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OPCS-4.9 Implementation

OPCS-4.9 Implementation. Preparing for implementation. Terminology and Classifications Delivery Service. OPCS-4.9 checklist. Here’s a checklist to help you plan and manage OPCS-4.9 implementation You may not need everything included here But, it will help you identify what needs to happen

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OPCS-4.9 Implementation

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  1. OPCS-4.9 Implementation Preparing for implementation Terminology and Classifications Delivery Service

  2. OPCS-4.9 checklist • Here’s a checklist to help you plan and manage OPCS-4.9 implementation • You may not need everything included here • But, it will help you identify what needs to happen • Take what is useful for you and your organisation ……..

  3. Topics covered • Overview of OPCS-4 • What is OPCS-4 • Overview of OPCS-4.9 • Impact and number of changes • Products delivered centrally • Implementation planning and strategies • Organisation, systems and coding readiness • Go live preparation • Post implementation • Links to central resources

  4. Overview of OPCS-4

  5. Overview of OPCS-4 What is OPCS-4? • An NHS Fundamental Information standard • Used to classify hospital interventions and procedures for secondary uses such as statistical purposes and reimbursement • Comprises a list of alphanumeric codes, organised into mainly anatomically based chapters, categories and subcategories

  6. Overview of OPCS-4 Under the Health and Social Care Act 2012 the following bodies must have regard to this information standard: • The Secretary of State • NHS England and Improvement • Public bodies exercising functions in connection with health services or adult social care • Anyone providing publicly funded health services commissioned by or on behalf of a public body

  7. Overview of OPCS-4 Scope of OPCS-4 mandate: • All “in-patient” episodes and day cases that contain procedures must be recoded using the mandated version of OPCS-4

  8. Overview of OPCS-4 OPCS-4 data uses include: • National data collections including Admitted Patient Care Commissioning Data Sets (APC CDS) • Hospital operational and strategic planning to support business processes including reimbursement

  9. Overview of OPCS-4 OPCS-4 update cycle:

  10. Overview of OPCS-4.9 OPCS-4.9 compliance • 1 April 2020 • Compliance date for NHS implementation of OPCS-4.9 • Inpatient episodes and day cases ending on or after 1 April 2020 must be coded using OPCS-4.9

  11. Overview of OPCS-4.9 Impact of OPCS-4.9 change • Minor impact • Processes understood and in place • Requires upload of new data into systems • People ready, aware and trained where appropriate • OPCS-4.9 does not require ‘conversion’ training

  12. Overview of OPCS-4.9 No change to architecture of OPCS-4.9 • Changes made in both the Tabular List and Alphabetical Index • Addition of new codes, retirement and modifications to existing code descriptions and notes • Sex (Absolute) Metadata field not populated in order to comply with the Equality Act 2010. Where a code in OPCS-4.8 had a Sex (absolute) flag assigned in the Metadata file this has been changed to a Sex (scrutiny) flag.

  13. Overview of OPCS-4.9 NHS and system supplier formal notification • The Data Coordination Board (DCB) oversees the development, assurance and approval of information standards, data collections, and data extractions • Notification of the intention to update OPCS-4 was communicated in the Terminology and Classifications Delivery Service Newsletter in February 2019 • Information Standards Notice (ISN) – published on 8th October 2019, mandated the implementation of OPCS-4.9 on 1 April 2020. See http://content.digital.nhs.uk/isce/publications/DCB0084

  14. Overview of OPCS-4.9 Number of changes

  15. Overview of OPCS-4.9 Changes to OPCS-4.9 • OPCS-4.9 contains updates submitted via the OPCS-4 Requests Submissions Portal at: https://isd.digital.nhs.uk/rsp/user/guest/home.jsf • Final summary of changes available at: https://hscic.kahootz.com/connect.ti/t_c_home/view?objectId=14270896#14270896

  16. Overview of OPCS-4.9 Products delivered centrally • Draft Summary of Changes (Published July 2019) • Final Summary of Changes (Published 8 October 2019) • OPCS-4.9 data files and technical specifications (4 November 2019) • OPCS-4.9 Volume 1-2 available to buy from The Stationary Office (January/February 2020) • OPCS-4.9 available in NHS Digital Classifications Browser and eVersion (January/February 2020) • National Clinical Coding Standards reference book and Key Learning Points (January/February 2020) • Updates to Clinical Coding Standards Course and Clinical Coding Standards Refresher course materials released to approved clinical coding trainers (January/February 2020) • Terminology (SNOMED CT) to OPCS-4.9 cross-maps (March 2020) All available from https://hscic.kahootz.com/connect.ti/t_c_home/view?objectId=14270896#14270896

  17. Overview of OPCS-4.9 NHS National Tariff Payment System • The NHS Digital National Casemix Office (NCO) is responsible for the mapping of OPCS-4.9 codes to Healthcare Resource Groups (HRG) for use in associated groupers. The OPCS-4.9 updates will be incorporated into the HRGs to ensure the codes are accepted by the grouper(s) to be used from April 2020 onwards. See https://digital.nhs.uk/services/national-casemix-office for details about the NCO and HRGs.

  18. Implementation planning and strategies

  19. Implementation planning and strategies Consequences of poor preparation • Compliance issues • Coding backlogs • Decisions based on inaccurate data • Incorrect reimbursement Problems can be prevented/mitigated with proper advance preparation

  20. Implementation planning and strategies Don’t delay getting started • Early initiation of the planning process, thorough preparation, adequate education and proper testing will result in smoother implementation and earlier realisation of benefits

  21. Implementation planning and strategies Who is leading within your organisation to prepare a plan for implementation?

  22. Implementation planning and strategies Suggested phases • Phase 1 – organisation readiness • Phase 2 – systems readiness • Phase 3 – coding readiness • Phase 4 – go live preparation • Phase 5 – post implementation Phases may vary, depending on the type, size and complexity of your organisation, phases may overlap

  23. Implementation planning and strategies Phase 1 - Organisation readiness

  24. Implementation planning and strategies – Phase 1 Phase 1 - Organisation readiness: • Project team established • Assess organisational readiness • Conduct survey of all business areas to determine extent of the impact • Analyse impact on all business processes • Develop communications plan • Document all risks and issues relating to implementation Delay to impact assessment will jeopardise ability to implement OPCS-4.9 by compliance date.

  25. Implementation planning and strategies Phase 2 - Systems readiness

  26. Implementation planning and strategies – Phase 2 Phase 2 – systems’ readiness: • Perform systems’ audit • Identify new or upgraded hardware or software requirements (if necessary) • Consider impact on electronic tools (e.g. encoders) • Ensure access to legacy data • Build flexibility into IT systems under development to ensure compatibility with OPCS-4.9

  27. Implementation planning and strategies – Phase 2 Systems/applications potentially impacted include: • Electronic Patient Record systems • Clinical systems • Patient Administration systems • Encoding software • Medical record abstracting systems • Decision support systems • Resource Utilisation • Quality management • Casemix systems • Case management • Financial • Compliance software

  28. Implementation planning and strategies – Phase 2 Determine your business readiness • Determine vendor readiness and timelines for software upgrades • Information Standards are included in NHS Contracts but check: • Which systems upgrades or replacements are needed, if any, to accommodate OPCS-4.9? • Which upgrades will be covered by existing contracts, what other costs are involved?

  29. Implementation planning and strategies – Phase 2 Determine system supplier readiness • When will upgrades be available for testing and implementation? • What customer support and training will they provide if required? • How will their products and services accommodate OPCS-4.8 and OPCS-4.9? • How long will their products accommodate both code sets?

  30. Implementation planning and strategies – Phase 2 Project plan is in place • Project lead to ensure all the activities and tasks required for local Trust implementation are included in the project schedule tracking tool and estimates for these tasks are regularly reviewed for accuracy

  31. Implementation planning and strategies Phase 3 - Coding readiness

  32. Implementation planning and strategies – Phase 3 Phase 3 – Coding readiness • Review final Summary of Changes • Consider local impact of proposed changes and plan accordingly

  33. Implementation planning and strategies – Phase 3 Assess quality of medical record documentation • Evaluate samples of various types of medical records to determine whether documentation supports level of detail found in OPCS-4.9 • Implement documentation improvement strategies where needed

  34. Implementation planning and strategies – Phase 3 Coding and documentation - always work toward better documentation • Avoids misinterpretation • Provides a more accurate clinical picture of the quality of care provided • Supports current and future initiatives aimed at improving quality and improved patient care • Issues related to poor documentation must be resolved by the provider • Develop closer links between clinicians and coders to effect improvement

  35. Implementation planning and strategies – Phase 3 Gap analysis • Conduct gap analysis of coding professionals’ knowledge and skills • Assess coding professionals’ knowledge • Refresh coding staff’s knowledge as needed on basis of assessment results

  36. Implementation planning and strategies – Phase 3 Education and training • Minor update, changes represent improvements to reflect latest clinical knowledge, better indexing to aid coding of interventions and operations. • Code format and coding process will not change, so conversion training not required • Coders to review the Key Learning Points (KLPs) and the table of changes and full coding standard in the updated National Clinical Coding Standards OPCS-4.9 reference book, available in January/February 2020.

  37. Implementation planning and strategies – Phase 3 Education and training • Trainers, managers and coders can use the Summary of Changes, KLPs and updated reference book to learn about the changes to OPCS-4.9 and the main changes to National Standards, available in January/February 2020 • Trusts to assess and decide level of update awareness training required to suit local needs. • To facilitate awareness sessions, the Terminology and Classifications Delivery Service provide a PowerPoint slide deck with associated Exercise and Answer Booklet for Trusts to adapt to meet the local needs, available in January/February 2020

  38. Implementation planning and strategies – Phase 3 Consider update awareness needs for: • Clinical coders • Information personnel • Clinicians • Senior management staff • Information technology staff • Finance • Auditors • Commissioners • Clinical department managers • Data analysts • Researchers • Epidemiologists/Public health

  39. Implementation planning and strategies – Phase 3 Data uses • Performance improvements • Corporate compliance • Data quality management • Data security • Clinical documentation • Reimbursement

  40. Implementation planning and strategies – Phase 3 Identify all implementation expenses and estimate associated costs including: • Education / training • Hardware / software upgrades if applicable • Staff time / temporary or contract staff • Systems’ testing related costs • Data conversion • Maintenance of dual code set • Purchase of OPCS-4.9 books (if required), the Classifications Browser and eVersion are available for free.

  41. Implementation planning and strategies – Phase 3 Additional implementation preparation steps • Refine project plan, timeline and budget as needed • Assess potential reimbursement impact • Develop strategies to minimise problems and maximise opportunities • Assess impact of • Decreased coding productivity • Decreased coding accuracy

  42. Implementation planning and strategies – Phase 3 Register now …. • Agree the authorised person within the organisation to accept licence agreements on TRUD • Register on TRUD in readiness for the OPCS-4.9 data files to download when released. Requestor will be notified when files become available.

  43. Implementation planning and strategies Phase 4 – Go live preparation

  44. Implementation planning and strategies – Phase 4 Phase 4 – Go live preparation • Follow-up on readiness of systems suppliers • Develop business continuity plan in case critical systems are adversely affected when the OPCS-4.9 implementation goes live • Completion of communication plan • Provide senior executives and stakeholders with updates

  45. Implementation planning and strategies – Phase 4 Information Standards Notice (ISN) • Review ISN and associated documentation and ensure those with responsibility for IT contracts have read and are taking appropriate actions to meet planned deliverables

  46. Implementation planning and strategies – Phase 4 OPCS-4.8 data files • Download data files released via Technology Reference Update data Distribution (TRUD) in November 2019: • OPCS-4.9 Codes and Titles • OPCS-4.9 Metadata • OPCS-4.9 Table of Coding Equivalences • Technical specification documents

  47. Implementation planning and strategies – Phase 4 Complete tasks identified in Phase 1 - during impact assessment • Implement system changes • Provide education to users where needed • Implement and monitor documentation improvement strategies • Re-engineer processes and workflows identified in Phase 1 if necessary • Complete internal testing • Begin external testing once system suppliers are ready

  48. Implementation planning and strategies – Phase 4 OPCS-4.9 volume sets • Purchase OPCS-4.9 Volumes sets from The Stationary Office from January/February 2017 if required, purchase and discount information will be available on our collaborative site – Delen • Ensure staff can download the eVersion from TRUD and access the NHS Digital eVersion Classifications Browser, when available • Clinical coders should not attempt to manually add the OPCS-4.9 changes into their OPCS-4.8 books because of the number of changes and of the risk of introducing errors which will impact data collection and statistical outputs.

  49. Implementation planning and strategies – Phase 4 Training and education • Deliver training requirements where needed • Download key learning points and National Clinical Coding Standards OPCS-4.9 reference book from Delen in January/February 2017 • Ensure protected time for clinical coders to review: • Changes to the classification • Key Learning Points and the table of changes and full coding standards in the updated National Clinical Coding Standards OPCS-4.9 reference book.

  50. Implementation planning and strategies – Phase 4 NHS Digital Classifications Browser • Accessible from any computer with an internet connection • Free to all so an alternative to purchase of books. Trusts may wish to purchase 1 or 2 copies as a backup. • OPCS-4.9 available in the browser January/February 2020 • Clinical Coders • Advise Trust IT department to allow access to the NHS Digital Classifications Browser • IT Manager/ IT department • Whitelist, if necessary, the NHS Digital Classifications Browser to ensure access OPCS-4.9 eVersion • Available for download from TRUD to load into eVersion January/February 2020 More information on the eVersion and Classifications Browser available on Delen.

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