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Patient Level Reporting & Management in Healthcare Finance: A Case Study

Learn about implementing a Patient Level Information and Costing System (PLICS) in a hospital setting, key timelines, system implementation details, and insights on data quality. Explore examples, costing processes, and valuable learnings for improved service line reporting. Discover the importance of reporting mechanisms and the collaborative efforts between Finance and IM&T departments.

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Patient Level Reporting & Management in Healthcare Finance: A Case Study

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  1. Service Line Reporting & Management • - The demands on IM&T (and Finance) staff.... • Steve Bridge • Assistant Director of Finance

  2. Introduction – The Countess of Chester Hospital NHS FT • North West England on border with North Wales • Serves population of c250,000 • 600 beds / £160m turnover • 1st Wave FT • Record of good performance • Good relationship with Monitor • However 20% of our activity not funded at tariff…

  3. PLICS / SLR Timeline • Decision to Implement PLICS January 2007 • SLM Pilot Site April to May 2007 • System Shortlisting June 2007 • Supplier Decision – BPLAN (Synergy) July 2007 • Initial System Implementation Sept to Dec 2007 • 1st cut Reports January 2008 • Initial Dashboard Implementation Jan to March 2008 • Monthly Patient Level SLR Reports April 2008 Onwards • Dashboard Development Ongoing • Business Objects Development Starting

  4. Data Flows & Monthly Processes Pre PLICS PAS (Meditech) Data Repository - Patient Activity PBR Income (SLAM) Ledger Costs (Cedar) Post PLICS Synergy Staging Area PLICS (Synergy) Intranet Reports (Active Dashboards) Business Objects Reports

  5. Top-Down Costing Process E.g’s Energy, Porters, Capital Charges & Training Levies Allocation Tables E.g’s Pathology, Radiology & Divisional Admin Allocation Tables E.g. Wards, Theatres, Medical Staff

  6. Top Down Costs – Assumptions & Allocations

  7. Bottom-Up Costing Process Patient Episode ExampleName: John Smith Procedure: W401 Primary Total Prosthetic Replacement of Knee HRG: H04 Primary Knee Replacement Specialty: Trauma & Orthopaedics Point of Delivery: Elective Cost Driver Episode Example Cost Pool Total Episode Cost = £1780.50

  8. Bottom-Up Costs – Assumptions & Allocations

  9. Costing System – Patient Level Detail Chart illustrating B-U process Ward Costs Patient: John Smith Specialty: Procedure: HRG Point of Delivery

  10. The ‘Bubble’ Chart

  11. Tools of the Trade 1 - SB • Patient Level Information & Costing System • - Demonstration & Examples

  12. Patient Level Costing

  13. Patient Level Costs - 1

  14. Patient Level Costs - 2

  15. Patient Level Costs - 3

  16. PLICS / SLR – Next Steps • Continue developing dashboards • Drug costs identified at patient level • Nurse costs based on patient acuity • Use of Business Objects for detailed reporting within Finance • Working with Service Lines to continue development of SLR

  17. PLICS / SLR - Learning • Time to implement depends on starting point • Data quality, completeness, architecture • Requires dedicated resources in Finance & IM&T • IT infrastructure – server speed & capacity • Honest relationship with system supplier • Don’t underestimate time & resources required • Reporting mechanisms are key • Iterative process • Volume of queries generated – both Finance & IM&T

  18. Questions ?

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