent’s Public Hospital, Fitzroy • St Georges Health Service, Kew • Caritas Christie Hospice, Kew • 700 inpatient beds • In 2005/06 • 52324 Inpatient Separations • 353604 Outpatient OOS • 34691 Emergency attendances • All specialties except Obs / Gyn and Paediatrics

3. The Clinical Information Unit • Commenced operation September 2005 • Purpose is to provide centralised activity and costing data reporting and analysis • Resources = • 1.0 FTE Manager • 1.0 FTE Data Processor (regular activity reports and basic costing processing) commenced April 06 • Current proposal for additional staff member pending approval

4. The Clinical Information Unit • Responsible for • Activity reporting and analysis where the item results in or impacts upon revenue for the Health Service eg Activity against DHS targets. • Projection and estimation of results to nominated targets based on known factors • High level data analysis support for senior managers. • Cost analyses to support implementation of new services, or modification of existing services. • Mandatory DHS reporting requirements eg. AIMs reporting, Cost Weight Study • Health Round Table – casemix data and KPI submission. • Activity and costing information to support external reviews eg Medihotel, Renal Dialysis reviews in 2005/06. • Clinical costing data processing, reporting and analysis. • Research based report requests.

5. Status of Clinical Costing as at 1/1/2006 • Information brought in 6 monthly usually in March (July – Dec data) and November (Jan – June data for the previous year • Processing took anywhere between 1 week and 4 weeks depending on issues that arose. • Information from PPM really only used to complete mandatory Cost Weight Study Requirements; very limited internal usage. • Attention to Clinical Costing received low priority • PPM had been implemented in 2003 but not reviewed since then.

6. SVH Use of Clinical Costing information as at 1/1/2006 • Internal costing review very limited due to • Managers were concerned as to: • How current was the data (ie most recent costed information available may be over 12 months old)? • How accurate was the data? • Knowledge base of people to report from PPM • ‘Joy to effort’ ratio when attempting to process earlier than scheduled dates

7. What was required? • More frequent processing of the information. • More regular reporting of the information. • A complete review of the structure of the PPM setup to account for numerous organisational changes that has occurred since PPM was originally implemented

8. Options for addressing issues • Allocate additional resources to Clinical Information Unit • Reduce the scope of the Clinical Information Unit to allow more time to be spent on Clinical Costing • Transfer the responsibility for Clinical Costing to another department within the facility with more capacity • Use technology to do things ‘smarter’

9. GOAL To shift the focus of clinical costing from Managing processing to Analysing and using the costed information

10. Decision To use Technology wherever possible to replace or streamline the manual processes Three components • Use SQL data transformation services to extract information from source systems to clincost server • Use PPM scheduling to complete ETVL, patient database build, Revenue calculation and Report Layer build • Use SQL scripts on clincost server and PPM views scheduled through DJ to produce data validation reports

11. Status as at 27/11/2006 • DTS runs from PAS system each Friday morning at 3am (Kestral and Merlin extracted monthly) • ETVL processing occurs each Friday from 5pm and runs through to mid Sunday • Validation rejects reviewed each Monday and corrected in the source system (including followup with the PSC if required) • GL Import processing completed manually each month after GL closed off. • Cost outputs built and weight file updated if required after GL build • Weighted activity calculate, Revenue calculate and Report Layer Build processed after hours as soon as GL processing complete.

12. What does that mean for Me? • Each Monday • Do we have the right records? • Are they valid? • 20th Day of the following month • How are our costs looking? • What have been the impacts of system setup review?

13. Outcomes for the organisation • Can review impact of changes to clinical costing setup on a regular basis. • Managers will soon start receiving monthly costing reports on their area of interest (self nominated). • Accurate and complete costing data will be available at short notice to complete costing requests. • Increased staff satisfaction in Clinical Information Unit as no longer ‘bogged down’ in manual data processing.

14. Next Steps • Complete inclusion of PPM View validation audits to processing. • Finalise the setup and review of PPM • Roll out clinical costing to other campuses.