1. The Health Roundtable Lucrative Liaisons: Coder- Clinician Liaison Database Presenter: James Muller Royal Brisbane and Womens Hospital Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012 1 4-4c_HRT1215-Session_MULLER_RoyalBRIS_QLD

2. The Health Roundtable KEY PROBLEM  Poor communication and liaison between coding and clinical staff  Inadequate recording and suspected under-reporting of coder-clinician liaison, and the benefits achieved  No formal mechanism for timely follow-up of unresolved queries  Reluctance from coding staff to undertake a coder-clinician query  No ability to collect statistics on specific areas of deficient documentation for use in clinician education programs  ACHS recommendation 2

3. The Health Roundtable AIM OF THIS INNOVATION  Standardise the reporting and capture of CCL queries  Monitor the initiation and completion of CCL queries  Provide a standard template for generating CCL queries  Feedback cost gains obtained through CCLs  Provide information back to individual units / clinicians regarding their assistance with CCL queries  Collect information on areas producing deficient clinical documentation  Maximise coding allocation, and thus hospital funding, through clarification of clinical documentation 3

4. The Health Roundtable BASELINE DATA No consistency from month to month Low rate of queries compared with facility size Inability to determine exact number of less formal CCL queries No indication of revenue through CCL process 4

5. The Health Roundtable KEY CHANGES IMPLEMENTED  Development and implementation of a CCL Database with the following features:  An interactive Coder-Clinician Liaison form  Links to data exported from HBCIS (Patient Administration System) to minimise data entry required by coding staff  Collection of information including break-down of query types, method of contact, etc.  Ability to print a completed CCL form within the system  Reporting functionality, including number of unresolved queries per coder / clinical unit, break-down of types of queries, etc.  Ability to easily update CCL details as required  The database went live in April 2011 5

6. The Health Roundtable KEY CHANGES IMPLEMENTED 6

7. The Health Roundtable OUTCOMES SO FAR 28.4% queries result in DRG change! Average revenue of $2,009 per query Database Go-Live 7

8. The Health Roundtable LESSONS LEARNT  Coder-clinician liaison is extremely valuable  Standardisation is important  Technology must make the process more efficient and not be a burden to use  Clinical staff and coding staff like to see the ‘results’ from their liaison (e.g. how much revenue they have generated) Dr L “This was a $12,000 20 minute conversation!” Dr H “The money made from this conversation could pay for all my medical overtime.” Dr T “Interns would really benefit from more education on documentation requirements for coding.” 8