NSW Implementation 2008 PPM User Conference David Perabo, Clinical Costing Manager State Based Build

Slide 2 PowerHealth Solutions 2008 Conference Agenda 1.History 2.Process 3.Methodology 4.Standardisation 5.Questions

Slide 3 PowerHealth Solutions 2008 Conference NSW Area Health Services

Slide 4 PowerHealth Solutions 2008 Conference History 1990sTrendstar 2000Statewide Solution started 2001Development of Statewide Tender (Bearing Point) 2002Tender Revised (Fujitsu) AHSs proceed alone 2006Tender Revised (Deliottes)

Slide 5 PowerHealth Solutions 2008 Conference History 2007 SWAHS release Statewide PCS RFT Clinical Costing Standards Development State Based Build Development

Slide 6 PowerHealth Solutions 2008 Conference Critical Issues Lack of commitment to Clinical Costing Delays in Hardware Procurement Development of a State Based Build MDS Understanding of PPM Modules General Ledger Set-up ETVL Patient Cost Allocation Report Layer Build

Slide 7 PowerHealth Solutions 2008 Conference ETVL / Extract MDS Data Junction mappings How to maintain Data Integrity across an AHS Does the Area use an area-wide MRN? What Validation Rules to apply Link and Loading Rules Linking timelines (hours/days) Create NAPOOS for unlinked records

Slide 8 PowerHealth Solutions 2008 Conference ETVL / Extract MDS Need to develop SBB extracts to standardise ETVL Different Source Information Systems No uniform dataset/extract Survey of all AHS revealed Lack of State-wide Clinical System standards, with the exception of PAS and Pharmacy Information management naming conventions HIE & Data management standards and business practices Some Areas lack clinical feeder system capability to support detailed patient level costing Confusion about the impacts of eMR on information availability.

Slide 9 PowerHealth Solutions 2008 Conference General Ledger Issues less complex due to existing SCOA standards, however: GL processing required to meet multiple reporting requirements Cost Centre Definitions Account Code Definitions Allocation Statistics Reclass Rules

Slide 10 PowerHealth Solutions 2008 Conference State Based COA Setup Acc Acc_ CodeDescAccount Rollup 1 Account Rollup 2Cost InputCost Output 1Cost Output 2 % Fix ed E15000 Payments to VMOs Payments to VMO's Payments to VMOs 100 E15010 Payments to VMOs - FFS Payments to VMO's Payments to VMOs - FFS 100 E15020 Payments to VMOs - Rural Payments to VMO's Payments to VMOs - Rural 100 E15030 Payments to VMOs - Sess Payments to VMO's Payments to VMOs - Sess 100 E21000Drugs Goods and ServicesDrugs 100 E21010 Drugs - Medical Gases Goods and Services Drugs - Medical Gases 100 E21020Drugs Goods and ServicesDrugs 100 E22000 Med & Surg Supplies Goods and Services Med & Surg Supplies 100 E22010Imaging Goods and ServicesImaging 100 E22020Imaging Goods and ServicesImaging 100 E22030Pathology Goods and ServicesPathology 100 E22040Prostheses Goods and ServicesProstheses 100 E22050Special Services Goods and ServicesSpecial Services 100

Slide 11 PowerHealth Solutions 2008 Conference General Ledger There was a lack of consistency in the sourcing of financial data used in costing: Some AHS extract financial data from the Health Information Exchange (HIE) into costing software Some AHS extract financial data from Oracle into costing software Some AHS extract financial data from Oracle into Excel for upload into cost modelling software The State Based Build project will establish a State-wide standard for the extraction of financial data, from the NSW data warehouse used as the source of financial data.

Slide 12 PowerHealth Solutions 2008 Conference General Ledger - Reclass Rules Program Fractions Creation NHEC reporting entities S&W adjustments Cost Offsets/Exclusions Source feeder system account rollups Teaching & Research

Slide 13 PowerHealth Solutions 2008 Conference Patient Cost Allocation Service Code Definition Definition of service codes used for Patient Care Areas Weight selection for Service Codes Area Mapping – Cost Output weight selection

PPM Implementation David Perabo, Clinical Costing Manager Rural Health Issues 2008 PPM User Conference

Slide 15 PowerHealth Solutions 2008 Conference Greater Western AHS

Slide 16 PowerHealth Solutions 2008 Conference Additional Complexities Small Facilities many Multi-Purpose Services Absence of Source Feeder Systems Cost Centres providing multi- purpose functions

Slide 17 PowerHealth Solutions 2008 Conference Questions David Perabo Clinical Costing Manager